BOISE, Idaho – Before Lt. Col. Tina Williams became an occupational health nurse, she grew up in a poor household in Washington with little to no food or heat.
She often visited her grandmother to fill milk jugs with fresh water from her well, pick blackberries from her bushes and fresh produce from her garden, and sometimes help butcher a cow to put food on the table.
When she was 8 years old, her grandmother told her stories about wanting to help people through nursing. Those stories first planted the seed, Williams said, for her to become a nurse.
“I grew up in a very, very poor home, where I was often hungry and cold,” said Williams. “I swore that I would never live the rest of my life like that. I wanted to have security and I saw that nursing was a career field that would provide that.”
Williams graduated from Boise State University in 2006 with a bachelor's degree in nursing. She simultaneously commissioned into the Idaho Army National Guard and later became the organization’s occupational health nurse.
She has since earned national board certification as a certified occupational health nurse specialist in 2013 and also completed a master's degree as a family nurse practitioner in 2020.
Certified occupational health nurses exceed nationally recognized standards of proficiency and professionalism, are clinical experts dedicated to providing quality, evidence-based care, and are committed to continuing competency, patient advocacy and professional practices, Williams said.
Certified Nurses Day was celebrated on March 19 on the birthday of Margretta ‘Gretta’ Madden Styles, a renowned expert of nurse credentialing. She was also known for advocating stricter credentialing standards that were instrumental in the foundation of the American Nurses Credentialing Center, Williams added. The certification board is approved by the U.S. Army for advanced and continued nursing education.
Williams is one of eight nurses in the Idaho Army National Guard who belong to either the organization’s Medical Detachment or C Company of the 145th Brigade Support Battalion. Together they work to maintain the health and readiness of the organization’s fighting force by serving as case managers, medical surgical nurses, public health nurses and occupational health nurses.
Williams started her career working in a nursing home her senior year of high school, become a certified nursing assistant and later learned of military nursing.
“I was working in the nursing home when Navy recruiters came to visit,” said Williams. “I wanted to enlist but they weren’t accepting females at the time, so I walked over to the Army recruiters and asked if they were. They said yes, so my next question was, 'Can I become a nurse?' and they said yes.”
Through the Army, Williams learned she could gain valuable skills as a combat medic while also earning college benefits like the GI Bill, which she later used to earn a free degree in nursing.
After enlisting in 1990 and completing training at Fort Sam Huston in San Antonio, Texas, Williams spent four years serving as a combat medic at Kenner Army Hospital in West Point, New York. Looking to focus on school, she left the active Army and joined the New York National Guard in 1994 before transferring into the Idaho Army National Guard two years later to be closer to family.
In the Idaho Army National Guard, Williams serves as a traditional Guardsman and chief case manager for the Medical Readiness Detachment. As a full-time technician, she maintains the organization’s occupational health program to meet OSHA requirements for approximately 300 Army federal technicians working in hazardous positions.
“My bread and butter are monitoring the health of our employees through medical surveillance screenings to ensure they are healthy and physically able to perform their jobs,” said Williams. “The other part of my job is inspecting workplaces, identifying hazards and making recommendations on how to reduce those hazards in order to provide our employees with safe workspaces.”
Federal technicians who work as welders, painters, mechanics, or hold jobs that involve tasks including grinding, sanding or exposure to toxic chemicals are required to participate in regular medical screenings for vision, hearing, respiratory, toxicology and radiation.
Williams said there are approximately 30,000 federal technicians in the Army National Guard and one occupational health nurse for every state and U.S. territory. The nurses ensure medical screenings are performed annually by focusing on identifying and investigating possible changes in an employee’s health.
“The difference between occupational health and going to a doctor or health care provider is that we don’t provide health care at all,” said Williams. “We look for changes in a Soldier’s health and compare their tests each year to baselines. We then determine if there are any significant changes that need to be investigated and work to identify and reduce any hazards found.”
While serving as the Idaho Army National Guard’s occupational health nurse, Williams helped the organization lead the way in a variety of risk reduction measures, making Idaho the first state to eliminate lead hazards from former indoor firing ranges and twice achieving 100% on Army National Guard Safety Development and Assessment Program inspections.
In 2010, Williams left Idaho for three years to serve as the chief occupational health nurse for the National Guard Bureau in Virginia. During that time, she also earned her board certification as a certified occupational health nurse-specialist from the American Board for Occupational Health Nurses in 2013.
Williams said that although the certification was encouraged by the Army National Guard for occupational health nurses, she was only the sixth Guardsman to certify as a COHN-S at the time.
“Having a special certification is kind of a rare thing,” said Williams. “A lot of professionals don’t get the certification within their specialty because of time, resources, money and having to maintain it.”
To earn an initial certification license, nurses must have 3,000 continuing nurse units and pass a difficult board exam, Williams said. Then to maintain their license, nurses have to earn 50 additional specialty continuing nurse units every five years in addition to paying annual renewal fees.
Once certified, COHN-S are considered experts in their specialty and focus on employee workplace hazards, medical surveillance, return-to-work and remediation or prevention of workplace hazards, with emphasis on toxicology.
“Earning my board certification has enabled me the opportunity to provide better occupational health outcomes through the National Guard and the Idaho National Guard,” said Williams.
While at NGB, Williams was able to secure $5 million dollars from Congress for the national occupational health program to fund medical surveillance requirements and assisting in the production of a National Guard policy for state occupational health programs to meet OSHA requirements in preventive medicine.
“The policy and resources I helped to acquire are what make it less of a fight for our occupational health nurses to provide these requirements to the more than 30,000 federal technicians we serve in all our states and territories so we can continue to train and fight our missions.”
The lady with the lamp
Whether working at a nursing home in high school or as the chief occupational health nurse at the NGB, Williams said she always strives to give back to the community and provide the highest level of care she can.
“In the nursing community we have a common health belief modeled after Florence Nightingale to do whatever you can to bring health to the environment to which you are working, whether that be sunlight, cleanliness, compassion or advocating for your patients,” said Williams.
Nightingale was a British nurse whose work reformed health care during the Crimean War and into the 20th century. She later became known as the founder of modern nursing and “the Lady with the Lamp” after lowering death rates at Scutari hospital in Constantinople by two-thirds in the 1850s.
At the time, more Soldiers died there from infectious diseases than from injuries sustained in battle. Nightingale started her work by providing Soldiers with sunlight and clean water. She then spent the next four years improving hospital conditions and health care standards. She even worked into the night, traveling dark hallways by lamp while tending to patients and earning the name “the Lady with the Lamp.”
“Her philosophy has always resonated with me and I’ve kept that close to my heart,” said Williams. “Being an Army nurse, I further associate with her because our job is to provide our patients better health and keep our Soldiers in the fight.”
The World Health Organization designated 2020 the "International Year of the Nurse and Nurse Midwife" in honor of the 200th birthday of Nightingale. Since the COVID-19 pandemic, the WHO has extended the "Year of the Nurse" into 2021.