Magazine article American Nurse Today

Keeping Nurses Healthy, Safe, and Well

Magazine article American Nurse Today

Keeping Nurses Healthy, Safe, and Well

Article excerpt

To keep patients healthy, safe, and well, registered nurses (RNs) have to be healthy, safe, and well themselves. Yet RNs face health, safety, and wellness risks unique to their profession. This article outlines how RNs and employers can identify, mitigate, and reduce these risks. To provide context and evidence for risks, it also describes key findings from the American Nurses Association's (ANA) HealthyNurse[TM] health risk appraisal (HRA).

Identifying risks

Workplace risks can be identified in various ways, including employee surveys, incident report reviews, literature reviews, hiring of occupational health professionals, workplace walkthroughs, and detailed observation of employees' routine job tasks. The HRA is another useful tool. In collaboration with Pfizer, ANA developed an HRA to help RNs and nursing students identify their personal and occupational health, safety, and wellness risks. This online survey allows them to compare their results with established ideal standards and national averages (where available). After completing the survey, respondents can access a wellness portal with resources specific to their identified needs. Compliant with the Health Insurance Portability and Accountability Act, this HRA is free and available to all RNs and nursing students enrolled in a program leading to RN licensure.

Findings from the HRA survey will help establish context for the actions that nurses and employers need to take. Preliminary findings provide a snapshot of the 3,765 RN and student nurse participants' responses received between October 2013 and October 2014. Of the participants, 90% were RNs, 8% were student nurses, and 2% were retired or former RNs. Because the HRA survey remains open, results can't be generalized to the broader nursing workforce yet. (See HRA's full executive summary at www. and see Selected HRA survey responses.)

Occupational safety

Occupational safety risks for RNs include stress; fatigue; injuries caused by manual patient handling; needlestick injuries; incivility, bullying, and workplace violence; and toxic chemical exposures.


Respondents in ANA's HRA survey identified stress as the top risk in the work environment; 82% believed they were at a significant risk level. In comparison, the average percentage of employees who feel stressed out is only 36%, as reported by the 2011 Stress in the Workplace Survey from the American Psychological Association.

To cope with stress effectively, RNs must practice self-care. Make the effort to recognize when you're feeling increased stress, and identify and use effective stress-reducing techniques, such as meditation, prayer, mindfulness, exercise, deep breathing, and work breaks. Employers can provide counseling, individual coping strategies, employee assistance programs, wellness centers, and support groups. A quiet place, such as a restoration room where nurses can go to decompress, may help. Most important, employers must decrease workplace stressors by ensuring optimal staffing, reasonable workloads, appropriate work hours, supportive policies and procedures, and a carefully cultivated culture of safety and respect for employees.


HRA survey respondents reported sleeping an average of 8 hours during a 24-hour period. To ensure a culture of safety, employers and RNs must reduce RN fatigue and sleepiness. ANA recommends RNs work no more than 40 hours in professional nursing during a 7-day period and strive for 7 to 9 hours of sleep in a 24-hour period. Employers need to eliminate mandatory overtime as a staffing solution and give RNs opportunities to provide input into scheduling.

Injuries caused by manual patient handling

Manually lifting, transferring, and repositioning patients is hazardous and commonly results in painful, career-ending injuries. In ANAs HRA survey, 42% of respondents identified manual lifting as a serious workplace concern and 53% reported experiencing musculoskeletal pain at work. …

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