Category Archives: Work environment
Health care may have some of the nation’s most promising career opportunities. But it also promises a lot of stress to go along with those jobs, according to a survey from CareerBuilder and its health-care-focused website.
Health care workers topped the list of most stressed workers in the United States, with 69 percent reporting that they feel stress in their current jobs. Next are workers in professional and business services, retail, financial services, information technology, leisure and hospitality, and manufacturing. Health care also had the highest percentage (17) of workers reporting that they are “highly stressed.”
“Stress is part of the environment in many health care settings, but high levels sustained over a long period of time can be a major detriment to employee health and ultimately stand in the way of providing quality care to patients,” CareerBuilder Healthcare President Jason Lovelace said in a news release.
Human Capital Blog: How does your study differ from previous research exploring the link between adverse working conditions and depression?
Sarah Burgard: The main contribution of this study was in the way we measured working conditions. Most studies that have looked at adverse working conditions and depression, or other measures of health, have looked at one adverse working condition at a time, such as job strain, job insecurity, or job dissatisfaction. But every job comes with a whole package of working conditions. We felt that capturing multiple indicators at the same time might give us a truer sense of the size, the magnitude, and the power of the association between work and depression.
Also, while some previous studies relied on longitudinal data that included multiple interviews with workers over time, they often excluded workers who did not participate in every interview because those workers didn’t have a measure of the focal working condition at every possible interview. That’s a problem because people who have worse jobs are probably more likely to drop out of longitudinal studies or leave work. Our approach was different; we analyzed data from everyone who participated in at least one interview, using all possible working conditions measure collected at each wave. We created an “overall working conditions score” at each wave using item response theory models. As a result, were able to get a more representative picture.
In a survey of more than 31,000 U.S. physicians for Medscape’s 2014 Physician Lifestyle Report, dermatologists emerged as the specialists who are happiest both at home and at work. Seventy percent of dermatologists said they are very to extremely happy at home, slightly behind ophthalmologists. But at 53 percent, dermatologists topped the list by a considerable margin in reporting a high level of happiness at work.
Among the least happy specialists are family and emergency medicine physicians, with only 36 percent reporting great happiness at work, followed at 37 percent by internists and radiologists.
U.S. hospitals recorded 250,000 work-related injuries and illnesses in 2012, according to the Occupational Safety and Health Administration (OSHA), and workers’ compensation expenses now reach $2 billion annually for hospitals. Lifting and moving patients, workplace violence, slips and falls, exposure to chemicals and hazardous drugs, exposure to infectious diseases, and needlesticks are among the serious hazards hospital workers face.
Fact books, self-assessments, and best practice guides are among the materials OSHA has assembled in a new Web resource, www.osha.gov/hospitals, designed to help hospitals prevent worker injuries, assess workplace safety needs, enhance safe patient handling programs, and implement safety and health management systems.
This is part of the January 2014 issue of Sharing Nursing’s Knowledge.
Hush!!! Testing nurse-designed noise-reduction strategies for hospital wards
A common complaint of hospital patients is that just when their bodies need it the most, they can't get a good night's sleep because of noise and interruptions. A new initiative of three nurses at Beth Israel Deaconess Medical Center in Boston takes direct aim at the problem.
In response to patient satisfaction surveys that highlighted the problem of nighttime noise, Gina Murphy, BSN, RN, Anissa Bernardo, LCSW, and Joanne Dalton, PhD, RN, studied existing literature on the topic, developed a program they call Quiet at Night, and tested it on a 44-bed medical-surgical unit. The program includes a number of strategies for reducing noise, including closing doors at night when medically appropriate, supplying earplugs to patients, keeping patients by themselves in semi-private rooms when the census permits, using mini-flashlights when performing overnight checks to avoid turning on the lights, performing change-of-shift conversations in the break room rather than in hallways or at the nurses' station, providing headphones to patients who need the television on at night, and using beep-free keypads on doors. In addition, after 9 p.m., they implemented a number of “quiet hours” practices, including dimming lights, turning pagers to vibrate, avoiding overhead pages and hallway conversations, and more.
After implementing the strategies, the trio compared before and after surveys. In the three survey periods before the program, 43 to 47 percent of patients reported that their rooms were “always” quiet at night. After the program was in place, that jumped to 60 percent, which is the goal the nurses had set.
Historically, the United States has relied on the recruitment of foreign-educated nurses (FENs) to fill gaps caused by widespread nursing shortages. Yet many FENs face unequal treatment on the job, according to a new study by researchers at the George Washington University School of Public Health and Health Services (SPHHS).
Forty percent of FENs, defined in the study as immigrants who are in the United States to work in hospitals and other health care facilities, say their wages, benefits, or shift assignments are inferior to those of their U.S.-born colleagues. The findings, which appear in the January issue of the American Journal of Nursing, suggest that FENs recruited by staffing agencies and from impoverished countries are especially vulnerable to potentially discriminatory treatment.
Lead author Patricia Pittman, PhD, an associate professor of health policy at SPHHS, called the findings “alarming” in a news release. Pittman added that “if confirmed by additional research, this survey raises a host of troubling ethical and practical concerns for health care facilities working to retain nursing staff and provide high-quality care to patients.”
This is part of the November 2013 issue of Sharing Nursing's Knowledge.
Creating Healthy Workspaces for Older Nurses
The nursing workforce is aging, in part because the nation's economic difficulties have prompted some nurses to delay retirement. A new literature review by Jaynelle Stichler, DNSc, NEA-BC, FACHE, of the San Diego State University School of Nursing, examines ways hospital work environments might be fine-tuned to help older nurses navigate the health challenges associated with their physically demanding work. The article was published online on October 17 by the Journal of Nursing Management.
Noting that Centers for Disease Control & Prevention data indicate that older workers' on-the-job injuries tend to be more severe than those suffered by younger workers, Stichler offers recommendations culled from 25 separate studies conducted since 2002. They include:
- Ergonomic seating and countertops with the correct height for charting tables, and adequate space for keyboards, in order to prevent strains caused by working in improper body positions;
- Adequate lighting and non-slip floor surfaces to reduce the risk of falling;
- Decentralized linen, equipment, and supply storage in or near patient rooms, and decentralized nursing stations, in order to diminish walking distances;
- Electrical and medical gas outlets placed on either side of the patients' beds and at an easily accessible height, rather than behind or above the head of the bed, so that nurses won't have to strain to plug in equipment;
- Enhanced task lighting options over beds or on swing arms to ease eye strain and help nurses with visual acuity problems; and
- Barrier-free patient bathroom and shower designs, with floor drains and shower curtains, so nurses needn't use towels to mop up water.
Seth M. Holmes, PhD, MD, is an alumnus of the Robert Wood Johnson Foundation Health & Society Scholars program and an assistant professor of public health and medical anthropology at the University of California, Berkeley. The following is an excerpt from his recently published book, Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States.
“The first Triqui picker whom I met when I visited the Skagit Valley was Abelino, a thirty-five-year-old father of four. He, his wife, Abelina, and their children lived together in a small shack near me in the labor camp farthest from the main road. During one conversation over homemade tacos in his shack, Abelino explained in Spanish why Triqui people have to leave their hometowns in Mexico.
In Oaxaca, there’s no work for us. There’s no work. There’s nothing. When there’s no money, you don’t know what to do. And shoes, you can’t get any. A shoe like this [pointing to his tennis shoes] costs about 300 Mexican pesos. You have to work two weeks to buy a pair of shoes. A pair of pants costs 300 Mexican pesos. It’s difficult. We come here and it is a little better, but you still suffer in the work. Moving to another place is also difficult. Coming here with the family and moving around to different places, we suffer. The children miss their classes and don’t learn well. Because of this, we want to stay here only for a season with [legal immigration] permission and let the children study in Mexico. Do we have to migrate to survive? Yes, we do.
This is part of the October 2013 issue of Sharing Nursing's Knowledge.
“It’s not like it’s an Olympic medal or anything. But it’s definitely a huge milestone in my life … Ideally, I want to work in a hospital setting, maybe in acute care or in a trauma unit. It’s that whole team approach to medicine, nurses and doctors working together, that I find attractive. I think some of being a hockey captain, being on a team, asked to be a leader, plays into all that. It’s where I think I can help people most.”
-- Jim Ennis, Ex-Hockey Player Starts New Life as Nurse, Boston Globe, September 22, 2013
“Recently, I cared for two patients who touched me so deeply it was impossible to maintain a professional distance. My grandfather had recently passed away, and both of these men reminded me of him … Watching them leave was like letting go of my grandfather again, but they also gave me the gifts of laughter and reminiscence, right when I needed them most. I know that, ultimately, I am still just the nurse, and they are still just my patients. But I think it’s better for both the patients and myself if we both sometimes allow ourselves to feel something more than a professional bond. Nurses and patients move in and out of each others’ lives so quickly, but we are nonetheless changed by every encounter. I became a nurse because I want to care for people and make a difference. Being touched in return is an added bonus.”
-- Sarah Horstmann, RN, When Nurses Bond With Their Patients, New York Times Well Blog, September 13, 2013
This is part of the October 2013 issue of Sharing Nursing's Knowledge.
Modeling Poor Infection-Prevention for Nursing Students
Clinical practice is a critical part of nursing students’ education, a chance to learn by watching and working alongside trained professionals in a real-world setting. But a new study from Great Britain suggests that in at least one important area of care, students could pick up some bad habits along the way.
An online survey of student nurses, conducted by researchers at Cardiff University and City University, London, found that all 488 respondents had witnessed lapses in infection-prevention and -control practices during their clinical practicums. According to the study, “Over 75 percent reported witnessing failure to cleanse hands between patient contacts, 61.2 percent reported health workers wearing rings (in addition to wedding bands), and 60 percent reported health workers wearing painted nails or nail extensions. Failure to comply with isolation precautions, poor standards of cleaning in the near patient environment, not changing personal protective equipment between patients, and poor management of sharp instruments had each been witnessed by over half the sample.” The researchers conclude, “The study findings indicate that ensuring safe infection control practice remains a challenge in the United Kingdom despite its high priority.”