When Sandy Bruskewitz, BA, RN, COHN-S/CM, started her career in occupational health 37 years ago, she was a “first aid nurse” whose primary role was to handle workers’ injuries. Today, as one of 35 OHNs with 3M in Austin, Texas, she adeptly juggles roles as a health promoter, wellness team member, health coach and safety observer.
The pendulum has swung between getting employees well enough to work and helping them improve their health to stay on the job, she said, adding the company’s financial interest always is considered.
“One of the hot topics is cost containment of health benefits,” she said. “Health costs, including insurance premiums and high deductibles, are affecting employees and companies.”
Marlys Nelson, RN, COHN-S, agreed. “Health insurance within the corporation is driving wellness a great deal. A lot of OCNs are getting involved in that side of wellness,” Nelson said, which means helping employees face issues such as excess weight, high cholesterol levels and hypertension. Nelson is coordinator for on-site services at Allen Hospital-UnityPoint Health in Waterloo, Iowa, where she and other OHNs oversee employee wellness at industrial and energy companies through the health system.
Increasingly, Nelson observes more stringent requirements by insurance companies for workers to receive premium incentives. She and colleagues visit industrial plants and worksites once or twice a year to assess workers for body mass index, BP and blood lipids.
Both Nelson and Bruskewitz provide health teaching, from five-minute weekly talks at employee meetings to health fairs and major programs. And both benefit from another trend in employee wellness: a team approach.
“It’s becoming a team effort to help improve employee health,” said Nelson; her system’s wellness staff do health coaching and provide wellness promotion. At 3M, Bruskewitz said the health team is a corporate initiative aimed at improving employees’ lifestyle management. Team members often include physical exercise trainers, dietitians and other health staff.
Increasingly OHN and employee wellness teams are addressing issues such as violence in and outside the workplace, sleep problems, stress and vulnerable workers, said Sheila Fitzgerald, PhD, RN-C, program director of occupational and environmental health nursing at Johns Hopkins University, Baltimore.
“Our program focuses a great deal on vulnerable workers,” Fitzgerald said. “The aging worker is a big issue. Baby boomers are now maturing, and their need to remain engaged is important, but with that comes issues of stamina, mental abilities, length of time they can work.”
The Ebola outbreak brought global health to the forefront. Kay Campbell, EdD, RN-C, COHN-S, FAAOHN, executive director of the American Association of Occupational Health Nurses, said, “More OHNs work globally today with 12% literally having responsibilities in countries other than the U.S.; however, many more OHNs provide travel programs for international travelers and offer programming for global workers.
The workplace is also increasingly using social media. Kim Olszewski, DNP, CRNP, COHN-S/CM, FAAOHN, assistant professor in the graduate nursing program at Bloomsburg University of Pennsylvania, has studied social media in the workplace.
“Occupational health nurses have recognized that social media/mobile apps are a way to the future for employee wellness,” she said, “and have specifically turned to mobile applications, such as those for weight loss, fitness accountability and wellness initiatives such as smoking cessation to assist their employees and employee families in holding them accountable for healthier lifestyles.”
She said the trend grew, starting in 2012 when the U.S. Surgeon General sponsored a healthy app challenge, offering many government-supported mobile health initiatives for nurses to use as wellness resources for their employees.
Toward the future
Looking ahead, Campbell said, OHNs are having to become “fully bundled OHNs” who can function in various subspecialty roles: case management, safety, health promotion and management in the context of a single job.
Campbell also believes worksite health programming has the potential to become the medical home associated with healthcare reform.
“As Americans become less well, the OHN will be doing more and more condition management and coaching workers to navigate the healthcare system,” she said. “OHNs will have increasingly more impact with their prevention and health promotion programming and services, on employee engagement and productivity.”