Nurses Are Exposed To More Health Hazards

Healthcare professionals are exposed to health and safety risks more than other workers of other sectors. According to Terry, Le, Nguyen & Hoang (2015), healthcare providers encounter several chemical, physical, psychological and biological injuries. The possibility of healthcare professionals encountering occupational hazards depend on their profession, the department they work in and they type of work they do. For example, healthcare workers who work in mental health facilities and emergency department are at higher risk to occupational hazards. Nursing profession is acknowledged as the most stressful profession with heavy workload and stress due to several negative factors stemming from work circumstances (Yasobant and Rajkummar (2015). Moreover, the odds of nurses encountering hazards and risks are higher than other healthcare professions because the nurses spend more of their time with patients and are in charge of caring for patients. For this reason, they are more vulnerable to occupational risks than other health professionals (Aras, & Uskom, 2015). Additionally, nurses may have several health problems arising from the work conditions and environment, such as violence, working overtime, long working hours, role conflict, and biological pathogens (Terry et al. 2015). Occupational health hazards that impact on the health status of nurses can be classified as psychosocial, physical ergonomic and biological.
This paper argues that nurses encounter more health hazards in their workplace than physicians.working environment, duties and responsibilities of nurses place them in the front-line of many occupational hazards (Alavi, 2014). They are more likely to suffer violence of patients and other healthcare workers, acquire infectious diseases due to their direct contact with patients and, suffer musculoskeletal problems due to workloads, experience work stress due to working environment and pick up more needle stick injuries.
Are Nurses Exposed To More Health Hazards Than Doctors?
While healthcare profession is the most vulnerable to work-related musculoskeletal injuries, nurses are at higher risk for developing musculoskeletal disorders. In a study to evaluate the risk of developing job-related musculoskeletal disorder among different health professionals, Yasobant and Rajkummar (2015) found the nurses to have the highest risk while the physicians had the lowest risk. In a study done by physicians, level of psychological stress, age and ergonomics were shown to contribute to the development of musculoskeletal disorders (Dilek et al. 2016). The researchers found older nurses who have worked for at least 11 years to have higher rates of discal hernia and backache problems. Nurses are more prone to acquire this condition because of their direct contact with patients. Musculoskeletal issues caused by reasons like long working hours, prolonged standing or sitting, neck flexion and frequently forward bending of trunk, pushing, pulling and lifting of patients and occupational devices, inadequate resting period. The finding of this study is the same to a previous study conducted by Emmanuel et al (2012) that reported highest prevalence among the nurses. Munabi et al. (2014) reported the same findings in over 80{b347ee882963fc078925bef44838eb079b614d3dde11dc0714b595823c2ade58} of nurses in Uganda. Knee, back, should and neck problems are the common complaints reported by nurses. The high risk of musculoskeletal injury is one of the reasons nurses quit the nursing profession.
Nurses are more vulnerable to biological pathogen infection than physicians. Healthcare professionals are exposed to several biological materials, such as bacteria, viruses, fungi and parasites. Due to the direct contact healthcare workers have with body fluids and blood, sharp objects and devices, transmission of biological pathogens is a major concern in healthcare industry (Gourni, Polikandrioti, Vasilopoulos, Mpaltzi, & Gourni, 2012). Occupational risks caused by biological agent exposure suffered by healthcare workers are deemed worrying factors. The World Health Organization (WHO) estimates that over 3,000,000 healthcare professionals are exposed to occupational hazards per year (da Silva, Malaguti-Toffano, Reis, Pereira, & Gir, 2017). Among the different categories, nurses are at the greatest risk of occupational accidents with biological agents. Nurses, while carrying out their work activities in the healthcare setting, are in direct contact with patients and thus face a higher risk exposure to contamination by biological material.
Work violence is high among healthcare professionals. There is a disturbing pattern of workplace violence toward healthcare workers worldwide. They are frequently subjected to physical and verbal abuses from staff members, patients and visitors. However, literature indicates that nurses are exposed to violence to significantly greater extent than physicians. Violence toward nurses continues to gain acceptance since it is more often perceived that nursing professionals are expected to stomach some level of violence in the course of performing nursing duties.   In fact, nurses are at the frontline of violence in healthcare environment. A 2017 study assessing the prevalence of violent incidents toward healthcare professionals, Shafran-Tikva, Zelker, Stern and Chinitz found nurses to be exposed to violence to a considerably extent than doctors. Companion and patients in particular assaulted nurses twice as much as doctors.  Other studies indicate that nurses and nursing aides working in the emergency department and psychiatric units are at the highest risk. Statistics indicate that 82.1{b347ee882963fc078925bef44838eb079b614d3dde11dc0714b595823c2ade58} of emergency department nurses reported physical assault and 100{b347ee882963fc078925bef44838eb079b614d3dde11dc0714b595823c2ade58} reported verbal abuse in 2012. By contrast, 78{b347ee882963fc078925bef44838eb079b614d3dde11dc0714b595823c2ade58} of emergency department doctors reported workplace violence (Phillips, 2016).
Violence against nurses is not committed by patients only but also by doctors. Doctor bullying of nurses is common in healthcare setting. In hospital break rooms and news reports, narrative abound of doctors berating nurses, physically assaulting nurses and hurling profanities. In the theatre rooms, doctors shove nurses; throw scissors, stethoscopes or surgical devices. In 2013, the Institute for Safe Medical Practice carried out a survey on disrespectful behaviors, such incivility, bullying and intimidation that are widespread in healthcare industry. The survey showed that in the previous year, 74{b347ee882963fc078925bef44838eb079b614d3dde11dc0714b595823c2ade58} nurses experienced doctors’ demeaning comments and 86{b347ee882963fc078925bef44838eb079b614d3dde11dc0714b595823c2ade58} encountered doctors who had refused to return calls or answer questions (Robbins, 2015). In addition to that, 26{b347ee882963fc078925bef44838eb079b614d3dde11dc0714b595823c2ade58} of surveyed nurses had instruments thrown at them. Physicians also spread malicious gossips, humiliated and ashamed 42{b347ee882963fc078925bef44838eb079b614d3dde11dc0714b595823c2ade58} of the nurses (Grissinger, 2016). Though doctor bullying is a widespread practice, it is not reported. Nurses do not report doctor bullying because the management is less likely to penalize the disrespectful doctors. Nurses also fear losing their job or retaliation if they report the incidents. They also fear being stigmatized by colleagues as whistleblowers. While nurses have genuine fears for not reporting this bullying, their silence put patients at risk.
Needle stick injuries are the major job-related injuries experienced by healthcare workers. They continue to be a serious problem and a source of biological pathogen transmission. Needle stick injuries increase the risks of acquiring blood-borne infections like Hepatitis and HIV/AIDS. Work practices like administering injections, recapping, blood sampling, and needle disposal, handling trash are the main activities causing needle stick injuries. These activities are mostly performed by nurses. In addition to that, nurses are the majority in the health workforce (Motaarefi, Mahmoudi, Mohammadi, & Hasanpour-Dehkordi, 2016). For this reason, most of the needle stick injuries happen to nurses.  Motaarefi et al. (2016) estimate the number of percutaneous injuries per 100,000 in-patient days to be 2.43 in nurses per years, which is ten times higher than 0.23 that is reported for doctors. According to Motaarefi et al. (2016) 74{b347ee882963fc078925bef44838eb079b614d3dde11dc0714b595823c2ade58} of all needle stick injuries in healthcare occur among nurses. Other studies report contradicting results showing that doctors suffer higher number of needle stick injuries than nurses.
In hospital environments majority of nurses sustain needle stick injuries while at the bedside. Primary issues associated with needle injuries involve punctures, scratches and skin lacerations (Zhang, Gu, Cui, Stallones, & Xiang, 2015). Secondary issues that may arise if the needle is contaminated include transmission of biological pathogens. The reasons nurses are more vulnerable include low skill level, sense of urgency and variable work shift. Needle stick injuries are more likely to happen in inadequately staffed departments, to nurses with variable shifts and women
Health professions are very stressful owing to the nature of their work. Literature indicates that health professionals suffer intense stress and it results in the reduction in self-esteem, increased depression, sleep disorders, somatic complaints and burnout. Work stress causes both organizational and personal problems in addition to affecting patients negatively. Many studies have examined the stress situation in nurses and physicians and they concur that the former are exposed to more stressful environment than others (Ulutasdemir, Balsak, Berhuni, Ozdemir, Atasalan, 2015). Nurses experience stress and intense pressure because of the prevailing conditions in the workplace. They also offer healthcare services to stressed or ill people. Various studies concur that nursing profession is difficult and the work stress because of the workplace is common among nurses (Ulutasdemir et al. 2015). In a 2015 study to examine the mean work scores of different health professionals, Ulutasdemir et al. (2015) determined that nurses experienced the maximum work stress among health professionals. In a study to compare burnout and job stress of diverse health professions in Taiwan, Chou, Li and Hu (2014) found high prevalence of job stress and burnout among nurses followed by physician assistants. The cause of stress and burnout included the intense nature of direct contact with patients, watching and the suffering and death of patients, heavy workload, inadequate staffing, long work g hours, inadequate training to cope with stress, lack of support, and conflict with peers and physicians, role conflict and performing routine tasks. Moreover, nurses use ineffective coping mechanisms to deal with stress.
Conclusion

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