INTRODUCTION:

Occupational hazards have a deleterious effect on the individuals health and safety as well as organizational effectiveness. The term occupational safety describes a comprehensive concept for the protection of employees from health risks in the workplace, which results from the job related activity itself and from biological and physical effects. Nurses have mastered of anticipating and attending to the physical and emotional needs of others. However, nurses tend to forget how to take care of themselves and each other.

Aspects of Occupational Safety:

The occupational safety issues may broadly be studied under two headings viz. Physical and psychological aspects.

A. Physical Aspects:

Physical aspects of occupational health related to the occupational environment and include injuries, accidents, ergonomic problems, physical hazards, chemical substances, communicable disease and violence in the workplace.

I. Injuries and accidents:

It is the most common physical hazard in the nursing work environment. The injuries and accidents can be due to many factors:

Needle stick injuries:

These injuries pose physical and emotional threats to healthcare workers such as hepatitis B, C virus and HIV. Occupational safety and health administration USA has issued a standard on blood borne pathogens which requires (a) Hep B virus vaccination for all health care workers (b) Implementation of universal precaution and (c) Prevention of dangerous exposure to blood, body fluid by correctly putting on, using and removing personal protective equipment like gloves, mask with goggles, face shield and gown.

Latex Allergy:

It is reaction (skin rash, hives, flushing, itching, nasal, eye or sinus symptoms, asthma and shock.) to certain protein in latex rubber when workers change gloves; the protein/powder particles become air borne and can be inhaled. Use non latex gloves and powder free gloves with reduced protein content, after removing latex gloves wash hands with a mild soap and dry thoroughly.

Bladder Health:

This problem arises when nurses suppress the desire to void during working hours due to high patient loads, heavy demands, long working days. Maintenance of good bladder health is important and possible through drinking 6-8 glasses of water daily, voiding every 3-4 hourly.

Others:

Other instances of accidents and injury include falls back injury in wet floor, bed making, lifting, lack of personal safety equipment leading to hand foot injuries and assaults by patients.

2. Ergonomic problems:

The chief problem relating to ergonomics in nursing is the musculoskeletal work related disorders (back injuries, neck, shoulder, arm, wrist, and knee disorder) Low back pain is a present problem in the population of nurses.

3. Physical hazards:

Physical factors which have adverse effect on health like heat, cold, humidity, light, noise, vibration, ionizing radiation and radiation hazards will cause leukemia, cancer, malformation, sterility and death.

4. Chemical Substance:

Volatile anesthetics in OR/OT cause spontaneous abortion, congenital anomalies, carcinoma, hepatic and renal problems. Formalin used in haemodialysis unit can cause inhalational formalin asthma.

5. Communicable Diseases:

National institute of occupational safety and health (NIOSH) recognise that occupational exposures for tuberculosis, SARS, influenza are common among health care workers. Respiratory protection involves preventing exposure to communicable agents through proper donning, isolation.

6. Violence in the workplace (Lateral violence and inter-personal conflict):

It is nurses directing their dissatisfaction toward each other and towards themselves.

B. Psychological Aspect:

It is now almost universally recognize that nursing is by its very nature, a stressful occupation. Stress can be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, recourses, or needs of the worker. Job stress has been linked with CV disease, musculoskeletal disorders, depression and burnout

McVicar (2003) reviewed literature and identified shift working, lack of reward, workload, staffing, role conflict, role ambiguity, meeting emotional needs of the patient, leadership style and professional conflict as the main sources of stress on nurses.

The primary sources of stress is hospital itself. The stressors can be studied under the following classification (i) Task stressors-which are related to general job task. (ii) Relationship stressors-which are caused by relationship with co-workers, supervisors and physicians (iii) System stressors-Which are concerned with workload and scheduling, and scheduling and facility design and maintenance.

Consequences of Stress:

When the stress response is elicited too intensely or too often, the individuals is unable to rapidly dissipate the effects of stress response and result is individual distress. They are reflected in physiological, psychological and behavioural outcomes.

Strategy for Stress Management:

Legislation in India

The Factories Act, 1948 provides for the health, safety and welfare of the workers. It has provision regarding carrying loads, working hours and holidays.

The Employees State Insurance Act, 1948 is another measure of social security and health insurance in our country.

Role of TNAI:

Ministry of Health and Family Welfare has given top priority to resolution in nursing and nursing profession adopted by TNAI council, which related to nurse patient ratio and staffing pattern, inclusion of nursing staff in planning and decision-making committees, improving working conditions of nurses, conducting staff development programmes and develop skill among student nurses (ICN 2006).

Organizational Level State:

These include prevention of stress, risk assessment and risk management by various approaches.

Stress Management Intervention Programmes (SMI):

It is defined as an activity programme or opportunity initiated an organization which focuses on reducing the presence of work related stressors or on assisting individual to minimize the negative outcomes of exposure to these stressors. They are physical health and emotional health.

Physical health:

Stress management interventions for improving physical health include relaxation, exercise, biofeedback and nutritional counseling CAM-complementary and alternative medicine.

Emotional health: The interventions at this level are cognitive or behavioural approaches what attempt to change stress related thoughts feelings and actions.

These include:

(a) cognitive restructuring such as rational -emotive therapy, self instructional training and structural psychotherapy; (b) coping skill therapies-problem focused coping strategies such as confronting, seeking social support and painful problem solving. Emotion-focused focused coping strategies include self controlling, distancing, positively reappraising, accepting responsibility, escaping/avoiding. (c) Problem solving therapies-These are a combination of cognitive restructuring and coping skill therapies. (Stephen 1994).

RECOMMENDATIONS:

(a) The nurse administrative has to implement the universal precautions, protective personnel equipment and compulsory HBV vaccination, needleless delivery system and non latex gloves, periodic breaks, safe working environment and safe patient lifting devices or lifting teams (b) Improving shift work schedule by avoiding permanent night shift, avoiding quick shift changes and planning some free weekends (c) Nurses must be given opportunity to discuss their problems at periodically with colleagues, supervisors, administrators and counselors.

Nurse administrators should provide a Stress Work Environment. Nursing control over the practice environment. Effective communication not only improves the quality of care and patient outcome but also nurses own health status and quality of life. (b) To set up stress management centre which has the components of massage table, computerized stress assessment, a VCR and monitor, a stereo system, a reclining launch chair and an extensive audio, video and text lending library. (c) To do a stress audit which identifies the stressors, psychological and physical health symptoms, high risk groups, predictors of stressor outcomes and finally to make recommendations for future actions. (Valerie et al. 1993)

IMPLICATIONS:

The nurse administrator has to implement the universal precautions, protective personal equipment and compulsory HBV vaccinations, needleless delivery system and vaccinations, non latex gloves, periodic breaks, safe working environment and safe patient lifting device or team. She should insist on practicing proper body technique to prevent muscular skeletal disorders. Occupational safety included as special subject in nursing curriculum. Conducting research on physical and psychological aspects of occupational safety and stress is yet another area.

CONCLUSIONS:

Organizations must consider what they can do to eliminate occupational physical problems, workplace stressors. This will necessarily result in improved well-being of the individual as well as increased effectiveness of the organization. Finally, the quote from philosopher Reinhold Niebuhr may help individuals to face stress effectively”. Grant me the courage to change the things I can change, the serenity to accept those that I cannot change and the wisdom to know the difference.”

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Received on 04.08.2020 Modified on 10.10.2020

Int. J. Nur. Edu. and Research. 2021; 9(3):370-372.

DOI: 10.52711/2454-2660.2021.00086