Chapter 31: Occupational Health Nursing

Occupational Health Nursing examines the historical evolution of the discipline, tracing its roots from early industrial nurses like Ada Mayo Stewart through the shift from agrarian and manufacturing economies to the modern service-based and technological landscape. The text emphasizes the multidisciplinary knowledge base required for effective practice, integrating nursing science with medical science, epidemiology, toxicology, industrial hygiene, safety engineering, and ergonomics to identify and mitigate workplace hazards. Significant attention is given to the changing demographics of the workforce, including the impact of an aging population, increased female participation, and the need for culturally competent care. The core of the chapter delineates the application of the nursing process through three levels of prevention: primary prevention strategies such as health education, vaccination, workplace violence programs, and safety walk-throughs; secondary prevention efforts including preplacement examinations, periodic health surveillance, and screenings for early detection of occupational and nonoccupational conditions; and tertiary prevention focused on rehabilitation, case management, and facilitating successful return-to-work transitions for injured employees. Furthermore, the summary addresses the critical legal and ethical frameworks governing the profession, highlighting the roles of the Occupational Safety and Health Administration (OSHA), the National Institute for Occupational Safety and Health (NIOSH), state-mandated Workers' Compensation Acts, and the Americans with Disabilities Act (ADA). It also outlines the necessary skills and competencies defined by the American Association of Occupational Health Nurses (AAOHN), classifying practice levels from competent to expert while discussing ethical dilemmas surrounding confidentiality and the dual responsibility to both employer and employee. Finally, the text categorizes specific workplace exposures, including biological-infectious, chemical, enviromechanical, physical, and psychosocial hazards, providing a comprehensive guide for nurses to assess risks and implement control strategies for total worker health.