I hope everyone had pleasant National Nurses Week, International Nurses Day, and Memorial Day celebrations last month. We were certainly glad to have been able to share ours with you. This month, I present to you a word on Memorial Day, a brief review of Workers' Memorial Day, and conclude with important reminders on working safely. I chose the topic of safety to tie in a few conditions that affect your health and welfare at work, namely Safe Patient Handling and Short Sleep Durations. I also included in this month’s newsletter Tips on Achieving and Maintaining Patient Satisfaction, which was drawn from an article I read in the Journal of Nursing Management. If you have a topic of interest that you would like to see included in our newsletter, or if you know someone who might like to receive our newsletter, please send your suggestions firstname.lastname@example.org
Memorial Day is a day of remembrance for those that forfeit their lives while serving in the US Armed Forces. Among the many brave souls who served our country faithfully in times of crisis were many nurses. Long before the Army Nurse Corps was formed in 1901, or the Navy Nurse Corps was formed in 1908, nurses left the comfort and safety of their homes and ventured into harms way to care for the wounded and dying. We honor their sacrifice and courage for contributions made in the past, and are grateful and thankful for the continued service to all of mankind today.
Worker's Memorial Day
A different type of Memorial Day, one that not many individuals are familiar with, occurs annually on April 28th. It is Workers’ Memorial Day and it has been observed in the United States since 1989. Workers’ Memorial Day is a day of mourning, remembrance, and action on behalf of those individuals who, while on the job, became injured, disabled, diseased, or died due to preventable work place accidents. It is in the spirit of remembrance and action on behalf of nurses injured and lost on duty, and in honor of those still out there working on the front lines in our hospitals, in our homes, and in other nursing facilities that these articles are written.
Safe Patient Handling
As long as people continue to work there will inevitably be accidents on the job. The best recourse employees have is to become educated on common workplace injuries, methods of prevention, and to work safe and smart. Prevention is the best cure, as most cases of workplace accidents are preventable.
Nurses have their own special list of injuries that occur at work. A short list would include needle sticks, lifting strains, sprains, and tears, slips and falls, and assaults by patients. One area of injury is musculoskeletal disorders which are caused by damage to the nerves, muscles, cartilage, joints, tendons, or spinal discs. It is believed that musculoskeletal injuries in nurses are often brought on by repetitive motions such as lifting and transferring patients. According to the Bureau of Labor Statistics for the period between 1995 and 2004, 53 percent of reported injuries that resulted in musculoskeletal disorders in nursing, psychiatric, and home health aides were due to overexertion. That number is about twice as high as it is for workers in other industries. The Centers for Disease Control and Prevention (CDC) published that 42 percent of reported musculoskeletal injuries to nurses are located in their necks, backs, or upper extremities. Many of the injuries are easily preventable by slowing down, observing the environment, and using protocols already in place. They are also avoidable by investment in, and utilization of contemporary safety techniques in regard to patient lifting and the consistent proper use of equipment when moving patients.
In response to the call for laws on safe patient handling, ten states have already enacted Safe Patient Handling legislation. The legislation encourages hospitals to implement Safe Patient Handling programs, organize committees, and to purchase patient lifting and moving equipment by offering them financial incentives to do so.
Short Sleep Duration
Another factor in workplace injuries for nurses is short sleep duration. The CDC reported that 3 out of 10 nurses who work overnight are not getting enough sleep. Individuals suffering from limited sleep duration may be at a higher risk for workplace accidents and injuries than someone who is getting a full 8 hours sleep.
Short sleep duration is defined as getting less than 6 hours of sleep in a 24 hour period. Short sleep duration most commonly affects individuals working the overnight shift, which for nurses is the NOC shift. The effects of sleep deprivation are not only brought on by working long hours, but by the disruption of natural sleep patterns called circadian rhythms.
According to an article on Melatonin and Sleep found on The National Sleep Foundation website, http://www.sleepfoundation.org, the central nervous system responds to the presence or absence of light. The light excites a nerve pathway that leads to the activation of the supra-chiasmatic nucleus in the hypothalamus. Once stimulated the supra-chiasmatic nucleus sends chemical messages to wake us by raising body temperature and releasing stimulating hormones, while suppressing melatonin production. In the darkness of late evening, the supra-chiasmatic nucleus notifies the pineal gland to begin producing melatonin which initiates the system’s desire to sleep.
The hormone melatonin is produced only when the human body is in a dark environment. It therefore follows that achieving and maintaining sleep during the light of day is very difficult without the production of melatonin and the natural suppression of stimulating hormones. Even artificial light can disrupt the body’s natural melatonin production, making short sleep duration seemingly inevitable for nurses working through the night.
Tips On Patient Satisfaction
1. Effective Patient-Centered Communication: Keep the patient actively involved in the discussion of their own care.
2. Communication Skills: Utilize the art of listening, make eye contact, be personable, remain calm, be patient, attend to nonverbal cues, and speak slowly and clearly. Remember if the patient doesn’t understand what you trying to convey, then you are not communicating, you are just talking.
3. Empathy and Compassion: Respond to calls in a timely manner, immediately respond to calls for assistance, or help, preserve the patient’s sense of privacy, and do what you can to maintain room cleanliness. Demonstrate sincerity and respect. Introduce yourself to the patient and their family members.
4. Language and Cultural Barriers: When nursing those with limited English use a translator and not one of the patient’s family members. Cultural differences may lead to communication breakdowns and patient discomfort, so try to recognize and adapt to cultural differences.
6. Bad News: Disclose possible negative outcomes to patients, alternative treatment choices, and if the worst should occur, be honest and remorseful when relaying a negative outcome.
7. Teach: Educate your patients when you can, using materials readily available or by directing them to other resources.
8. Double Check: Clarify discharge instructions, be available and knowledgeable should the patient ask you to explain what the doctor just explained to them, provide patients a resource person with contact information should the patient have issues after they leave the facility.
9. Be You: Be yourself. There is a high probability that the reason you went into nursing in the first place is because you wanted to help people, to contribute positively to the human race, and that you are a loving caring intelligent person. We all get busy, buried, slammed, misunderstood, undervalued, overworked, and at times generally mistreated. Just remember who you are, what you stand for, and why you are there. You’ve got this!
Squires S. Patient satisfaction: How to get it and how to keep it.
Nursing Management. 2012;43(4):26-32.
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