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THE WORKPLACE

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Title: THE WORKPLACE


1
CHAPTER 12
  • THE WORKPLACE

2
Introduction
  • Over 50 of time is spent in the workplace
  • Occupational hazards exist in work areas
  • It is important to improve the quality of life
    in the workplace

3
Workplace Safety
  • Environmental hazards
  • Physical safety
  • Emotional safety

4
Reducing Risk
  • Occupational Safety and Health Administration
    (OSHA)
  • Centers for Disease Control and Prevention (CDC)

5
Reducing Risk
  • Workplace programs
  • Safety plan
  • Consult federal, state, and local governments
  • Distinguish between real and imagined risk
  • Seek administrative support
  • Calculate costs of program

6
OSHA Focus
  • Biological
  • Chemical
  • Psychological
  • Physical
  • Environmental

7
CDC Focus
  • Lead federal agency for protecting health and
    safety of citizens at home and abroad
  • Publishes updates on a variety of health issues
    and concerns
  • Partners with other agencies in investigating
    health threats and research

8
NIOSH
  • Part of the CDC
  • Conducts research and makes recommendations for
    preventing work-related injuries and disease

9
American Nurses Association
  • Quality indicators for acute care setting
  • Commission on Workplace Advocacy
  • Core initiatives

10
Core Initiatives
  • Nursing shortage
  • Patient safety/advocacy
  • Workplace rights
  • Appropriate staffing
  • Workplace health and safety

11
JCAHO
  • National patient safety goals
  • Change each year
  • Based on type of facility
  • Ambulatory
  • Assisted living
  • Behavioral health
  • Critical access
  • Home care

12
Workplace Programs
  • Identify potential hazard
  • Assess degree of risk
  • Develop a plan
  • Implement the program

13
Violence
  • Violence is a social issue
  • The rate of assaults on hospital workers is much
    higher than that of private industry
  • Threats
  • Physical assaults
  • Muggings

14
Violence
  • Situations that increase workers susceptibility
    to homicide and assault are
  • Having routine contact with the public
  • Working alone or in small numbers
  • Working late
  • Poor security

15
Violence
  • Situations that increase workers susceptibility
    to homicide and assault are
  • Patients and families who carry weapons
  • Lack of experienced staff members
  • Units and patients that need seclusion or
    restraint activities

16
What Nurses Should Know
  • Does violence in the surrounding community affect
    my workplace?
  • Does the layout of the facility invite violence?
  • Is there a prompt response by administration to
    violence?

17
What Nurses Should Know
  • Are incidents being reported and addressed by
    management?
  • Would training that deals with workplace violence
    be adequate for employees and management?
  • Which types of patients are more prone to
    violence?

18
Behaviors
  • History of violent behavior
  • Delusional, paranoid, or suspicious speech
  • Aggressive and threatening statements
  • Rapid speech and angry tone of voice

19
Behaviors
  • Stiff posture, clenched fists, tight jaw
  • Alcohol/drug use
  • Male gender or a youth
  • Unrealistic policies

20
When Assault Occurs Placing Blame on Victims
Victim Gender Women receive more blame than
men Subject Gender Female victims receive a
greater amount of blame from women than from
men Severity The more severe the assault, the
more often the victim is blamed  
21
When Assault Occurs
Beliefs The world is a just place therefore,
the person deserves the misfortune Age of
Victim The older the victim, the more he or she
is held responsible for the assault
22
Keep an Eye Out
  • Look for clues indicating potential violence
  • Call patients, family members, and visitors by
    their names
  • Encourage the patient or the patients family to
    vent anger

23
Keep an Eye Out
  • If you feel uncomfortable, trust your intuition
  • Know your institutions policies and procedures

24
Preventing Workplace Violence
  • Have management commit to an ongoing prevention
    program that addresses different scenarios on
    workplace violence
  • Require that all violent incidents be reported
    and reviewed
  • Hold all patients, visitors, staff members, and
    management accountable for their behavior adopt
    a zero-tolerance policy related to workplace
    violence

25
Preventing Workplace Violence
  • Follow current information and guidelines from
    agencies such as your state nurses association
    and OSHA
  • Insist on an ongoing education program for all
    staff members that includes comprehensive
    treatment for victimized employees

26
Participate in Workplace Safety
  • Assess the workplace regularly
  • Be alert for suspicious behavior
  • Maintain behavior that helps to defuse anger
  • If situation escalates, remove self and call
    security
  • Know your clients

27
Participate in Workplace Safety
  • Report situation to supervisor
  • Call the police
  • Get medical attention
  • Contact collective bargaining or state nurses
    association
  • Participate in policy-making

28
Sexual Harassment
29
Behaviors Defining Sexual Harassment
  • Pressuring another to participate in sexual
    activities
  • Asking another person about his or her sexual
    activities, fantasies, or preferences
  • Making sexual innuendos, jokes, comments, or
    suggestive facial expressions to another person

30
Behaviors Defining Sexual Harassment
  • Continuing to ask for a date after the other
    person has expressed disinterest
  • Making sexual gestures with hands or body
    movements or showing sexual graffiti or visuals
  • Making remarks about a persons gender or body

31
Sexual Harassment
  • Two forms of sexual harassment are
  • Quid pro quo
  • A hostile environment

32
Sexual Harassment
  • Fight sexual harassment per American Nurses
    Association (ANA)
  • Confront
  • Report
  • Document
  • Support

33
Latex Allergy
  • First identified in the 1970s
  • Has become a major problem in the workplace
  • Estimated that 8-12 of health-care workers are
    sensitive to latex

34
Symptoms
  • Contact dermatitis (most common)
  • Generalized hives
  • Urticaria
  • Rhinitis
  • Wheezing
  • Anaphylaxis

35
Decreasing the Potential for Latex Allergy
  • Reducing unnecessary exposure
  • Using alternative gloves (nitrile)
  • Employee education programs
  • Identifying workers at risk

36
Needlestick Injuries
37
Needlestick Act
  • Passed in 2001
  • Revised blood-borne pathogens standards
  • Obligates employers to consider safer needle
    devices

38
OSHA Blood-Borne Pathogens Recommendations 1991
  • Free hepatitis B vaccine
  • Protective equipment that fits
  • Immediate and confidential medical evaluation

39
OSHA Blood-Borne Pathogens Recommendations 1991
  • Implement universal precautions
  • Provide adequate sharps disposal
  • Remove hazards in workplace
  • Provide annual training for employees

40
The Nurses Responsibilities
  • Always use universal precautions
  • Use and dispose of sharps properly
  • Get immunized against hepatitis B
  • Report all exposures
  • Know the human immunodeficiency virus/hepatitis B
    virus (HIV/HBV) status of your patient

41
The Nurses Responsibilities
  • Comply with postexposure follow-up
  • Support others who have been exposed
  • Become active in safety committees
  • Educate others

42
Ergonomics
43
Preventing Back Injuries
  • Participate in safety committees
  • Work in teams do not be afraid to ask for help
  • Use transfer and lifting equipment
  • Do back exercises

44
Repetitive Stress Injury (RSI)
  • Usually affects individuals who spend long hours
    at computers
  • Most common injury is carpal tunnel syndrome
  • Mouse elbow
  • Badly designed computer stations present the
    highest risk

45
Preventing RSI
  • Monitor placement
  • Keyboard alignment
  • Mouse position
  • Body alignment
  • Vary tasks
  • Use fingertips when typing
  • Keep fingernails short

46
Impaired Workers
47
Common Signs of Impairment
  • Witnessing an employee consuming alcohol or
    other substances on the job
  • Apparent in employees dress, appearance,
    posture, and gestures
  • Employees use of slurred speech and
    abusive/incoherent language

48
Common Signs of Impairment
  • Reports from patients/coworkers
  • Witnessing unprofessional employee conduct
  • Employee has significant lack of attention to
    detail
  • Witnessing an employee stealing controlled
    substances

49
Impaired Nurse Programs (INPs)
  • Most employers and 37 boards of nursing have
    strict guidelines
  • INPs conducted by boards of nursing work with
    employers to assist impaired nurses
  • Compassion from coworkers is of utmost importance

50
Professional Responsibilities
  • Nurses need to uphold the standards of their
    profession
  • Ignoring substance abuse places clients and other
    nurses in danger
  • It is important to help a colleague obtain help

51
Microbial Threats
  • SARS
  • Tuberculosis
  • MDR-TB

52
Workload
  • Rotating shifts
  • Mandatory overtime
  • Staffing ratios

53
Reporting Questionable Practices
  • Most employers have policies regarding reporting
    behaviors that affect the workplace environment
  • Code for Nurses (2001) is specific regarding this
    responsibility

54
Behaviors
  • Endangering a clients health or safety
  • Abuse of authority
  • Violation of rules, regulations, or standards of
    professional ethics
  • Gross waste of funds

55
Whistleblower
  • Describes an employee who reports employer
    violations to an outside agency
  • Do not assume doing the right thing will
    protect you

56
Guidelines
  • Gather the facts
  • Does the practice violate any actual law
  • Know the state law requiring mandatory reporting
  • Type your documentation and include day, date,
    time, and circumstances

57
Guidelines
  • Identify witnesses
  • Do not breach confidentiality in any way
  • Send a copy of your complaint to the CNO or
    nursing department or any other department
    affected
  • Utilize the ethics committee of your institution
  • Keep copies of your records

58
Nursing Responsibilities in Terrorism
  • Know the evacuation procedures and routes in your
    facilities
  • Develop your knowledge regarding the most likely
    and most dangerous biological weapons
  • Monitor for unusual disease patterns
  • Know the back-up systems for communication and
    staffing

59
Enhancing the Quality of Work Life
  • Social environment
  • Working relationships
  • Support your peers and supervisors
  • Involvement in decision-making

60
Enhancing the Quality of Work Life
  • Professional growth and innovation
  • Encourage critical thinking
  • Seek educational opportunities
  • Encourage new ideas
  • Reward professional growth

61
Understanding Cultural Diversity
  • Communication
  • Space
  • Social organization

62
Understanding Cultural Diversity
  • Time
  • Environmental control
  • Biological variations

63
Organization Diversity Fitness
  • Personnel reflect the current and potential
    population that the organization serves
  • Silence and gestures are respected

64
Organization Diversity Fitness
  • Awareness of special family and holiday
    celebrations
  • Individuals first culture second

65
Managing Diversity
  • Be aware of and sensitive to your own
    culture-based preferences
  • Explore your own biases and values
  • Be knowledgeable about other cultures

66
Managing Diversity
  • Be respectful of and sensitive to diversity among
    individuals
  • Be skilled in using and selecting culturally
    sensitive intervention strategies

67
Dos and Donts for Managing Diversity
68
Nursings Agenda for the Future
  • Leadership and planning
  • Delivery system
  • Legislation/regulation/policy
  • Professional/nursing culture
  • Recruitment/retention

69
Nursings Agenda for the Future
  • Economic value
  • Work environment
  • Public relations/communication
  • Education
  • Diversity

70
Conclusion
  • Workplace safety is a growing concern
  • IOM and JCAHO will continue to impact workplace
    safety issues
  • Support the ANA
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