Nursing is a constantly changing profession. While the nature of nursing employment has stayed relatively similar over the years, nurses are nevertheless at risk in the workplace (Cherry & Jacob, 2016). These dangers have both immediate and long-term consequences on nurses' health. According to McCaughey, DelliFraine, McGhan, and Bruning (2013), there are 6.5 work-related injuries and illnesses for every 100 employees in the healthcare context. Furthermore, the study found that nurses lose nearly 16.5 million hours every year due to disease and injury (McCaughey et al., 2013). The enormous amounts of hours lost annually translate to the loss of full-time nursing positions across the globe despite the chronic shortage of nursing staff. It creates a burden on the health care system which emphasizes the need to improve the working environment for nurses to avert the detrimental effects that it has on the delivery of quality patient care. Besides, this is oblivious to the fact that the future of the health care system lies in the safety, health, and well-being of healthcare professionals (McCaughey, McGhan, Walsh, Rathert, & Belue, 2014). A healthy work environment creates a culture of safety which is paramount in ensuring efficient patient-centered health care delivery (McCaughey et al., 2013). This paper focuses on the major hazards facing nurses in the workplace, their impacts, and future implications. Also, possible interventions are presented as well as their pros and cons.
Nurses are exposed to hazards ranging from infectious diseases, musculoskeletal injuries, sharps injuries, dangerous drugs and chemicals, radiation, workplace violence, etc. (Cherry & Jacob, 2016). The close and prolonged contact with patient predisposes nurses to potentially infective organisms. These can be transmitted through various ways such as the air, hand to hand transmission or even blood borne diseases (McCaughey et al., 2013). Injuries through needle stick pricks are also common, especially in surgical settings. These injuries predispose them to occupationally acquired diseases (McCaughey et al., 2014). Hazardous chemicals that nurses are exposed to range from disinfectants, sterilants, anesthetic gasses, latex and medications such as antineoplastic drugs (Cherry & Jacob, 2016). Nurses are also exposed to ionizing radiation which has detrimental effects on their health. Laser beams or inhalation of smoke produced by laser machines is also a potential hazard to their health. Increased physical demands among nurses expose them to musculoskeletal injuries and disorders (MSDs). Tasks such as heavy lifting, twisting and bending are highly physically demanding situations and as such, predispose nurses to MSDs (McCaughey et al., 2014). Workplace violence cannot be understated. Nurses at the emergency department especially are faced by the hazard of assault by patients or their families (Farrell & Shafiei, 2012). Most of the cases of violence, however, are unreported. Extended work days and stress on the job are also hazards that face nurses in the workplace (Cherry & Jacob, 2016).
Hazards experienced by nurses in the workplace have significant impacts in their nursing practice. Long working hours and shift work are associated with the disruption of the circadian rhythm (McCaughey et al., 2013). An interruption in the circadian rhythm results in a reduction in the quality and quantity of sleep. Deprivation of sleep is associated with a decreased efficiency of service delivery to the patients (McCaughey et al., 2013). There is a reduction in the amount of time spent with family and friends which consequently results in stress-associated physiological responses. McCaughey et al., (2013) showed that there exists a link between job stress and destructive activities such as smoking and alcohol consumption. Long working hours also reduce the amount of time that could have otherwise been used for activities such as exercise. Shift work is also associated with gastrointestinal complaints besides other psychological complaints such as depression and mood disorders (Cherry & Jacob, 2016). MSDs are costly regarding medical costs, disability and turnover. MSDs are associated with myalgia which further reduced the quality of sleep and consequently leads to effects of sleep deprivation (McCaughey et al., 2013). Exposure to hazardous chemicals poses serious risks. For example, glutaraldehyde, a sterilant common in medical settings is associated with eye irritation and occupational asthma. In a review to establish the effects of glutaraldehyde on health, almost all cases of occupational asthma were found in nurses serving in the endoscopy unit (McCaughey et al., 2013). Others such as formaldehyde have been shown to be carcinogenic. Volatile organic compounds such as artificial fragrances predispose nurses to allergic reactions. Some sterilants have been associated with irritation of the skin and dermatoses. There has been a reported increased risk of spontaneous abortion in health care workers exposed to antineoplastic drugs (McCaughey et al., 2014). Natural proteins found in latex have been shown to cause allergy among health care workers. McCaughey et al., (2013) reported an annual incidence rate of 4 cases of allergy for every 2000 full-time workers. Workplace violence results in lost workdays besides the physical or emotional trauma inflicted on the nurse (Farrell & Shafiei, 2012).
Various interventions can help to curb the hazards that are experienced by nurses in the workplace. They are, however, laden with their strengths and weaknesses. To cope with long working hours where inevitable, new work schedules should be designed in addition to the creation of rest breaks in the course of work (McCaughey et al., 2014). Nurses can take naps during work to help rejuvenate their energies and improve their alertness (Cherry & Jacob, 2016). This approach, however, needs to have proper policies outlining the maximum length and period during which one can take a nap to improve the efficiency. Also, there is the need for an ideal environment at work which is conducive for one to take a nap (Cherry & Jacob, 2016). Equipment and devices for handling patients such as the electric bed that are height-adjustable can be used to reduce MSDs associated with patient handling (McCaughey et al., 2014). They enhance safe lifting procedures to reduce physical exertion. However, these devices are expensive, and it might prove costly to purchase a piece of equipment for each and every risk identified (Cherry & Jacob, 2016). Also, competency if every nurse must be ensured before the use of these devices which may consume more time than manual means of doing the same. In cases where the machines are not available, patient lift teams may be used the risks of MSDs (McCaughey et al., 2014). However, the logistics of providing a lift teams to a whole hospital throughout the year may not only be costly but unfeasible (Cherry & Jacob, 2016). Besides, lift teams tackle the problem of patient lifting while disregarding other critically cumbersome tasks such as repositioning, bathing, and toileting. Safer needle devices may be used to prevent needlestick injuries (Cherry & Jacob, 2016). Safety syringes have been reported to reduce the rate of injuries as well as the probability of acquiring infections from accidental pricks. They have not however been adequately tested and as such, may not be fail-safe. Besides, only a few of them are in use as they are much more costly that conventional needles. Safer alternatives to the hospital chemicals should be sought to reduce the harmful exposure to chemicals (Cherry & Jacob, 2016). It will reduce the occupational effects associated with chemicals exposure. However, complete elimination may prove impossible in some cases. Besides, it might prove costly to engineer ventilated systems to curb volatile chemicals. Nitrile synthetic gloves, a substitute for latex gloves, may not be available in all states (Cherry & Jacob, 2016). Nurses can be trained on how to handle aggressive patients to mitigate the risk of aggressive patients. There is however little evidence of the efficiency this training. Enhancing workplace security comes in handy in preventing assaults in the workplace (Farrell & Shafiei, 2012). There is a misconception however that administrators consider assault as part of the job especially in mental-health hospitals (Farrell & Shafiei, 2012). This may curtail efforts to reduce workplace violence.
The institution of all-rounded no-lift policies, administrative policies regarding workplace violence, and advocacy for safe medical equipment and chemicals is crucial in tackling this menace of workplace hazards. The all-rounded policies should be followed by an administrative enforcement to enhance the implementation of the measures contained in the systems. In this way, there will be a safe and healthy working environment for all health workers, and especially nurses, which in return, enhances compassionate patient care with little or no possibility of injury to the nurse. There is a need for more research on safety and health issues concerning nurses in the workplace to enhance the already available evidence-based findings on the prevalence and possible interventions of these matters. Stronger evaluation designs coupled with conceptual and theoretical models are necessary to aid research in this field. The benefits of improving nurses' safety will not only help the nurses but will also lead to a more productive workforce that ultimately, is beneficial to the patient.
References
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.
Farrell, G. A., & Shafiei, T. (2012). Workplace aggression, including bullying in nursing and midwifery: a descriptive survey (the SWAB study). International journal of nursing studies, 49(11), 1423-1431.
McCaughey, D., McGhan, G., Walsh, E. M., Rathert, C., & Belue, R. (2014). The relationship of positive work environments and workplace injury: Evidence from the National Nursing Assistant Survey. Health care management review, 39(1), 75-88.
McCaughey, D., DelliFraine, J. L., McGhan, G., & Bruning, N. S. (2013). The negative effects of workplace injury and illness on workplace safety climate perceptions and health care worker outcomes. Safety science, 51(1), 138-147.
Weaver, M. D., Wang, H. E., Fairbanks, R. J., & Patterson, D. (2012). The association between EMS workplace safety culture and safety outcomes. Prehospital emergency care, 16(1), 43-52.
