Sail the 'seven Cs' to go from good nurse to great occ-health nurse
It takes more than clinical skills to succeed in business
Any occupational health nurse knows that merely being a good nurse is not enough to succeed and excel in the demanding world of occupational health.
Donna C. Ferreira, RN-C, COHN-S, MS, a nurse practitioner at National Grid in Westborough, MA, found herself wondering what were the most important strengths and tools occupational health nurses should cultivate to be competent and confident, and came up with what she calls the "seven Cs."
"I wanted to give occupational health nurses an understanding that they can be strong in one area, but if they're not strong in other areas, it can negate the strengths they have," says Ferreira. "I tried to come up with a recipe for a strong, effective, efficient occupational health nurse."
The first C — Clinical
"If someone is going into occupational health, they should have a clinical background — for example, med-surg or emergency medicine experience," she says. "If they are going fresh from school into an occupational health setting, they don't bring strong clinical skills."
A clinical background gives a nurse not only knowledge but hands-on experience critical to making good decisions in the wide range of situations the occupational health nurse or nurse practitioner may come across, says Ferreira — it makes him or her a good nurse to start with.
"If they have that experience under their belt, they have the knowledge base to make sure they're doing the correct things — referring when it's appropriate, for example — and then they have the actual skills that they'll use when they have to take blood pressures, when nurse practitioners might be suturing injuries and dressing wounds, doing audiometry, phlebotomy. They'll have the hands-on skills."
The second C — Certification
Credentials run the gamut — COHN, COHN-S, spirometry, hearing conservation, cardiopulmonary resuscitation, phlebotomy, automated electronic defibrillation, safety and health, case management, first aid, advanced life saving, to name a few. But having credentials does more than add acronyms to your name, Ferreira says. They add weight to your opinions.
"Credentials can strengthen your recommendations if, for example, you're in a board meeting and discussing an addition to your wellness program or [the cause of] an injury," she says. "Credentials give you more clout."
Ferreira says when she lectures she tells nurses to use their certifications to underline their recommendations to give them more strength, but to refrain from using certification as a sledgehammer to prove their recommendations are better than someone else's.
The third C — Compliance
While the word "compliance" can carry ominous overtones when used in the workplace, conjuring images of visits by unhappy Occupational Safety and Health Administration (OSHA) inspectors, compliance can be a key tool for occupational health nurses as they strive to make their workplaces safer and healthier. Ferreira says if it can be demonstrated that some occupational health initiatives are necessary for compliance with federal, state or local safety and health requirements, employers are more likely to beef up their budgets to ensure the health and wellness of employees.
"Compliance is a key tool that occupational health nurses can use to help convince businesses to do particular programs," she says. "It's often the key to getting more resources, more money, and getting your ideas across the table," as well as bringing a workplace into compliance with OSHA, the Family and Medical Leave Act, Americans with Disabilities Act, Department of Transportation, workers' compensation, and state practice acts.
The fourth C — Confident presentation
You might be a terrific clinician with great ideas, but Ferreira suggests that if you cannot present your ideas and yourself in a confident and competent way "nobody will listen to you."
Confidence includes projecting a confident appearance — which may mean not dressing in traditional nurses' whites.
"Some occupational health nurses choose to dress in the traditional white uniform, and I think in that case sometimes people at higher levels treat you as 'just a nurse,' but if you go into a board meeting to represent your department, you might want to dress for success and the appropriate occasion," she says. "A business suit would probably be more appropriate for a high-level meeting."
Being an occupational health nurse means you're always "on," she points out.
"People watch what you're doing," she continues. "They watch what the nurse eats in the cafeteria. You are making an impression when you're on the phone, in elevators, in hallways, in one-on-one meetings, teaching, doing wellness programs, making training tapes, and in union arbitration."
Besides physical appearance, successful presentation encompasses your air of confidence, your trustworthiness, and how you come across in the first impression you make.
Communication and presentation skills can make or break a good idea, she points out. Body language and other non-verbal skills — firm handshakes, refraining from nodding at every comment made [and thereby sending a message you agree with everything said], making eye contact — are important to master.
"And your voice should be interesting, not meek or monotone," Ferreira suggests. To reduce anxiety prior to an important presentation, be well prepared, arrive early, and be cautious in the use of words, particularly clinical or technical words that if used incorrectly can cost you your credibility.
Other factors of confident presentation, Ferreira notes, include knowing the cultural differences in word choices and protocol if the company is foreign-based or does international business, and learning how to deal with difficult participants (whisperers; "showboaters," who ask questions to draw attention to their own knowledge or accomplishments; and "bullies" who try to make the speaker look bad).
The fifth C — Comprehend your business
An occupational health nurse who is a superb clinical nurse but has no comprehension of his or her employer's business is lacking a crucial tool.
"It is essential that the occupational health nurse comprehend the basis of economics, political forces, and economic trends that shape the business environment," she says. Occupational health nurses should be aware of events and conditions and how they influence the companies they work for. War, global shipping, and import/export conditions, the value of the dollar, and international trade agreements all can affect a business's bottom line, and therefore, its budget for employee health, wellness, and safety.
"I would suggest the occupational health nurse's role expands and contracts with the company's business cycle," Ferreira says. "In 17 years with my company, I have experienced downsizing with nurses offices in our field locations closing; after a while, those offices were reopened and staffed by nurse practitioners."
As companies expand across state lines, occupational health nurses might find themselves dealing with travel medicine issues, health education, immunizations, expanded case management duties, and psychological support programs.
"So an occupational health nurse, to comprehend the business of her company, needs to ask three questions: What is the mission of the company? Who are the company's customers? And who are the patients of the occupational health nurse?"
The sixth C — Correct etiquette
Building on the previous five Cs, Ferreira says a nurse can be a good clinician, with a good presentation and a head for business, but an etiquette gaffe can torpedo his or her reputation and credibility.
Among the business etiquette pearls Ferreira teaches are:
- when introducing two people, the person introduced first is shown the greatest respect and honor;
- when introducing yourself, take fewer than 10 seconds;
- "save" people who you've met but who obviously have forgotten your name; introduce yourself by saying, "I think we met last year…"
- use the name of the other person when you're talking one-on-one, but make sure you're using the right name;
- when doing business by phone never leave someone on hold longer than 20 seconds, answer within three rings and don't take calls while you're in meetings or with patients.
The seventh C — Connections
"You can have all the other Cs, but if you're not connected within the company and linked to strategic people in strategic places, you might still not have a strong enough voice within the company," Ferreira points out.
Having connections to people with the knowledge a nurse needs to make a successful occupational health program is imperative. Ferreira suggests cultivating relationships with people who can serve as resources in the following departments: human resources, labor, benefits, upper management, facilities, legal, security, safety, industrial hygiene, unions, trusted employees, and a director in each department served by the occupational health program.
Connections need to extend outside the company, as well, to occupational health peers and associations such as the American Association of Occupational Health Nursing; OSHA and other federal and state agencies; and specialists in orthopedics, neurology, psychology, forensic psychology, workers' compensation, disability management, and, if applicable, outside occupational health vendors.
For more information on the seven Cs, contact Ferreira at [email protected].
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