During my years working as a nurse practitioner at an urgent care clinic, I had the opportunity to participate in a few different occupational health roles. Many urgent care clinics have contracts to provide occupational health and/or wellness services with local companies. My employer did the same.
First, I became involved in the occupational health world when my employer called on me to staff a clinic on site at an area high school. The clinic was housed in a portable on campus at the high school and offered primary care services to school district employees and their families. I treated school administrators, teachers, and cafeteria workers to name a few. Most of my patients were relatively healthy and maintained a relationship with a primary care provider using the on site clinic namely for sick visits. I staffed the clinic alone but also had the support of a more experienced NP available by phone should a question or issue arise.
My second role was that of providing health and wellness services for an area wholesaler. The company operated a warehouse with a series of loading docks where employees loaded and delivered groceries to be delivered to local stores. A large company, the front office also staffed around 50 employees. My role was to give a brief talk once a week on a health topic, educating about anything from the importance of blood pressure management to healthy eating tips. The first meeting I held on diet and exercise got awkward when an overweight employee brought a tray full of Hostess cakes to the 10am affair.
After delivering a brief educational talk, I would sit in a conference room and check blood pressures as well as offer personalized health advice. Employees would ask questions like “should I go see my doctor for _____” to “what are the best OTC medications to take for seasonal allergies?”.
I have to say, this job wasn’t my favorite. Without clinical equipment or a private exam room I felt my hands were tied. I could only offer limited medical advice. I didn’t have access to patient’s medical records or lab services so I felt I wasn’t providing real patient care. Driving to and from the business once a week gave me some flexibility and allowed me to get outside of the walls of the urgent care clinic but ultimately I didn’t enjoy the assignment.
Finally, my most integral role in occupational health came from working within the walls of the urgent care practice where I was employed. I treated large numbers of patients who had been injured on the job as well as performed DOT physicals and other employment screening exams. From suturing lacerations to treating sprains, strains, and head injuries, I saw multiple workman’s comp patients each day.
Working in a clinic offering occupational health services required careful documentation as well as communication with the employer regarding the employee’s health status. I arranged follow up visits and coordinated with insurance companies to get testing like CT scans and MRIs approved. The added red tape of involving an employer in a patient’s care could be frustrating to manage, but overall this was my favorite occupational health role. It allowed me to perform procedures and treat urgent care type patients, one of my favorite practice settings.
Occupational medicine is a growing job market for nurse practitioners and one to consider whether you’re an NP with an interest in primary or urgent care.
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