Nurses need to be aware that their profession can be risky and take steps to protect themselves from workplace health hazards.
If that statement seems a little overdramatic, consider: According to the U.S. Bureau of Labor Statistics (BLS), 12 out of every 100 nursing and residential care facility full-time workers suffered an injury or illness in 2015.
That was the second-highest rate among all industries, government or private. Only aquaculture, with its near-constant exposure to wet surfaces, electrical equipment and heavy loads to lift, had a higher incidence rate of injury (13.6 per 100 workers).
Nurses might not need to worry about getting bitten by sharp-toothed fish, but the health hazards they do face are serious and, in some cases, virtually unavoidable.
In response to the high rate of nursing injuries and illnesses reported by the BLS in 2015, the Occupational Safety and Health Administration (OSHA) issued a memo that attempted to identify the major health hazards threatening the well-being of nurses in the U.S. The five main areas the memo focused on were:
- Musculoskeletal disorders related to handling patients
- Workplace violence
- Bloodborne pathogens
- Slips, trips and falls
Listed below our health and safety knowledge quiz are some of the most prevalent health threats and risks that nurses face on the job, along with suggestions from OSHA, the Centers for Disease Control (CDC), the Occupational Health Safety Network (OHSN) and the American Nurses Association (ANA) on how to limit risks and avoid serious injury.
Test your health and safety knowledge:
Musculoskeletal injuries – The CDC reported in 2015 that 44% of all reported injuries in the healthcare industry resulted from overexertion, which taxes the muscles, joints, tendons and ligaments. Strains and sprains and other relatively minor acute injuries can cost workers days on the job, but the real problem occurs over time – wear and tear on the spine, knees and hips can result in chronic injury that not only causes pain, but also can limit a nurse’s ability to do his or her job.
Another risk factor in musculoskeletal injury is patient handling, or lifting and/or transferring patients. In response to OSHA’s 2015 memo, Debbie Dawson Hatmaker, the executive director of the ANA, said that her organization endorsed a federal ergonomic standard and opposed all manual lifting and moving of patients by nurses.
OSHA suggests using only mechanical lifting machinery to safely move patients, if possible, and maintaining proper posture and body mechanics when manual lifting is unavoidable. Nurses also should be mindful of their shoes, which should provide plenty of arch support and feature a slip-resistant sole.
Violence – Nurses are exposed to the potential occupational violence, no matter if the workplace is a hospital, a clinic, a resident facility or a patient’s home. The CDC suggests that home healthcare workers participate in violence-prevention training and report all physical assaults, verbal incidents or other threats to their employers. Bottom line: If you feel threatened, leave immediately.
Slips, Trips and Falls – In addition to wearing comfortable, slip-resistant shoes, nurses should remain aware of their immediate surroundings to avoid slipping, tripping or falling. According to the CDC, slips, trips and falls are the second-most prevalent cause of injuries among healthcare workers.
To reduce “STF” incidents, the OHSN suggests that hospitals and other healthcare facilities devise and implement a comprehensive STF program that trains workers to recognize and mitigate the major STF hazards, such as contaminants on the floor, poor drainage for water pipes and drains, irregularities with the walking surfaces, inadequate lighting and more.
Infectious Agents and Chemical Hazards
“Sharps” injuries – OSHA estimates that one-third of injuries related to sharp objects such as needles and blades occur during disposal. Nurses are injured by needles more often than other healthcare workers, so they must be particularly vigilant around “sharps.”
All nurses should become familiar with “sharps” safety procedures and follow them diligently. In addition, medical facilities can consider using safety devices such as blunt-tip surgical needles to reduce the risk of inadvertent puncture.
Bloodborne pathogens – Related to needle sticks is the risk of becoming infected by pathogens passed on by patients. Needles can transmit bloodborne conditions such as HIV, hepatitis B (HBV) or hepatitis C (HCV), and nurses should report potential exposure immediately.
In the wake of a puncture incident, it is vital to identify any patients who might have used the needles to determine whether they could be a source for a bloodborne pathogen. OSHA mandates that employers provide an evaluating healthcare profession’s written opinion on what treatment steps should be taken, if any.
Transmittable diseases – Nurses should take steps to limit their exposure to infectious agents that cause illnesses such as tuberculosis, influenza and MRSA (methicillin-resistant Staphylococcus aureus). Vaccines and immunizations should be kept up to date and personal protective equipment should be worn when applicable.
In addition, healthcare facilities must be well-ventilated to ensure optimum infection control.
Job pressure – Work overload is one of the major causes of workplace stress among nurses, according to the National Institute for Occupational Safety and Health. Nurses might face a lack of task control or even ambiguity about their roles within an organization.
Shift work, inadequate staffing levels, potential physical injury and illness and a lack of social support on the job make nursing an emotionally demanding profession. All of this, in addition to long hours and the high stakes of any healthcare job, can lead to irritability, job dissatisfaction, headaches, blood pressure spikes and other potentially troublesome health issues.
Emotional distress – Nurses often are subjected to traumatic events, and this can lead to post-traumatic stress disorder (PTSD). Employers need to be aware of the risks of PTSD and provide support where possible.
One way to help nurses cope with high levels of stress on the job is to clearly define roles and responsibilities. Another way organizations can help is ensure a nurse’s workload is reasonable and within the capabilities of the individual.
Sleep deprivation – In 2015, the CDC initiated an online course for nurses and nursing managers to explain the health and safety risks of long hours and shift work. The course warns that working tired can result in a decline of cognitive function, poor health behaviors (smoking, overeating) and other short- and long-term health problems.
Current research shows that shift workers, whose sleep habits might be irregular or disrupted, are at greater risk for cardiovascular disease, gastrointestinal disorders, cancer, psychological disorders and other health issues.
In order to ensure healthy sleep habits, nurses should be aware of “sleep debt” and the circadian effect. The amount of sleep necessary varies from person to person – usually seven or eight hours per night. If a person sleeps less than needed for several days in a row, he or she accumulates “sleep debt” that can cause drowsiness and other sleep-deprivation symptoms throughout the day.
People are attuned to night-time sleeping, in general. Individuals develop personal circadian rhythms, which according to the CDC are “biophysical, physiological, behavioral processes of living beings” that interact with the sleep drive to determine when a person needs to go to sleep and wake up.
Nurses who ignore their circadian rhythms risk fatigue, which can lead to on-the-job errors and other problems.