Health care professionals are facing new challenges as an ever-changing regulatory environment, the evolution of patient care and fierce competition come together to create the perfect storm. Uncertain health care reform adds to the mix, and the industry is also predicted to face nurse and physician shortages.
As we look at the trends in the health care industry today, we begin to understand how they may be impacting the workforce. Ultimately, we can then look at specific things each organization can do to lessen the impact of these new challenges. The end result? A safer working environment for employees.
CHALLENGE NO. 1: Job shortages and providing an overall safe environment
Health care continues to be one of the fastest-growing industries in the United States, but we also have a high turnover rate for nurses. Do the working conditions and the working environment and safety of those nurses play a role in filling job shortages? I believe that they absolutely do. In fact, surveys have shown that nurses often leave their jobs and, in some cases the profession altogether, because they’re concerned about incurring an on-the-job disabling injury.
You can impact the environment in which employees work by minimizing the hazards they’re exposed to and providing a safer work environment. You can develop and implement policies, procedures and programs to reduce the likelihood that they’re going to be injured while moving a patient, taking a blood sample or simply walking down the hall — things like safe patient handling and movement programs, safer needle devices and exposure control programs, and effective slip, trip and falls programs (including footwear policies).
Health care has always been an industry known for workers wearing many hats, but with staffing shortages, we’ll likely see this taken to a whole new level. This means they’ll be doing more. It also means more needs to be done to keep them safe.
In addition to safe patient handling and movement programs, employers will need to implement a worker fatigue program to address the increased demands on their time and their bodies.
CHALLENGE NO. 2: The unique needs of an aging workforce and their aging patients
Over the next decade or so, 1 million nurses are expected to retire. That’s a significant portion of the current nursing workforce. Some companies are trying to provide a working environment that encourages the aging workforce to stay on so their institutional knowledge doesn’t go away. But if we want to retain older employees, we must provide a safer work environment, one that is particularly sensitive to the physical vulnerabilities that come along with the aging process. This means safer ways to lift patients and to interact with less mobile, heavier, more violent patients due to cognitive and/ or dementia issues. This involves a safe patient handling and movement program as well as a workplace violence program.
It means providing an environment that is responsive to the aging workers’ needs — better lighting, reduced standing, use of ergonomics, self-paced training, flex time, job sharing and maybe job rotation.
To make jobs both easier and safer, this could also include engineering controls such as ceiling mounted patient lift systems and other patient handling equipment, administrative controls such as minimizing or eliminating overtime, making sure that breaks and lunches are actually taken, and the use of personal protective equipment, which could include gloves, face masks, and face shields.
CHALLENGE NO. 3: Worker fatigue and its dangers
Health care worker fatigue is another issue that is a concern within most health care organizations. Fatigue can be brought on by a number of things, from workers doing shift work to inadequate staffing levels, excessive workloads and employees that moonlight at another facility. In one past poll, 74% of nurses said stress and being overworked were their top concerns.
As an employer, what can you do about worker fatigue? You can create and implement a fatigue management program. You can ensure safe staffing levels. You can examine work demands and workloads. You can limit work hours and shifts, limit consecutive night shifts, avoid staff meetings at the end of a night shift. A lot of hospitals do this so they can catch the night shift and the day shift at the same time. But then instead of the night shift being a 12-hour shift, it might turn it into a 13-hour shift or longer, and the night workers may be very fatigued on their way home.
CHALLENGE NO. 4: Prevalence of workplace violence
Almost every day, we read about or see on TV another horrific event of violence. Health care workers are five times more likely to be assaulted at work than in any other industry. Some organizations and even some health care workers feel that violence is simply part of their job, but it’s not.
The building blocks for developing and implementing an effective workplace violence prevention program can include things like:
• Unwavering commitment from leadership and management
• Employee involvement every step of the way from program formation, implementation and evaluation through analysis of the work site
• Identification of hazards that may be present and looking at measures to prevent and control these hazards
• Educating staff about the program and then training them on how to address these hazards
• A process to record and track incidents, evaluate the success of the program and identify ways to continuously improve it
Constant change in the health care industry isn’t going away, from evolving staffing models to aging workers and patients to health care reform. There is plenty of opportunity to manage your organization’s risk. You can provide a safe work environment by supporting a culture of safety that is demonstrated by effective policies, procedures, and programs.
Develop programs that keep older workers safe, particularly those that might be thinking about retiring, such as programs that help prevent slips, trips and falls and implement processes like ergonomics and safe patient handling to keep them safer.
These same programs are vitally important to older workers who are most vulnerable to musculoskeletal injuries. Incorporate a comprehensive fatigue management program and create a workplace violence prevention program that includes effective procedures for dealing with both combative patients and active shooters.
In conclusion, health care organizations that develop, implement, and fully support these programs, from top leadership down, will be well positioned to successfully address today’s health care workforce challenges.
Darrell Toenjes is an account executive at Midwest Employers Casualty, where he helps design, develop and implement employee safety and workers compensation programs. He can be reached at dtoenjes@mecasualty.com.
