An Approach to Future Directions for Occupational Health Nursing

In a post-pandemic context where the labor market is under stress, there is an uneven recovery, and social justice is in question (International Labour Organization [ILO], 2023a). The positioning and role of occupational health nursing in organizations invites a debate with a self-critical view based on what we have learned and experienced over the last few years. This speciality has the capacity to make an even greater contribution to worker health. I suggest consider compromise in order to innovate and embrace new directions in the traditional nursing roles (González-Caballero, 2022). For example, we may need the reorganization of the typical array of services (International Council of Nurses [ICN], 2023; The National Academies of Sciences, Engineering and Medicine, 2021, 2022), while still ensuring continuity and competency of care (Ruiz-Bravo et al., 2022). We must imagine and embace the digitalization of nursing care processes (Vilaseca & Howe, 2022), coordinate with the public health and primary care systems (García et al., 2021), and collaborate with other professions in the field of occupational risk prevention (ILO, 2019a). Nursing care should be accessible, timely, continuous, and comprehensive; yet there is a need to rethink the portfolio of nursing services aimed at responding to the demands of the worker, with special attention to mental health problems (ILO 2023b; World Health Organization [WHO], 2022a) and persistent COVID-19 in companies (European Commission, 2022). Consequently, this set of present and future challenges conditioned by the pandemic should be addressed in workplaces.

We are witnessing a work and professional reality that is increasingly flexible, diverse, fluid, changing, globalized, and technological (ILO, 2019a, 2023a; World Economic Forum [WEF], 2023). In response to this situation, occupational health and safety in the workplace is in constant transformation (Felknor et al., 2023). The coming years will be marked by an ecological and digital transition accompanied by economic and demographic challenges, in addition to the evolution of the working environment toward models based on delocalization, the gig-economy, and digital platforms—realities that are breaking away from other more traditional types of work (European Agency for Safety and Health at Work, 2021; European Commission, 2021). From this perspective, the regulatory framework that defines the professional competencies of this speciality in every country, access to occupational health nursing in companies, and the holistic approach in the care of the working population determines the space that this discipline occupies in the process of improving working conditions but also increasing the quality of life at work (González-Caballero, 2021; Schulte et al., 2022).

The priorities of an occupational health service are the anticipation and assessment of occupational risks and the prevention of the adverse effects of their exposure (ILO, 2019a, 2023a). We are currently immersed in a reality of changes in the forms of work and jobs that condition well-being at work to a greater or lesser extent (Delclós et al., 2022; WHO, 2022b). This circumstance makes it necessary to focus our actions on limiting the deleterious effects on the worker’s health based on anticipation (Felknor et al., 2021). In a post-pandemic context where different business models, sectors, and ways of developing the professional facet emerge, the Strategic Framework of the European Union 2021–2027 (European Commission, 2021) states that new actions on occupational health and safety at work are required, and the World Commission on the Future of Work (ILO, 2019a) calls for a comprehensive view of current and future risks to which workers are exposed. In addition, the ILO (2019b, 2022) advocates people-centered policies in the economic, social, and business spheres that promote work–life balance. In a complementary manner, the WHO (2020a) proposes developing public health programs throughout the professional career, and the National Institute for Occupational Safety and Health designs the Total Worker Health^® program (NIOSH, 2016) with a more holistic vision, projecting its action beyond work-related aspects, an issue ratified in an institutional position of the American Association of Occupational Health Nurses (AAOHN, 2021). Finally, these postulates are consistent with the Sustainable Development Goals 2030 (no. 8) adopted by the United Nations (2018).

However, the description of possible future work scenarios invites a broader analysis of professional practice (WHO, 2020b, 2021). Although the competencies of the speciality are regularly reviewed, this new reality prompts an exchange of views on issues related to the nursing role in the team, multidisciplinarity in care delivery, care praxis, ethical aspects, and the pursuit of professional development (Murray, 2019). It also invites an active debate on some changes related to globalization, digitalization, and the intensification of routine work (ILO, 2023a; WHO and ILO, 2022), in addition to the incorporation of the migrant population, the aging workforce, and new forms of work and interaction with the environment. How do we incorporate this reality into training programs of future occupational health nurses? How do we design of new lines of research? And, finally, how do we translate new evidence into company policies (Schulte et al., 2019, 2022). It is incumbent on the speciality to question the professional adaptation to this new socio-occupational reality and to analyze the needs and expectations of organizations and their members to provide expert and quality care (European Trade Union Institute [ETUI], 2017; Schulte et al., 2019). This reflection translates into a balance between maintaining the safety and health of employees, the productivity of companies, and well-being at work. I invite all OHN’s to participate in this professional debate.