Deborah DiBenedetto, on occupational health nursing

By Bree LeMaire, MS, RN
April 2, 2003

What is occupational health nursing?

I use the butterfly as my unofficial symbol to illustrate the scope of diversity of OH nurses and their various practice environments. There are thousands of different butterflies and the same holds true for variations in the occupational health nurses' careers. When comparing butterflies, no two are the same. OHNs, even in the same company, have different roles and responsibilities. So consider the various species of butterflies and know that there is as much diversity in occupational health nursing.

Where is the business of occupational health nursing headed?

We have a decreasing number of available occupational health nurses, which mirrors the projected nursing shortage. Companies may outsource or eliminate the OHN position to buffer the deficiency. While many OHNs are providing clinical services, many are moving into managerial or case management functions. A number of our members are not prepared for this changing business arena. Some are still in traditional health roles such as the clinic nurse and the on-site, hands-on nurse. Businesses are looking to streamline staff functions and often outsource these services as well.

Nurses are caught in between, and we need to provide them with the tools, information and educational opportunities to prepare them for the business needs of today and tomorrow.

What are the challenges of the AAOHN?

First, we need to demonstrate the value of OH nursing in today's business economy.

Secondly, in this age of all-hazard heightened awareness, the occupational health nurse is often the first responder to hazards in the workplace, so we're on the forefront of recognizing and addressing potential bioterrorist activities or exposures to hazardous materials in the workplace. OH nurses are there to help companies, communities and the public to respond appropriately.

AAOHN has just celebrated its 60th anniversary. What are some distinctive changes the association has made?

The values of today are much the same as yesterday, but the role of the nurse has definitely changed.

We're more dynamic as an organization and increasingly involved in governmental and external affairs and showing the role of the OH nurse whether it's to the government, business or the community at large.

We are now involved in taking the pulse of the public that we serve and of the broader worker populations. We can look at the value of the OH nurse and solicit from clients the values they see in such things as worksite wellness and health promotion programs.

Where do you see the association in 10 years?

It will be a very different association. Managed care is taking shape daily as we speak. Employers are increasingly outsourcing services. There will be more coordination of care to community services. As there are fewer nurses and our profession gets older, there will be more occupational health professionals (many non-nurses) with a broader scope of responsibility. Other professionals will be utilized to deal with work-life issues. OH nurses also will band with other service providers such as school nurses and public health nurses to meet the health and welfare needs of the workforce, communities and our youth.

What special challenges do occupational health nurses face?

I've always said we're on the cutting or bleeding edge of the profession. We've assumed roles and heard, "Oh, that's not what an occupational health nurse does," and a few years later found that's exactly what we do.

Better lines of communication from leadership will recognize these new and emerging trends. It's time to expand our horizons and try new things rather than play catch-up.

Cutting-edge examples?

I was one of the first insurance rehabilitation specialists in 1978 and wanted to join AAIN, the precursor to AAOHN, and was told insurance rehabilitation wasn't in the scope of industrial or occupational health nursing. Twenty years later, AAOHN is advocating the role of the OH nurse as a disability case manager, which is what I was doing 20 years ago. Managing lost time in the workplace is still an acute issue. Today, it is a growing area called absence management and integrated disability management or health and productivity coordination.

In the mid-'80s, we had occupational safety and health programs and were again told this was a safety manager's job. Today, OHNs take on environmental health and safety, much the same as many of us did 15 to 20 years ago.

Anything you'd like to add?

Occupational health nursing is a dynamic and exciting career. Nurses can make out of it whatever they want. It only takes the art of balancing business knowledge with nursing know-how and some innovative willingness to adapt and seek broader goals,
which benefits the nurse, their career and their employer.