2005 Salary Survey

New opportunities rise amid EH retirement

Time to show your value, experts say

Employee health professionals are beginning to retire, leaving opportunities for other nurses to move into the field and raising the value of the more seasoned, experienced practitioners.

About one in four (28%) employee health professionals have been in their positions for three years or fewer, according to the 2005 Hospital Employee Health Salary Survey. A shift in the experience level of employee health professionals also was apparent in a 2005 member survey conducted by the Association of Occupational Health Professionals (AOHP) in Healthcare in Wexford, PA, which showed the largest group of respondents had been in their position for one to five years.

"We're starting to see a shift because of the aging [of the work force]," says MaryAnn Gruden, president emeritus and community liaison for AOHP and employee health coordinator at Western Pennsylvania Hospital in Pittsburgh. "We have an influx of new faces in employee health."

The salary picture in employee health has remained stable. Most employee health professionals (56%) received a raise of 1% to 3%, although a significant number did better than that. About 21% of EHPs received a raise of 4% to 6% and another 6% received raises of 7% to 10%, while 15% received no raise at all.

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There were 330 respondents to the HEH survey. They were more likely to work at a nonprofit hospital in a rural or medium-sized city and at a hospital with 300 or fewer beds. The most prevalent salary ranges were $40,000 to $50,000 (reported by 20%) and $50,000 to $60,000 (reported by 25%).

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Broaden your scope

Employee health continues to attract seasoned health care professionals. About half of survey respondents were older than 50 years, and 61% had worked in health care for more than 25 years. That experience is becoming even more valuable as employee health expands to encompass a broader set of responsibilities, employee health experts say.

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At Children's Healthcare of Atlanta, Jean Randolph's title changed from employee health to occupational health manager, representing a different perspective on the job. She is involved with family and medical leave, disability, workers' compensation, ergonomics assessment, and injury prevention, among other duties.

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"We're doing many more things than we ever did before," says Randolph, RN, COHN-S/CM, MPA. "Like every other facet of nursing, we're being asked to broaden our scope as much as we can."

Her work contributes to the hospital's bottom line, as she tries to control employee health care costs. For example, employees with chronic conditions such as diabetes and hypertension receive education and disease management. The department is even promoting work-life balance with a new program called Club MED (Motivate, Explore, and Discover) that aims beyond traditional wellness.

During lunch hours and on weekends, the hospital is offering classes on gardening, cooking, and scrapbooking. The hospital encourages employees to develop their personal interests and to spend time with their families. "We want them to recognize that family time is important to your life as well," says Randolph.

Randolph hopes to engage employees with topics they enjoy, but she also plans to incorporate such elements as health risk appraisals. Wellness programs help employees stay well and stay fit, and they serve as a retention tool, says Randolph.

Some employee health professionals may feel that wellness programs are a frill — something they will never have time to develop. But you have to move beyond the basic tasks of pre-placement physicials, TB testing, and immunizations, Randolph says.

"You've got to bring your value to people," she says. "You can't be in this job just to pass out Band-Aids and aspirin."

Employee health also can play a more prominent role in hospital planning. For example, Randolph also chairs the emergency management committee in her hospital, acting as a liaison with the community.

"Occupational health nurses are the perfect people to be responsible for emergency management within their institution," she says. "They should have relationships with outside agencies and they should have [had some education with] curriculum in emergency management."

How can you take on additional responsibilities when you're understaffed even for the basics?

That a tough dilemma for many employee health professionals. You'll need to partner with others at the hospital and even use volunteer resources, says Gruden.

She has just 1.8 FTE (full-time equivalent) employees in her department — herself and a part-time nurse. She has no clerical support. She serves 2,500 employees, plus medical students and volunteers. (About 37% of employee health professionals report that they have no clerical support, according to the AOHP survey.)

She and her nurse have learned how to work together efficiently. "We're a team. If we have to get it done, we get it done," says Gruden.

But she also depends on others at the hospital. Every fall, nurses volunteer to help administer flu vaccines to the staff. Managers also allow nurses to take time off their units to help with TB testing every January.

Meanwhile, if she has a question about the Family and Medical Leave Act, Gruden knows who to contact in human resources. She works closely with colleagues in infection control, safety, and risk management.

"You don't work in a vacuum. You're interdisciplinary," she says. "You need to know where to go to tap into the resources you need."

Through collaboration, you also inform others about the importance of employee health. After all, your work extends beyond the employee health clinic. By providing services such as ergonomic assessments and blood pressure checks, you raise your profile to the staff and administration.

"You have to think outside your box so you can find a way to have time to do some of the other things," say Randolph. "Even if it's just making yourself visible doing hypertension screenings, you've go to do that."

Education and networking are key

Employee health professionals also need to build adequate career tools to do their jobs. That means networking, continuing education, and certification, employee health experts say.

At first, when nurses move into employee health, they may view it as another clinic for patient care, with employees as patients, says Georgia Knuth, RN, MS, COHN-S/CM, executive director of the American Board for Occupational Health Nurses in Hinsdale, IL.

"Many people continue to do the same kind of one-on-one treatment of patients that they did in a different arena," she says. "An occupational health nurse looks at the exposures that are there in the work environment. They're doing more upper-level decision making."

AOHP offered "Getting Started" courses at its annual conference in October, and the American Association of Occupational Health Nurses in Atlanta offers on-line courses as well as sessions at its annual conference in May. (More information is available at www.aohp.org and www.aaohn.org.)

The National Institute for Occupational Safety and Health also supports 16 university-based education and research centers around the country, which offer courses in occupational health nursing. (See www.niosh-erc.org.)

When you get beyond the basics, occupational health certification demonstrates that you have reached a level of experience and competency in the field and is a good marketability tool, says Knuth.

"Certification is extremely important," agrees Gruden. "It validates your competency in the specialty."

The HEH survey found that 14% of respondents had the COHN-S certification, a decline from 19% in 2004. AOHP also found a decline in certification in its member survey, from 81% in 2000 to 48% in 2005.

That may simply reflect the influx of new employee health professionals, says Gruden. COHN certification requires 4,000 hours of occupational health work experience in the past five years and 50 contact hours of continuing education in occupational health in the past five years.

Continuing education and professional organizations help employee health professionals stay current in their field, says Gruden. "There's just so much that's changing," she says. "There's really a need to stay on top of the issues and be able to respond to those issues as they come up."

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At many hospitals, employee health is staffed with only one specialist, or with a nurse who has responsibility for both employee health and infection control. AOHP and AAOHN provide networking opportunities with colleagues at other hospitals through local or state chapters.

"You don't have to be alone," says Susan Randolph, MSN, RN, COHN-S, FAAOHN, president of AAOHN and a clinical instructor in the Occupational Health Nursing Program at the University of North Carolina at Chapel Hill. "There's a whole network of people available to share ideas and to provide guidance."

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