The Hazards of Being an Emergency Room Nurse
The Hazards of Being an Emergency Room Nurse
Emergency nursing is a specialized field of the nursing profession. In this field, nurses are equipped and trained to deal with patients in critical phase of their illness and injury. Emergency room nurses are capable of treating patients in this phase without any or complete diagnosis.
Emergency room nurses are used to fast paced environment. Since the emergency department of a hospital, is usually overcrowded emergency room nurses can be seen multitasking to balance and prioritize patients and their time. How dangerous is it to be working in a hospital?
With increasing reports of emergency department violence, emergency nurses are placed among police officers and other peace officers. The Massachusetts Bureau of Labor Statistics reported more than 4.000 health care professionals to experience verbal and physical assault while working in the ER (2005).
Different steps are being undertaken to address the escalating umber of violence experienced by emergency room staff. Legislations in increasing the penalty for perpetrators are awaiting decision from the Assembly. Various programs and trainings to resolve violence are commencing in hospitals and other health care institutions.
So what else is dangerous about being an emergency nurse?
According to the International Hazard Datasheets on Occupation as released by the International Labour Organization, there are seven main dangers emergency nurses can be exposed to.
1. Emergency room nurses, as part of their responsibilities; cleans, disinfects and sterilize medical equipment. They may be exposed to agents that may damage the skin, mucous membranes and respiratory system.
2. Emergency room nurses can also be exposed to anesthetic gases, drugs and radiation.
3. Emergency room nurses may be injured by shard objects like needles, blades and other similar objects.
4. They may contact with hot surfaces, faulty electrical equipment and may cause skin burns.
5. Sick patients in the emergency room present a risk of infection from body fluids.
6. Emergency room nurses may suffer from musculoskeletal problems and back pains due to handling heavy patients. Continuous work while standing and walking may cause fatigue and leg problems.
7. Emergency room nurses also may suffer from stress and burnout caused by shift and night work and by other psychological and organization factors.
The Emergency Nurses Association recognizes the increasing number of emergency nurses experiencing stress. The emergency care environment can be very stressful and physically and emotionally traumatic for the health care workers and nurses.
ENA recognizes the following contributing factors in the increasing stress levels of emergency room nurses.
1. Critical incidents that can cause strong emotion and may interfere with the ability to perform the duties. Incidents like mass casualties, disasters, unexpected death of a child or co-worker can be attributing factors.
2. Long term demands can also be a stressor. Long work hours, job insecurity, poor communication and an increased potential for a workplace violence fall under this factor.
ENA sees that unresolved issue of stress can result into absenteeism, sleep disorders, burn out, emotional difficulties and health problems.
So how can these repercussions be avoided?
International Labor Organization (ILO) provided several pointers to keep the emergency department safe for the emergency room health workers. Nurses should comply with all safety instructions and conduct periodic inspection of electrical medical equipment. Keeping all passages clearly visible and uncluttered is also another tip. Following appropriate procedures in infection control and handling and disposing sharp objects is necessary.
To resolve the stress emergency nurses are experiencing, ENA supports the development and utilization of critical incident stress management. ENA also supports the use of personal stress management strategies like relaxation, meditation, exercise, group therapy, guided imagery, massage or humor therapy.
ENA also recognizes the impact of workplace violence and the need for a program which would include education, prevention, appropriate security measures, identification of incidents, reporting and protocols.
Emergency nurses have a very rewarding job and at the same a dangerous one. These are all the sacrifices they have to put up the serve the people.
Emergency nurses are starting to get hurt.
According to the Health Promoting Hospitals and Health Services International Conference held in Berlin this year, 98 percent of emergency room nurses in the Unites States reported verbal harassment and 67 percent reported physical violence.
While in Canada, 84 percent of the nurses in the emergency department witnessed verbal harassment once in every shift. While there are 90 percent of them claimed to experience verbal abuse at least once a week. In Australia, there are 70 percent of nurses who experience violence at least five times a week.
Emergency room nurses are falling victims to increasing violence in the emergency department of hospitals.
The Emergency Nurses Association conducted a study and 86 percent of all the ER nurses involved in the survey had some form of violence committed against them while they are on duty.
Last 2005, the Massachusetts Bureau of Labor Statistics reported that there are 4,000 hospital employees assaulted while working in the ER. In the same year, ER doctors in Michigan reported that 28 percent has experienced physical assault while 75 percent received verbal assaults.
Patients themselves could be the perpetrators of this violence occurring in emergency departments. Intoxication and long delay in the waiting room are common things that might fire up a patient.
Based on one of the largest studies made on the issue made on 2004 in Minnesota, patients committed almost all of the physical assaults and two-thirds of the verbal harassments.
Visitors as well as physicians and other staff members are responsible for the other assaults and harassments. It is only possible to receive aggression from the patient’s family members. If the patient was involved in a traumatic incident, his family members’ anxiety levels could be very high and may overwhelm them.
The most common assaults against nurses could sometimes result into serious injury. Typical assaults would include spitting, hitting, kicking, hair pulling and attack using an object or weapon.
There would be incidents that would result into serious injury, an example would be an ER nurse who lost her baby when kicked by a patient in the stomach. Drug or alcohol, psychiatric conditions, neurological problems and a history of violence are factors for such violent acts.
Between 1980 and 1990, there were 26 physicians, 18 registered nurses, 27 pharmacists, 17 nurses' aides, and 18 other health care workers were killed on the job (U.S. Department of Labor). While there were 221 hospitals in America and Canada that reported 42 homicides, 1,463 physical assaults, 67 sexual assaults, 165 robberies, and 47 armed robberies in 1995 according to the International Association for Healthcare Security and Safety.
There are also behavioural clues is a patient or visitor is likely to be abusive. Postures tend to be tensed while speech is load and can be threatening or insistent. Aggressors would constantly drop threats or plans of violence.
There are also certain diagnoses associated with violent behaviour like substance abuse, acute psychoses, acute organic brain syndrome, personality disorders and partial complex seizures.
The time is also relevant.
Incidents which occur on a night shift are more likely to produce violent patients. In a study conducted by University of California at Irvine, 31.8 percent of violent incidents occurred between 11 p.m. and 7 a.m. while only 13.3 percent of the patient volume was seen during these hours.
So what are the public doing about this?
Nursing organizations and unions are constantly working to draw the attention and educate the public on this issue. They are also lobbying for a legislation in increasing the penalties against perpetrators. Programs are being developed in healthcare institutions to address this issue. Security has been reinforced in hospitals to prevent the escalating violence in emergency departments.
Emergency nurses are the first one to give first aid to hurt and injured people. Now seems the time to help them stop getting hurt.
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