How to Become an Occupational Health Nurse


    Nurse checking patient's blood pressure in office

    By: Kathleen Gaines, RN, BSN, MSN, BA, CBC

    Occupational Health Nurses, also known as employee health nurses, recognize and prevent health effects from hazardous exposures and treat worker’s injuries and illnesses. If you are considering becoming an Occupational Health Nurse, this career guide will give you all of the information you need to help make that decision.

    Part One What is an Occupational Health Nurse?

    Occupational health nurses are registered nurses that focus on caring for the workforce. According to the Occupational Safety and Health Administration (OSHA), occupational health nurses work to assess workers’ health status with respect to their job tasks and hazards. These nurses recognize and prevent health effects from hazardous exposures and treat worker’s injuries and illnesses.

    They are the center of coordinated care for employees within an organization and are responsible for delivering comprehensive and qualified service while reducing medical benefits from the company’s bottom line.

    Occupational Health Nursing Categories of Competency

    There are currently nine categories of competencies required for effective occupational health nursing practice:

    1. Clinical Practice: Document the nursing process in care management via assessment, diagnoses and treatments consistent with appropriate standards and laws.
    2. Case Management: Identify the need for case management intervention and be able to conduct a thorough and objective assessment of the client’s current status and case management needs.
    3. WorkForce, Workplace, and the Environment: Coordinate client health screening and surveillance programs and services, and monitor the work environment to protect the health and safety of workers.
    4. Health and Safety Education and Training: Implement occupational and environmental health and safety education and training.
    5. Management, Business, and Leadership: Coordinate cost-effective occupational health services and programs and monitor for the best quality, most cost-effective vendor products and services.
    6. Research: Identify and share resources and applications that help support relevant, evidence-based practices.
    7. Regulator/Legislative: Bring awareness of current legislative activities that may impact nursing practices, workers, workplaces, and the environment.
    8. Health Promotion and Disease Prevention: Assess the health needs of workers and worker populations.
    9. Professionalism: Maintain scientific, regulatory and business knowledge appropriate to the nursing profession

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    Part Two What Do Occupational Health Nurses Do?

    Occupational Health Nurses take care of employees at their place of work. They work closely with both employers and employees to ensure safe working environments and to make sure that workers are appropriately taken care of after suffering from workplace-related injuries and illnesses. The goal of an occupational health nurse is to get employees back to work quickly and safely, while reducing the medical costs for the employer and the lost wages to the employee.  

    The major roles and responsibilities associated with occupational health nursing practice include:

    • Clinician: Clinical and Primary Care
    • Educator/Coordinator:  Training, Disease Prevention
    • Manager/Advisor: Research, Health Promotion
    • Consultant: Workforce Issues, Workplace Issues, Environmental Issues
    • Case Manager: Regulatory responsibilities, Legislative management

    Occupational Health Nurses perform a wide variety of responsibilities and duties, specifically:

    • Administering medications related to workplace injuries
    • Performing physical examinations, including pre-employment physicals
    • Performing rehabilitation therapy after workplace-specific injuries
    • Conducting vision tests, hearing tests, drug or alcohol screenings and other job-related laboratory testing 
    • Assistance with crises and patient support
    • Job-related vaccinations
    • Counseling employees on physical and mental health issues and guiding them toward community resources and employee assistance programs
    • Coordinating care for employees with workplace-related injuries or illnesses
    • Maintaining OSHA compliant logs and documents
    • Managing worker’s compensation claims and record
    • Fit testing (equipment include n95 masks)
    • Maintaining employee records
    • Implementing policies and procedures for maintenance of confidentiality
    • Documenting all employee injuries and illnesses within the workplace
    • Conducting research on the effects of workplace exposures, gathering health and hazard data
    • Treating injuries and illnesses for employees, including follow-ups and referrals
    • Overseeing and implementing emergency and disaster preparedness programs and planning
    • Developing disease prevention programs, like smoking cessation, exercise, and healthy eating programs

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    Part Three Where Do Occupational Health Nurses Work?

    Occupational Health Nurses can work in a variety of areas. Essentially, they can work in any place, or for any company, that employs a large number of employees and has their own occupational health department. Not all companies will have their own occupational health nurses on-site and might contract out to another vendor. In these cases, the nurses would be employed by the vendor vs. the actual company. Primarily they work in the following areas:

    • Hospitals
    • Urgent Care Clinics
    • Counseling centers
    • Schools and/or universities
    • Manufacturing and Production: Textile Mills or Oil Refineries
    • Government
    • Utilities
    • Consulting
    • Private contractor
    • Finance/Insurance/Real Estate
    • International organizations

    Part Four Occupational Health Nurse Salary

    According to the U.S. Bureau of Labor Statistics (BLS) the median salary for a registered nurse in 2019 is $73,300 per year, or $35.24 per hour, but conditions in your area may vary. They don’t go into the specific salary for occupational health nurses, but Salary.com reports that the average salary for Occupational Health Nurses in the United States is $65,870 per year. While Payscale.com found that as of May 2020, the average yearly salary for Occupational Health Nurses is $71,883 and the hourly rate is $32.64.

    Specifically, Occupational Health Nurses can earn a higher annual salary with increased years of experience.

    • 1-4 years of experience earn an average salary of $67,617
    • 5-9 years of experience earns an average salary of $73,847
    • 10-19 years of experience earns an average salary of $71,468
    • 20 years and higher years of experience earns an average salary of $76,904

    Currently, the highest average paid states for Occupational Health Nurses that have reported salaries, according to payscale.com are as follows:

    • Boston, Massachusetts - $96,750 per year
    • Houston, Texas - $81,000 per year
    • Dallas, Texas - $78,701 per year
    • Washington, District of Columbia - $78,000 per year
    • Rochester, New York - $72,500 per year

    Most health care systems pay Occupational Health Nurses on an hourly scale while others have a fixed annual salary, such as Occupational Health Nurses working for a private company. Those paid on an hourly scale are able to earn overtime pay whereas salary employees would need to discuss that with the hiring committee.

    As with all jobs in the nursing field, earning potential increases with additional education and experience. Nurses typically are awarded a raise during annual employee performance reviews. Certifications can give nurses an additional bump in their paycheck. 

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    Part Five How Do You Become An Occupational Health Nurse?

    In order to become an occupational health nurse, you’ll need to complete the following steps. 

    • Step 1: Graduate with a BSN or an ADN from an accredited nursing program
    • Step 2: Become a registered nurse by passing the NCLEX examination
    • Step 3: Gain at least 2 years of nursing experience
    • Step 4: Obtain a position that specializes in occupational health nursing
    • Step 5: Become certified as an occupational health nurse

    Certifications for Occupational Health Nurses

    There are two possible certifications for Occupational Health Nurses, either the COHN or the COHN-S, but you cannot hold both certifications at the same time. The certifications are similar but slightly different.

    Both certifications include:

    • 160 questions (135 scored and 25 pre-test) multiple choice
    • Computerized exams offered at 190 locations in the United States
    • Three hours to complete the exam
    • Application: $150.00
    • Exam Fee: $400.00

    Recertification for both certifications is required every 5 years. Recertification eligibility criteria includes:

    • Current, unrestricted registered nursing licensure
    • 50 Continuing Nursing Education continuing education hours related to occupational health earned within the previous 5 years
    • 3,000 hours of occupational health nursing experience for paid compensation during the previous 5 years. (You do not have to be currently employed at the time you apply for recertification.)
    • Renewal Fee: $150.00

    1. Certified Occupational Health Nurse (COHN)

    The COHN examination focuses on occupational health nursing clinical practice. To be eligible individuals must meet the specific criteria:

    • Current, active RN license
    • 3000 hours in occupational health nursing in the past five years OR
    • Time spent in a graduate program related to occupational health or in a baccalaureate completion program related to occupational health may be considered for a portion of the occupational health nursing work experience requirement. The degree must be completed within the five-year period prior to application to be considered. The maximum number of hours that can be applied are:
      • 2,000 hours for a baccalaureate or graduate degree program related to occupational health 

    COHN Test Blueprint:

    • Clinician Role (42%)
    • Coordinator Role (27%)
    • Advisor Role (13%)
    • Case Manager Role (18%)

    2. Certified Occupational Health Nurse – Specialist (COHN-S)

    The COHN-S examination focuses on occupational health nursing with an emphasis on administration vs. clinical practice. To be eligible individuals must meet the specific criteria:

    • Current, active RN license
    • Bachelor Degree or higher (does not have to be in nursing)
    • 3000 hours in occupational health nursing in the past five years OR
    • Time spent in a graduate program related to occupational health or in a baccalaureate completion program related to occupational health may be considered for a portion of the occupational health nursing work experience requirement. The degree must be completed within the five-year period prior to application to be considered. The maximum number of hours that can be applied are:
      • 2,000 hours for a baccalaureate or graduate degree program related to occupational health

    COHN Test Blueprint:

    • Clinician Role (20%)
    • Manager Role (34%)
    • Educator Role (15%)
    •  onsultant Role (14%)
    • Case Manager Role (17%)

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    Part Six What is the Career Outlook for an Occupational Health Nurse?

    Currently, there is no exact career outlook data for Occupational Health Nurses. According to the BLS, in 2018, there were 3,059,800 Registered Nurses in the United States. By 2028, there will be a need for additional 371,500 nurses, which is an expected growth of 12%. With the aging population, this number is expected to be even higher.

    There is an increasing need for nurses throughout the United States and this number will only continue to rise. As more and more companies try to defer costs especially related to workplace accidents and illnesses, employing occupational health nurses will help. Employers will be absorbing the costs directly for examinations, labs, and other care provided on-site vs paying an offsite doctor or specialist.

    Part Seven What are the Continuing Education Requirements for Occupational Health Nurses?

    Occupational Health Nurses have the same continuing education requirements as other RNs. This will vary on a state by state basis. There are no specific CEU requirements for Occupational health nurses unless they have obtained advanced certification.

    The COHN and COHN-S certifications require 50 Continuing Nursing Education continuing education hours related to occupational health earned within the previous 5 years to maintain certification.

    Generally, in order for an individual to renew their RN license, they will need to fill out an application, complete a specific number of CEU hours, and pay a nominal fee. Each state has specific requirements and it is important to check with the board of nursing prior to applying for license renewal.

    A detailed look at Continuing Nurse Education hours can be found here.

    Part Eight Where Can I Learn More About Occupational Health Nursing?

    Occupational Health Nursing focuses on the promotion of safety and wellness in a workplace environment. They help prevent injuries and illness as a result of workplace-related incidences and work closely with both employees and employers to ensure all federal and state mandates are met. Occupational Health Nursing can be a rewarding career for those that want to work in a diverse and different work environment, especially if not employed by a healthcare institution.

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    FAQs

    • What is an occupational health nurse?

      • The Occupational Safety and Health Administration (OSHA) classifies occupational health nursing as nurses who assess a worker’s health status with respect to their job tasks and hazards. These nurses recognize and prevent health effects from hazardous exposures and treat worker’s injuries and illnesses.
    • What does an occupational health nurse do?

      • Occupational Health Nurses are the center of coordinated care for employees within an organization. They are responsible for delivering comprehensive and qualified service while reducing medical benefits from the company’s bottom line.
    • What do occupational health nurses make?

      • According to Payscale.com as of May 2020, states the average yearly salary for Occupational Health Nurses is $71,883 and the hourly rate is $32.64.
    • What qualifications do you need to be an occupational health nurse?

      • Occupational Health Nurses are Registered Nurses with specialized training in occupational health. Individuals should have several years of bedside nursing experience, generally in medical-surgical nursing or intensive care nursing, before transitioning into occupational health. Generally, new graduates are not offered positions in occupational health directly from nursing school. Some Occupational Health Nurses will have a master’s degree in public health or nursing.

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