A full 25% of preventable accidents in the workplace involve slips, trips, and falls.
It was a crisp February morning as Geoff (named changed for privacy) raced to his unit, his mind buzzing faster than usual from his Frappuccino-induced caffeine high. He was eager to start the day, unlike past months on the job. In fact, he was excited. Geoff was still considered a newbie by nursing standards, but he wasn’t naïve’. No, anything but. He was second generation nursing. He came to the profession with a set of high expectations and an abundance of fears. His Mom had been injured on the job, and he intended to avoid a similar fate. As a result, he had requested (and received) notice he was being sent to a seminar on prevention of workplace accidents.
Geoff couldn’t wait! Today was the first day and he was ready.
What Geoff was about to learn was that workplace injuries make hospitals and the nursing profession one of the most dangerous jobs in the country, worse than driving a forklift! In fact, according to the Occupational Health and Safety Administration (OSHA), hospitals may be “uncommonly dangerous places to work.” Nurses may encounter a variety of potential workplace injuries from overexertion to slips, trips, or falls, to contact with harmful objects (including sharps and microbes) to workplace violence, contact with potentially unsafe chemicals, or a myriad of other causes. It’s enough to make any nurse quite anxious.
To decrease worker and financial burden of musculoskeletal injuries, many facilities have shifted to “no-lift” or minimal lifting policies. Musculoskeletal injuries are not only the #1 cause of hospital injuries, but they also tend to be cumulative, leading to repetitive risk during patient handling tasks. Figures for the year 2011 (the last detailed worker safety study on osha.gov) estimated the annual Workmen’s Compensation claims related to injured hospital workers at $2 billion annually, and that is only the claims that were reported. Imagine the number of claims that went unreported to supervisors!4
It was also reported that at least 24% of nurses and CNA’s changed shifts or took sick leave to recover from unreported injuries, possibly from fear of reprisal? And at the same time, 8 of every 10 nurses reported working shifts with musculoskeletal pain, as Geoff remembers vividly when his Mom came home from work.4
On the flip side, hospitals that have implemented safe handling programs have seen incredible results in preventing worker accidents and injuries. For example, a small hospital in South Carolina “cut turnover of older nurses by 48% and saved $170,000” on associated costs. Another hospital instituted mechanical lifting equipment and reduced patient handling injuries by 65%, as well as significantly reducing similar costs. Such programs not only reduce worker accidents on the job, but they may also save nursing careers and keep nurses at the bedside for years of valued expertise.4
However, as Geoff was about to learn, implementing a program is only half the story. Equipment needs to be available to nursing staff, and it needs to fit easily into the workflow and be manageable for nurses to use. If nurses must share equipment, or it is cumbersome to assemble, or difficult to maneuver, they might not utilize it, defeating the purpose of the program.
Exposure to bloodborne pathogens remains a high-risk incident that can occur in the workplace for those in healthcare. OSHA estimates this risk at 5.6 million out of roughly 12.2 million workers, including needlesticks and splashes. Not enough workers take specific precautions at the bedside, especially related to the use of eyewear during procedures where splash might occur. Workers need to remember patients may be positive for Hepatitis C and be completely asymptomatic and/or unaware they have the disease.2
A full 25% of preventable accidents in the workplace involve slips, trips, and falls. Although patients will invariably spill liquids from their food trays, the Nurse/CNA needs to know what the institutions’ policy is regarding Housekeeping and spills. Minor spills can probably be mopped up safely in the room with a cloth, but spills should never be left untended while an employee searches for assistance. An Aussie nurse recounts her horrific (and painful) slip when she entered a patient room and landed unmercifully on her back, not knowing the patient had splashed water everywhere on his way to use the facilities! It happens, but as nurses, we know better. We should stay to warn the next nurse until the surface is safe and dry once more.1
One of the newest “accidents” for healthcare workers has been causing many to permanently leave the bedside, and that is the unfortunate problem of contact dermatitis. Nurses/CNA’s cannot avoid rigid skin hygiene practices that are required to take care of patients in hospitals, but they are suffering as a result. A study from the University of Manchester determined that healthcare workers are 4.5 times more likely to suffer moderate to severe skin damage as opposed to non-healthcare workers. Leaders need to be proactive at finding solutions to preserve the hands and skin of their workforce, whether it is through less irritating cleansers or the ways in which we utilize gloves.2
Workplace violence, while accounting for approximately 9% of worker accidents, has become a national focus, and one that is hauntingly tragic. Nurses are placed in a desperate situation during active shooter alerts, as they run drills that focus on protecting both themselves and patients from harm. It is harder to institute an acronym of run, hide, fight when trying to protect the elderly, fragile, or immobile patients from a crazed individual with a firearm. Consequently, Physicians have taken a more active stance on gun control as gun violence begins to invade the hospital setting. Unfortunately, gun violence has persisted, with four people killed in a recent shooting at Mercy Hospital on the Southside of Chicago on November 19th, 2018.5
By mid-morning, Geoff was overwhelmed, but excited by what he was learning. What he really wanted to absorb was the topic coming after lunch. He was completely enthralled by the idea of working in Occupational Therapy, or perhaps as an associate for OSHA later in his career. He wanted to know how to prevent a crisis if someone delivered a letter with suspected Anthrax or a possible biological agent to the workplace. He yearned to be able to coordinate assistance and be at the forefront of saving lives and preventing a potential biological disaster.3
If such a catastrophic incident were to occur, Geoff learned that OSHA would play a key role in accident prevention according to its National Response Plan. OSHA would work cooperatively with State and Federal employees to perform response, cleanup, and recovery. During all phases of an incident, employers would have primary responsibility for their employees, including first responders and HAZMAT teams. However, only OSHA would have authority to determine when a worksite could be opened to re-occupancy after a disaster.
Follow-up care would be the job of the Occupational Health Nurse, or Safety Officer. Small to medium-size enterprises may not actually have their own Occupational Health Nurse, so nurses might need to travel to receive the necessary support. Occupational assist may include a range of specialties, including physiotherapists, hygienists, psychologists, ergonomic experts and possibly occupational therapists. These experts would decide if/when nurses were ready to return to work or if they needed transfer to another level of physical performance.
Geoff was enthusiastic about everything he had learned. He believed he not only had the skills to avoid many of the most common accidents that befall nurses in the workplace, but he had also learned about the importance of OSHA and Occupational Health in assisting Nurses to be at their best in a potentially dangerous environment. He couldn’t remove the pain and repetitive injury that his mother had suffered during her years on the job, but he hoped to avoid the same mistakes in his career.
Maybe this, he thought, was worth another Frappuccino!
- Ausmed.com “Workplace Injuries in Nursing-Protect Yourself.” Gilkes, M., 2016, Copyright @ Ausmed. 2016.
- Beckerhospitalreview.com “4 Common Nursing Hazards Demanding Hospitals’ Attention.” Gooch, K., July 14th, 2015, Clinical Leadership and Infection Control.
- Concentra.com “10 Tips to Prevent Workplace Injuries.” Page, L, January 2018, Concentra, a division of Select Medical Health Services.
- Osha.gov “Worker Protection: OSHA’s Role to Catastrophic Incidents Guide.” United States Department of Labor. Available via 1-800-321-6742 or www.osha.gov.
- Osha.gov/dsg/hospitals “Worker Safety in Your Hospital.” Bureau of Labor Statistics, 2013.
- Rightpatient.com “6 Most Common Injuries to Healthcare Workers.” Trader, J., December 2016, Guest Blog, Kennell Health.
Information Related to Mercy Hospital Gun Violence and Killings
Wgntv.com “Chicago Police Officer, Doctor, Pharmacy resident dead after Mercy Hospital shooting; gunman killed.” Lowe, M. et al, November 2018.