When Patients Put Healthcare workers at Risk

I too feel that as nurses we are even at more risk than the doctors.These out of control patients see us as easy targets,and in some cases enjoy the harm they cause.i am not referring to demented or hypoxic or true psych patients... but the ones that if they were in the real world would be arrested for assault.It is very hard to care for people when it seems more and more patients want to hurt you!!!!

It is definately terrifying when you allow yourself to think about it, but Im a scaredy-cat about a lot of things. I think being a worry wort makes me a better caregiver though, it's when you get into the routine of "I haven't been stuck, bit, coughed on, scratched, etc. yet... so I'm doing fine with my safety practices" kind of thought that is dangerous. That is when you become complacent and do get stuck, bit etc.

Of coarse there is always the chance that something will happen no matter what you do. I like to relate this to my experience of my husband teaching me to shoot a shotgun: I was so nervous about the power that I held in my hands that I made sure to do everything right, like not taking the safety off until your aimed and ready to pull the trigger, to make sure you have correct form and tuck it tight to your shoulder so you don't break your jaw, that you load the shells the correct way etc... it shows you respect the amount of damage you could cause to yourself and others, which can be just as deadly as unsafe care practices. Can I get an Amen?

Here are the top 10 most dangerous of jobs...

http://moneycentral.msn.com/content/...tra/P63405.asp The 10 most dangerous jobs
Occupation Fatalities per 100,000
Timber cutters 117.8
Fishers 71.1
Pilots and navigators 69.8
Structural metal workers 58.2
Drivers-sales workers 37.9
Roofers 37
Electrical power installers 32.5
Farm occupations 28
Construction laborers 27.7
Truck drivers 25
Source: Bureau of Labor Statistics; survey of occupations with minimum 30 fatalities and 45,000 workers in 2002

Yep, nursing not on the list. However, the fatalities cited by the Bureau are mostly traumatic and drastic, whereas a nurses death might not be attributable to nursing and not considered a work related injury or death if it is death by disease. So many nurses I have come across over the years should be more concerned about lifestyle choices (vs. contagious disease) such as what they eat or smoking, IMO. Morbidity (& co-morbidity) is poor health due to any cause & can slowly lead to "mortality." Nurses are unlikely to get crushed by a fallen tree, fall off a roof, or get zapped by a high-voltage power line!

I agree about the lifestyle choices that often are indulged in by nurses. These are more likely to lead to health problems down the road that the threats cited by the OP.

And definitely a problem that is being worked on...we were taught about the comorbidities among nurses in school...high rates of smoking, alcohol consumption, drug use, poor sleeping habits, etc. But while they may be more of a problem, the OP and the author of the blog have a very real point. Statistics are being tracked on the lifestyles that health care workers maintain...but they aren't being tracked on how many of us die because of an accident related to work. So we really don't know how bad of a problem it is.

The link the OP provided shows that the reason nurses (and healthcare workers) AREN'T on the list is that there currently is NO list for us.

the purpose in the article is to encourage the data collection related to obvious occupational-related fatalities. (contraction of SARS, MRSA, etc)

Since healthcare workers do not appear on a work fatality database structure, the (incorrect) assumption is that the jobs performed are relatively safe. The public (and our employers) need to better understand the risks that we take daily and how to better protect healthcare workers from injury.

Nursing and health care workers might not have made it to the top 10 list of most dangerous jobs, but it does have risks. We are not out there fighting the elements, but we intentionally step into hazardous situations all the time. Not that many other jobs involve choosing to get close to confused, combative patients ( who may or may not also be infectious and not mindful of their blood and body fluids). We do this while stressed, rushed, and while handling life and death decisions. (and with full bladders- I bet every one on that top 10 list gets a bathroom break when they need it).

But I love what I do! I have the skills to usually make each situation a little better, and to usually keep myself safe. (Just keep the guns off my floor,ok?)

Only healthcare workers WHO REPORT EXPOSURES go on lists. How many of you reading this, do that?
(to the tune of Ghostbusters) "Who do you call?"
Answer: THE INFECTION CONTROL NURSE &/OR THE Employee Health Nurse!

I have worked in both capacities, and at 2 places, both positions simultaneously. When any hospital employee had an exposure to blood/body fluids that he/she reported, I counseled her/him about the ramifications of it, drew their blood for baseline tests for HIV, HepBs antibodies and antigen (if they hadn't been vaccinated sufficiently), and later after the test became available, Hep C. MRSA hadn't been isolated, yet.

The tubes were labeled in code with the name of my department, to protect the identity of the employee. At 6 weeks, 3 months and 6 months after the exposure, the tests were repeated as before. The number of tests has been diminished since then, with the ones at 6 weeks and 3 months eliminated. The Hepatitis B series of vaccinations were commenced with the employee's permission, immediately if their HbsAb (antibody) was negative.

We discussed safer sex practices, until 6 months passed, and I offered to talk to their SO (significant other). If they developed any s/s of superficial infection at the puncture or cut site, they returned to have a culture taken and labelled as above, by me. Each month I sent only the positive results to the Public Health Department to add to their data regarding the same type of information from other hospitals. No one developed the diseases to which they had been exposed while I was there. When I left those positions the data was left in a locked file drawer, and only my successor could access that.

As far as I know, all the IC nurses had the same protocol, and we included it in the information given at orientation of new employees and yearly skills reviews. There shouldn't be a reason for anyone to keep the incidents to themselves, yet fear is a strong motivator for forgetfulness, and most exposure occasions are not reported.

When I worked at the vaccination clinic one summer for the Public Health Dept., a toddler squirmed out of his parents arms, as I was giving the 9th vaccine, and the needle I'd just used punctured my finger. The denial of the other staff there, when I said I'd report the incident, was incredible. I was told "the parents seem nice", and that no one had done that before (really!). I got the parents permission to have the toddler tested, and urged them to go to the lab immediately, so they wouldn't neglect that. No one, including the head of the clinic knew if or what the protocol was for reporting it.

I stuck to my guns, read the IC procedure book, and carried through........ After that, everyone knew what to do, but I doubt that they'll report their future exposures, as the modus operandi was against it (sad).