Page 374 - Encyclopedia of Nursing Research

NuRSING OCCuPATIONAL INJuRy AND STReSS n 341

surfaces during the preparation, recon- patient was the most frequent cause of injury,
stitution, manipulation, administration, at a rate of 47.5 cases per 10,000 workers.
or disposal of treated patient waste or the Physical agent exposure in health care N
hazardous drugs themselves (Connor & settings occurs less frequently. However,
McDiarmid, 2006). radiation exposure has been linked to can-
Although the clinical significance of cer and reproductive toxicity, and eye and
exposure is unclear, evidence indicates that skin damage can result from laser exposure
workers are being exposed to hazardous (Rogers, 2003).
drugs and are experiencing serious health Psychosocial factors such as organiza-
effects despite claims of compliance with cur- tional climate including interpersonal con-
rent work practice guidelines. Sessink and flicts, caring for patients and their worried
Bos (1999) noted that 11 of 12 studies reported or grieving families, shift work, personal
cyclophosphamide in the urine of health issues, and work-related violence can result
care workers, indicating continued exposure in enormous amounts of stress leading to
despite safety precautions. Recent studies burnout, job turnover, and ultimately leav-
continue to show various hazardous drugs ing the profession. In 2001, the American
in workers’ urine, despite supposed compli- Nurses Association conducted a survey of
ance with safe handling procedures (Connor 4,826 nurses from across the united States;
& McDiarmid, 2006; Rogers, 2003). Factors 88% of those responding reported that health
that affect worker exposures include the and safety concerns influenced their deci-
drug-handling circumstances (preparation, sion to remain in nursing and the kind of
administration, or disposal); the amount, fre- nursing work they chose to perform. More
quency, and duration of drug preparation; than 70% said that the acute and chronic
and the adherence to safe handling guidance effects of stress and overwork were one of
including use of engineering controls, warn- their top three health concerns. More than
ings, and administrative controls, safe work two thirds reported being required to work
practices, and personal protective apparel mandatory overtime every month. Disabling
and equipment. back injury and fear of contracting HIv or
enviromechanical factors including hepatitis infection from a needlestick injury
heavy lifting and awkward postures can were also among the top three health con-
result in falls, lacerations, and disabling cerns. Seventeen percent had been physically
musculoskeletal injuries. Studies have indi- assaulted, and more than half were threat-
cated that nurses working for at least 1 year ened or had experienced verbal abuse in
reported neck problems (45.8%), shoulder the last year. Remarkably, less than 20% of
problems (35.1%), and back problems (47%) respondents felt safe in their current work
(Trinkoff, Lipscomb, Geiger-Brown, & Brady, environment.
2002) and that nearly 80% of nurses expe- Poor match between organization of
rience low back pain during the course of work and the capabilities, resources, or needs
their working life. In 2005, more than 20,000 of workers can lead to a stress response;
recordable cases of back and other pain, car- reduced time available for sleep, family, and
pal tunnel syndrome, and tendonitis were nonwork activities; and longer exposures to
reported in the HCSA sector by BLS; of these, occupational hazards (Hurrell & Kelloway,
more than 42% were among health care sup- 2007; Rogers, 2003). These immediate effects
port occupations such as aides and assistants can lead to mood disturbances; difficulty
(Silverstein & Adams, 2006). In 2005, the thinking; disturbed sleep; fatigue; pain;
incidence rate of sprains and strains involv- neurological, cognitive, and physiological
ing days away from work was 82.3 cases per dysfunction; and negative health behaviors
10,000 workers (BLS, 2006b). The health care such as smoking and substance abuse. This