Nurses at Risk: A Guide to Health and Safety at Work PDF
Preview Nurses at Risk: A Guide to Health and Safety at Work
Nurses at Risk Nurses at Risk A Guide to Health and Safety at Work Second Edition Rosemary Rogers Jane Salvage and Roger Cowell Foreword by Harriet Harman, MP Cartoons by Kipper Williams ~ MACMillAN © Rosemary Rogers and Jane Salvage 1988 © Rosemary Rogers, Jane Salvage and Roger Cowell 1999 Foreword© Harriet Harman MP 1999 Canoons © Kipper Williams 1999 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No paragraph of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright, Designs and Patents Act 1988, or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Coun Road, London W1P 9HE. Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages. The authors have assened their rights to be identified as the authors of this work in accordance with the Copyright, Designs and Patents Act 1988. First edition published 1988 by Butterworth-Heinemann Ltd Halley Coun, Jordan Hill, Oxford OX2 8EJ This edition published 1999 by MACMillAN PRESS LTD Houndmills, Basingstoke, Hampshire RG21 6XS and London Companies and representatives throughout the world ISBN 978-0-333-73185-7 ISBN 978-1-349-14803-5 (eBook) DOI 10.1007/978-1-349-14803-5 A catalogue record for this book is available from the British Library. This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. 10 9 8 7 6 5 4 3 2 1 08 07 06 05 04 03 02 01 00 99 Copy-edited and typeset by Povey-Edmondson Tavistock and Rochdale, England Contents Foreword by Harriet Hannan MP ix Introduction xi 1 Health services: bad for your health? 1 Contexts 3 The politics of occupational health 6 Occupational health in the NHS 10 2 Health and safety: the legal framework 23 Employers' duties 25 Employees' duties 29 Duties of manufacturers and suppliers 31 Safety representatives 31 The legislation 33 Enforcement of the health and safety regulations 38 The role of the European Union 38 Financial awards and injury benefits 39 3 The working environment 44 Buildings 44 Asbestos 50 Fire 51 Security 58 Staff facilities 59 Lighting 63 Temperature and ventilation 66 Noise 68 Conclusion 69 4 Stress 70 How stress is defined 72 Societal stressors 74 Employer-induced stressors 79 Professional stressors 84 Action on stress 87 Conclusion 93 v vi Contents s Violence and bullying 95 Violence 95 Bullying 104 Whistle blowing 107 Conclusion 111 6 Toxic substances and agents 112 Toxic chemicals 112 Waste anaesthetic gases 123 Drugs 126 Cytotoxic drugs 128 Radiation 133 Mercury 140 7 Infection and infection risks 142 Microbiological hazards 143 Protection 144 Enteric infections 150 Methicillin-resistant Staphylococcus aureus (MRSA) 156 Hepatitis 159 HIV and AIDS 164 Legionnaire's Disease 172 Tuberculosis 174 8 Technological hazards 177 Equipment safety 177 Sharps 182 Electrical hazards 186 Lasers 187 Computers 189 9 Reproductive hazards 192 Anaesthetic gases 194 Biological risks 195 Radiation 197 Workload and stress 198 Employees' rights 198 10 Manual handling: time to stop? 204 The costs of manual handling 204 The regulations 207 Guidance on manual handling 210 Safer patient handling policies 212 Contents vii 11 Injury at work and work-related illness 218 Accidents 218 Supporting the work-injured nurse 220 Conclusion 232 12 The healthy nurse 235 Personalconrurrritrnent 235 Working conditions and the working environment 239 Occupational health services 243 Conclusion 249 Appendix 1 lnfonnation 255 Appendix 2 Organisations 263 Appendix 3 An A to Z of hazards 268 Index 271 The authors and publishers are grateful to the Editor-in-Chief of Nursing Times, Emap Healthcare Ltd, for permission to reproduce copyright material from that journal. Foreword A decade ago, in the foreword to the first edition of this book, I said that nurses were one of the most valuable resources of the National Health Service. They are hard-working and dedicated people who deserve the best possible conditions in which to carry out their vital work. Ten years on these words still apply. The health and well-being of staff are integral to the well being of the NHS. If they are off sick or injured, they cannot treat patients at all. This book raises nurses' own concerns about the hazards they face and suggests ways of tackling them. The most frequently reported type of injury is caused by lifting and handling. Research in one trust has shown that as the result of a safer handling policy, time off for injuries sustained by handling patients was reduced by 84 per cent. This saved £400,000 a year in replacement nursing costs alone. Research also shows that stress at work is a widespread problem in the NHS and this rightly falls within the remit of health and safety. Current research will lead to the issuing of guidance to the service on ways of coping with organisational stress. Fourteen per cent of recorded accidents to staff involve physical assault, making it the third most common type of accident to staff. Violence can cause pain, suffering and disability, and verbal abuse and threats can damage health through anxiety or stress. The issue of violence to staff must be managed as a health and safety risk. These problems are difficult ones, but the fact that so much work-related illness - mental and physical - can be prevented should give us hope. This book offers valuable guidance to nurses and to their employers and managers on how to improve matters. The authors' research into the problems is backed by sound practical advice on how to tackle them. The NHS is taking action on a number of issues relating to staff. The framework for human resources currently being developed will raise the profile of staff health and welfare as core management issues. The Health at Work in the NHS project has been disseminating guidance and good practice information; 80 per cent of NHS employers are participating, and NHS Estates have been working on benchmarking and risk management tools. The NHS is determined to tackle these areas to ensure that nurses are able to work properly, safely and happily, thus helping them to give better care while enjoying greater job satisfaction and better morale. RIGHT HoNOURABLE HAluuET HARMAN MP ix Introduction It is a decade or so since the first edition of Nurses at Risk - a decade which has seen many changes in health care and nursing. Yet much of what we wrote in that first edition is, sadly, still relevant today. In revising this book, we found that all the issues researched then remain topical now - indeed there appear to be more rather than fewer hazards, while the failure of the Conservative government to tackle the key issues concerning the well-being of the NHS workforce has taken an even greater toll, especially on nurses - its front-line workers. Rarely a week passes without new evidence of old and new hazards. Improving the Health of the NHS Workforce, published by the Nuffield Trust and the biggest ever report on the health of NHS staff, was issued just after our manuscript was completed in March 1998. It provides compelling research-based evidence of how little has changed in the last decade and points out the appalling human and financial consequences of this systematic and shameful neglect. There have of course been some positive developments. New Labour has yet to prove its Bevanite credentials as the saviour of the health service, but it has more card-carrying credibility in this area than its Tory predecessors and a lot more to lose in public credibility should it let the NHS down. Initiatives such as the Health at Work in the NHS project, described in Chapter 12, may eventually prove to have no teeth but at least on the surface promise a greater commitment to the health and welfare of the NHS workforce. Meanwhile a raft of much tougher European legislation affecting health and safety at work, covering the whole spectrum of workplaces where health care is delivered, has come into effect in the UK since 1988. Despite these hopeful signs, however, we found the persistence of many familiar hazards to health and well-being - such as back injuries caused by staff shortages, poor training and lack of equipment - as well as the emergence or escalation of new ones: glutaraldehyde, latex allergy and methicillin-resistant Staphylococcus aureus (MRSA), to name just a few. Some of these problems are attributable to new evidence or to changes in clinical practice. Use of the sterilising solution glutaraldehyde, for example, has risen in the past decade because of the increasing use of endoscopes for diagnostic and therapeutic surgical procedures; at the same time, evidence based awareness of the risks it poses has risen dramatically. Latex allergy is a massively more significant health and safety problem than it was ten years ago, thanks to the introduction of universal precautions and the consequent increase in glove use. The effects of widespread and often indiscriminate xi
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