Nurses’ and Other Health Professionals’ Wellness and Safety Resource Update

The World Health Organization proclaimed 2020 the Year of the Nurse and Midwife. None of us could have anticipated how prescient that would be. This year has seen nurses all over the world step up and battle coronavirus disease 2019 (COVID-19) fearlessly, often while navigating evolving guidance and operating under difficult conditions with strained resources. The American Nurses Association (ANA) and ANA Enterprise’s Healthy Nurse, Healthy Nation™ (HNHN) salute all nurses and recognize their efforts during our month-long celebration in May of nurses, as part of ANA’s Year of the Nurse.

Below, we have gathered several resources and updates on issues that nurses face daily—some now more than ever due to the COVID-19 pandemic.

Mental Health

Some nurses have become sick with COVID-19, but many others will suffer from anxiety, fear, anger, loss, isolation, loneliness, depression, stress, grief, or bereavement as a result of the pandemic. This is especially true for those who had pre-existing mental health conditions, or those serving on the front line. For all of us, mental health screenings, learning to build resilience, and getting the mental help needed immediately are key. Please see this blog and these webpages on nurse mental health and combating stress for further resources.

Self-Care

An empty plate has nothing to offer. If nurses are not rested, safe, well-nourished, fit, and satisfied with their work-life balance, then they may suffer personally and not be able to give the best care to their patients and families. That’s why self-care is so important. Work and meal breaks, at least 7 hours of sleep daily, physical exercise, healthy food, and restorative “down time” need to be non-negotiable items in nurses’ routines. HNHN has a plethora of blogs on self-care and stories of inspirational nurses.

Bullying

Bullying can be anything from the passive cold shoulder and eye rolling to sarcastic words and blatant actions. This type of behavior adds to nurse stress. Stress is already a top workplace hazard for nurses (reported by 79% in an HNHN survey). Incivility and bullying can result in an unhealthy work environment, decreased productivity, impaired judgement, and health professionals leaving the profession.

ANA developed a position statement for nurses that is applicable for all health professions. The position on Incivility, Bullying, and Workplace Violence contains background information, resources, and recommendations on how to establish a culture of safety and respect, and how to prevent, address, and mitigate incivility and bullying in the workplace.

Workplace Violence/#EndNurseAbuse

According to HNHN’s 2019 HealthyNurse® Survey, 34% of nurses have been verbally or physically threatened by a patient or a patient’s family member. The U.S. Government Accountability Office (GAO) indicated in their 2012 report that health care workers experience workplace violence-related injuries at a rate at least five to twelve times higher than the rate of private-sector workers. Additionally, in the current climate, nurses can find themselves victimized when encountering protests outside their healthcare facilities, or while enforcing physical distancing and visitor policies. A major challenge in addressing these issues is that healthcare personnel frequently choose to not report incidents. The reasons may vary: because they do not consider the incident to be serious; the patient may have been impaired; there is not a clear reporting mechanism; or from fear of reprisals.

ANA developed the #EndNurseAbuse initiative to support and educate nurses and health care workers, and to provide a forum to share their experiences and communicate with their legislature. Violence against healthcare personnel should never happen in the workplace. Employers and staff are encouraged to maintain a culture of safety and zero tolerance, and they should use reporting mechanisms to track incidents, educate staff and facility leaders, and recognize potential warning signs when the environment is unsafe (see this website and brochure for more information). All workers deserve a safe place to work.

Safe Patient Handling & Mobility Standards Revision

Nurses indicate in the HealthyNurse Survey that 58% have experienced musculoskeletal pain at work in the past year. This pain is typically caused by the repetitive motions of transporting, mobilizing, repositioning, or ambulating patients. Musculoskeletal pain is not new to healthcare workers, and for the past 20 years ANA has advocated for safer practices and no injuries for all professionals across the care continuum.

In 2013, ANA developed the Safe Patient Handling and Mobility (SPHM) Interprofessional National Standards to assist organizations in creating SPHM policies and implementing and sustaining SPHM programs. Creating a culture of safety is the foundation for the standards. Without a commitment from staff and leadership, as well as the necessary financial resources, a successful SPHM policy cannot happen, and an SPHM program cannot be maintained.

We at the ANA realize that it is time to refresh our SPHM standards. In addition to updating the resources and references, we are including information about the interconnectedness of SPHM with other aspects of patient care. When patients can be moved safely, there is a reduction in falls, pressure ulcers, skin injuries, and aggression among patients. The revised SPHM will be available in late 2020 on the ANA website.

Conclusion

Now more than ever, nurses, alongside other health professionals and their employers, need to focus on wellness and occupational health and safety. Nurses cannot do it alone; safe, respectful, and just workplace cultures are everyone’s responsibility. To learn more about occupational health and safety for nurses and health professionals, including immunizations, COVID-19, (see also CDC COVID-19 HCP guidance) staffing and more, visit www.nursingworld.org. For additional resources on self-care and nurse wellness, visit www.hnhn.org.

Ruth Francis, MPH, MCHES, Senior Policy Advisor, Nursing Practice & Work Environment Department at the American Nurses Association. 

Holly Carpenter, BSN, RN, Senior Policy Advisor, Nursing Practice & Work Environment Department at the American Nurses Association.

This blog is part of a series hosted by NIOSH to commemorate nurses during the Year of the Nurse. The views expressed by guest authors do not necessarily reflect the views of CDC or NIOSH.

Other blogs in the series include:

Year of the Nurse

Managing Fatigue During Times of Crisis: Guidance for Nurses, Managers, and Other Healthcare Workers

Surgical Smoke Inhalation: Dangerous Consequences for the Surgical Team

Safety Culture and Health Care

Work Ability among Older Nurses

The Unique Occupational Environment of the Home Healthcare Worker

Can Exoskeletons Reduce Musculoskeletal Disorders in Healthcare Workers?

Preventing Needlesticks and Sharps Injuries: Reflecting on the 20th Anniversary of the Needlestick Safety and Prevention Act

Celebrating Nurses

ANA is a membership organization representing the interests of the nation’s 4 million registered nurses. HNHN is nurse wellness initiative designed to improve the health of U. S. nurses in order to improve the health of the nation. It is based on 5 crucial domains: safety, quality of life, rest, nutrition, and physical activity. HNHN is free and open to everyone. Visit this link to join.

References

ANA Enterprise. Healthy Nurse, Healthy Nation: Year two highlights 2018-2019. Am Nurse Today. 2019;14(9, suppl):1-11.

U.S. Government Accountability Office. Additional Efforts Needed to Help Protect Health Care Workers from Workplace Violence. 10. Web: http// www.gao.gov/assets/680/6755858.pdf.