Why I think you should become an Occupational Health Nurse

"I am a true believer in remaining on the “front line” with your team to fully understand what is happening at ground level."

Specialist Practitioner, Tracie McKelvie, is passionate about her job as an Occupational Health Nurse. She explains why she loves it, and offers a full guide to how you can do what she does.

Topics covered in this article

How I became an Occupational Health Nurse

What I love about my job

The role of an Occupational Health Nurse / Advisor

What does the job pay?

What qualifications and skills do you need to pursue a career in Occupational Health?

What are the Challenges in Occupational Health?

How I became an Occupational Health Nurse

I have been nursing for over 30 years, having started my career as a “care assistant” in 1989.

I started my “formal” nursing career pathway as a trainee SEN, also known as RN2 in 1991, and took this route because I did not have the qualifications for direct entry onto the RGN course.

While successfully completing my SEN training, I also attended night school to get the relevant qualifications that I needed and a few years later, I converted to RGN, (RN1) via degree route.

I class myself as a good example of having worked my way up from the bottom rung of the career ladder, and with my passion, hard work and determination to succeed, I have gradually progressed up that ladder to be where I want to be today.

Over the years, I have had the opportunity to develop a wide range of skills having gained a vast amount of exposure to a variety of settings throughout the UK, and the Isle of Man.

I have worked within the NHS, public and private sectors, and have witnessed first-hand how some health detriments can significantly affect our quality of life, and potentially our livelihood.

Health promotion and health education has always been a passion of mine, but not just for my patients, their families and carers; but for myself and my colleagues too.

I have always felt strongly that in order to do a great job, to be happy in your job, and to be the best that you can be, our own physical and psychological wellbeing is paramount.

I naturally promoted this, often taking the lead on health and wellbeing initiatives in the workplace, making sure that I was able to gain relevant knowledge and access further development, whether this be self-funded, or through the NHS, and when an opportunity arose to enter into Occupational Health Nursing in 2002, I jumped at it.

That was 18 years ago and although it has taken a lot of self-discipline and further structured formal learning, to include my Specialist Practitioner Degree in Occupational Health Nursing with the Robert Gordon University to get where I am today, it has been an incredibly worthwhile journey; I haven’t looked back.

I now hold a managerial position within Occupational Health and I have more of an opportunity to influence change.

I have a voice both within my organisation, and within the wider public health arena.

I have been extremely lucky to have been further supported in gaining enhanced management training, successfully completing an Executive Nurse Leadership Course which was fully supported by the Queens Nursing Institute.

What I love about my job

I am incredibly lucky to be doing a job that I love!

Not only can I practise what I am passionate about, by holding a management position means I get to shout about it too!

Working in Occupational Health enables me to help our “working communities” to remain safe and healthy at work, as well as at home too.

My job also allows me to support those who despite having health detriments, to continue to work, and being able to make changes, make a difference, and see the benefits unfold compliments the drive that I have in ensuring as best as I can the health and wellbeing of our people.

My job is never boring and presents with new challenges frequently.

I thrive on these challenges and how this often generates complex case discussions; simply a natural form of clinical supervision, which is so important in Nursing, allowing myself and my team to learn and develop further.

My role is autonomous and I welcome this; this allows me to hold my own clinics and work directly with clients, while also taking more of a strategic role for the wider function of the organisation.

I am a true believer in remaining on the “front line” with your team to fully understand what is happening at ground level, and I love that despite progressing my career into management, my current job allows me to continue to do this, to some extent.

We have a varied workforce, who operate in highly stressful and complex specialist functions.

Some of these specialist areas include firearms officers, hostage negotiators, dog handlers, crime scene investigators, control room operatives, and disaster victim identification and recovery officers, to name but a few.

Having the opportunity to engage with and observe some of these groups to gain a better understanding of what the role entails means that we can deliver our services proactively, as well as tailoring our services to meet specific need.

I am proud of the close working relationships I have developed with these groups and other disciplines within my organisation, such as HR and the Chief Officer group for example, and while we work closely together, there is an absolute respect throughout that Occupational Health is an independent and confidential function of the business.

I am passionate about what I do, and about maintaining high standards and providing the best possible care, and being in a position to encourage and empower a dedicated and hardworking team to further promote this is incredibly job satisfying.

I feel inspired by what I come across from within our unique policing working community, and their families, and I take a new learnt skill from this almost every day!

The hours in Occupational Health Nursing are favourable and are usually structured during weekdays.

My hours are generally Monday – Friday 08:30 – 16:30, although there are times when we can work outside of these parameters, in response to need.

The role of an Occupational Health Nurse / Advisor

Some may perceive Occupational Health Nursing as not being as “clinically hands on” as a traditional Nursing role, but there is no doubt that Occupational Health Nurses are highly skilled in their speciality.

We work autonomously, and we utilise a wide range of clinical skill sets in order to undertake our roles and make effective decisions.

Duties can range from undertaking pre-employment medicals, health surveillance and health screening, administering vaccinations, phlebotomy, oversea travel clinics, assessing fitness for work, promoting health promotion and health education, client consultations, and complex case management.

This list however is not exhaustive but gives a snapshot of the general duties of an Occupational Health Nurse / Advisor.

I have worked for several organisations, but for the last 6 years, I have worked for the Police.

My role as Occupational Health Nurse Manager sees myself and my team delivering a wide range of services; one aspect is that of the recruitment process.

Occupational Health Nurses will undertake an initial clinical paper medical assessment before progressing an applicant onto full medical process.

This may involve liaising with other health professionals.

The medical itself involves examining lung function, hearing, vision, blood pressure and pulse, urinalysis, height, weight and body fat composition, as well as identifying any underlying health conditions that may need further exploration.

Upon completion, we utilise our clinical skills to review and analyse results in order to make a determination on fitness for role.

We also have to exercise sound clinical judgement skills to be able to identify when to refer onto another Specialist, such as an Occupational Health Doctor.

In addition to this, we undertake other clinical screenings for fitness tests, we provide psychological screenings for higher risk roles, we run busy vaccination and phlebotomy clinics, and we hold daily client consultation clinics that present us with challenges relating to varying aspects regarding both physical and psychological health.

Having an understanding of the biopsychosocial model helps.

We also deliver force wide training on health and wellbeing and infection control for example, and we promote the role of Occupational Health and what this means from a business perspective.

We arrange and undertake several annual health fares throughout force division which is a bit like going “on tour” to deliver health and wellbeing roadshows.

This is a particularly popular activity within the department as we, including myself go out and meet the wider workforce, and engage with them in an informal but worthwhile capacity.

As an Occupational Health Nurse Manager, I am responsible for a multi-disciplinary team.

I am responsible for ensuring that we have the right skill mix in the unit at any one time, to ensure effective function.

My role as manager extends to that of a strategic function, and this is not only about having a voice around the table and about making effective changes, but it’s also about ensuring that protocols and policies are in place, and that appropriate legislative requirements and specific guidance under the College of Policing and Home Office for example are being met.

What does the job pay?

Salary will vary depending on experience, qualifications and role, but for a postgraduate qualified Occupational Health Nurse / Advisor / Manager, this will usually attract a salary from around £32,000 - £60, 000 per annum.

Trainee Occupational Health posts for RNs will attract a salary from around £26,000 – £30,000 per annum with the employer usually funding full Occupational Health course fees on top; an Occupational Health Technician post will usually see a salary offer of between £22,000 - £24,000, per annum.

What qualifications and skills do you need to pursue a career in Occupational Health?

Occupational Health is evolving and is becoming more and more multi-disciplinary.

For example, within my team, I have recently taken on a Registered Mental Health Nurse to support the existing team, which consists of Occupational Health Nurses and Nurse Advisors, Specialist Doctors in Occupational Health Medicine, a Physiotherapist and a team of Counsellors and Psychotherapists.

To practise as an Occupational Health Nurse / screening nurse in an Occupational Health setting, as a minimum, you will need to have a valid RGN qualification, and ideally a background in accident and emergency or community nursing, although the latter is not set in stone.

I do believe however, that having a sound General Nursing background is hugely advantageous before progressing into Occupational Health.

To practise as an Occupational Health Nurse Advisor, in addition to a valid RGN qualification, most employers will require you to have the relevant experience and a specialist postgraduate qualification in Occupational Health.

Some employers also insist that applicants have active registration status on both parts 1&3 of the Nursing and Midwifery Council (NMC) register.

Occupational Health Technicians do not need the RGN status, however there are courses specifically designed for this role.

For anyone who is interested in embarking on a career in Occupational Health, some employers will appoint a “trainee post” offering candidates the opportunity to undertake a fully funded postgraduate course in Occupational Health.

If this were an option, I would thoroughly recommend this specialist area of nursing.

It keeps you clinically sound, it certainly keeps you on your toes, and allows you to make such a difference to the not so sick, in supporting them to remain well.

Some good tips for advancing into the world of Occupational Health is updating yourself on relevant legislation such as COSHH, Noise at Work, Employment Law, Working with Lead, or where possible undertaking interim training on such topics.

For example, undertaking a NEBOSH course provides a very relevant background encompassing a variety of areas that very often crop up in Occupational Health.

It is also important to note that soft skills such as communication, negotiation and networking, cultural awareness, critical thinking, empathy, integrity, and conflict resolution be at the forefront of your professional mind-set, as these are all essential skills needed in order to be successful in a career in Occupational Health; coming from a nursing background will be advantageous as these soft skills will mostly be embedded in us from the offset of our nursing career.

What are the Challenges in Occupational Health?

Nationally, there is a shortage of qualified and skilled Occupational Health practitioners, to include both Nurses and Doctors.

There are less training courses available and older practitioners are retiring and are not being replaced, simply due to the shortage of specialist-trained staff.

The NMC are reviewing their current standards for Occupational Health, as existing ones are outdated.

This is a positive step forward to ensure that standards are indeed relevant in today’s climate.

Due to the National shortage for Occupational Health practitioners, this has placed Occupational Health high on the government’s agenda having been recognised and cited again in papers such as “our healthier nation” and “improving lives”.

The Department of Health and Social Care’s Lord Bethell is also recently noted to have said “Occupational health services are vitally important in keeping people healthy and safe in the workplace. The command paper, “improving lives: the future of work, health and disability”, committed to setting out a clear strategy for the future of Occupational Health market reform”.

He went on to say that following on from the publication, health is everyone’s business, a consultation paper that was published in July 2019, “an upcoming response will outline future Occupational Health strategy”.

As part of the NHS plan that recognises that the health and wellbeing of NHS staff is important, this will set out a comprehensive package of support that all NHS staff can expect to receive from their employer, including “rapid access to Occupational Health services”.

While this is exciting and a positive step forward for our profession, due to the current COVID-19 crisis, publication of the final NHS People Plan has been deferred.

In addition to the NHS, there are several sectors that welcome Occupational Health services, such as local authority, industry, Blue Chip companies and private organisations, and in ordinary times, the private sector for Occupational Health generates a healthy income.

This will likely be challenged somewhat during the Coronavirus outbreak, although that said, as Occupational Health professionals, one key skill that we do have is determination, and ensuring that where possible, we can continue to do things, albeit if in a different way.

I believe that while there is much understandable uncertainty regarding our UK economy and its recovery from the current crisis, there are exciting times ahead for the future of Occupational Health and the government reform is certainly something I urge people to look out for in future months.

At the end of the day, with us, the people being our nation’s biggest commodity, we have to look after ourselves, and each other.

Being able to be a part of the bigger picture excites me; wouldn’t it you?