International Hazard Datasheets on Occupation

Nurse, Nursing Home

What is a Hazard Datasheet on Occupation?

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This datasheet is one of the International Datasheets on Occupations. It is intended for those professionally concerned with health and safety at work: occupational physicians and nurses, safety engineers, hygienists, education and Information specialists, inspectors, employers ' representatives, workers' representatives, safety officers and other competent persons.

This datasheet lists, in a standard format, different hazards to which nurse, nursing homes may be exposed in the course of their normal work. This datasheet is a source of information rather than advice. With the knowledge of what causes injuries and diseases, is easier to design and implement suitable measures towards prevention.

This datasheet consists of four pages:

• Page 1: Information on the most relevant hazards related to the occupation.
• Page 2: A more detailed and systematized presentation on the different hazards related to the job with indicators for preventive measures (marked as and explained on the third page).
• Page 3: Suggestions for preventive measures for selected hazards.
• Page 4: Specialized information, relevant primarily to occupational safety and health professionals and including information such as a brief job description, a list of tasks, notes and references.

Who is a nurse, nursing home?

A nursing home nurse is a registered nurse who works in a nursing home (primarily intended for geriatric or chronic cases) providing professional care for the patients

What is dangerous about this job?

• A nursing-home nurse is exposed to practically all hazards of a medical institution These include communicable diseases due to her direct contact with the patients; exposure to various dangerous chemicals, in particular medications, cleaning, disinfecting and sterilizing agents, anesthetic gases, etc., and to radiation. Injuries may be caused by sharp objects (needles, blades, etc), hot surfaces or flames, faulty electric equipment, etc. A particularly important hazard in nursing homes is that of muscoloskeletal problems and back pains resulting from the handling of heavy patients. Continuous work while standing up or walking causes fatigue and leg problems. Shiftwork, night work, contact with terminal cases and their families, and a feeling of personal responsibility and involvement cause stresses and burnout

Hazards related to this job

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Specific preventive measures can be seen by clicking on the respective in the third column of the table.

Accident hazards	Slips, trips and falls, on wet floors, and in particular during emergency situations or when assisting incapacitated patients
	Stabs and cuts from sharp objects (in particular needle-sticks and cuts by blades)
	Burns and scalds from hot sterilizing equipment, or contact with hot water and steam
	Electrical shock from faulty or improperly grounded equipment, or faulty insulation
	Injuries to legs and toes by falling heavy objects, e.g., food containers or medical instruments
	Acute poisoning due to inhalation or ingestion of disinfectants or sterilizing compounds or their vapors
	Acute back pain, resulting from awkward body position or when performing over-strenuous movements when handling heavy patients
	Muscoloskeletal damage as a result of lifting incapacitated patients
	Acute poisoning due to accidental release of a chemical agent
Physical hazards	Exposure to ionizing radiation from x-ray equipment and radioisotopes
	Exposure to laser beams
Chemical hazards	Danger of exposure to anesthetic materials (ethyl-bromide, ethyl-chloride, ethyl-ether, halothane, nitrous-oxide, etc.)
	Exposure to chemicals during an accident (contact with scattered or spilled chemicals, leaking agents and unidentified chemicals)
	Chronic poisoning because of long-term exposure to medications, sterilizing fluids (e.g., glutaraldehyde), anesthetic gases, etc.
	Danger of poisoning due to contact with drugs and with materials that result from the mixing of unidentified chemicals, as a result of an error or an accident
	Skin defatting, irritation and dermatoses because of frequent use of soaps, detergents, disinfectants, etc.
	Irritation of the eyes, nose and throat because of exposure to aerosols containing washing and cleaning formulations (some of them alkaline) in the air, or by droplets of washing liquids
	Latex allergy caused by exposure to natural latex in gloves, catheters, etc.
Biological hazards	Hazard of contacting a communicable disease from the patients
	Exposure to pathogenic microorganisms in body fluids of patients constitutes a major biological hazard, esp. for blood-borne diseases (AIDS, hepatitis)
Ergonomic, psychosocial and organizational factors	Fatigue and low back pain due to the lifting or other handling of heavy patients and to prolonged working while standing or walking
	Stress, strained family relations and burnout due to shift and night work, overtime work, and contact with sick patients, in particular terminal cases and their relatives
	Physical violence and verbal abuse, in particular from patients with mental disturbances

Preventive measures

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	Wear shoes designed for nurses, with non-slip soles
	Handle needles, scalpels and other sharp objects with extreme care; use special safety receptacles to store used hypodermic needles until disposal
	Install ground fault circuit interrupters; call qualified electrician to test and repair faulty or suspect equipment
	Comply with all safety instructions on the installation and periodic inspection of electrical medical equipment
	Learn and comply with safety instructions on the lifting and handling of heavy loads (consult an occupational safety specialist on the safe handling of heavy patients); use lifting aids whenever possible
	Wear a radiation dosimeter (badge or other) when exposed to radiation; comply with all safety instructions to reduce exposure to a minimum
	Install air conditioning in the emergency room, with effective general ventilation, to alleviate heat stress, and remove smells, gases and vapors
	Provide eye flushing bottles or fountain
	Nurses sensitive to natural latex must use non-latex gloves and avoid contact with other latex products
	Consult an occupational psychologist on how to deal with problems arising from mental exhaustion and burnout, and with physical violence or mental abuse from patients or relatives

Specialized information

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Synonyms	Geriatric ward nurse; old folk home nurse
Definitions and/or description	A nursing home nurse is a professional nurse, as defined in DOT (see Note) who works in a nursing home and tends ill, infirm, geriatric, and mental patients, patients with chronic diseases who need hospitalization, and recuperating cases. She is supervising the practical nurses and all the other nursing aids.
Related and specific occupations	Nursing home assistant; nursing home infirmary; private home nurse
Tasks	Accompanying (the physicians); administering; applying (dressing); arranging; assigning; assisting (Medical doctors etc.); attending; bandaging; bathing; caring; carrying; checking (health situation); cleaning; contacting (patients families, etc.); coordinating; curing; dealing; directing; disinfecting; dispensing; evaluating; examining; exercising; explaining; feeding; fixing; handling; injecting; inoculating; inspecting; lifting (patients); maintaining; massaging; measuring; nursing; observing; performing; preparing; providing; resolving (complaints); rubbing; specializing; sterilizing; supervising; taking pulse; treating; visiting; washing
Primary equipment used	Catheters; masks; medical supplies (syringes, needles, bandages, gauze, sterile pads, scalpels, dressings, etc.); function monitoring equipment; sterilization equipment; stethoscope; sphygmomanometer; thermometers; watch; patient lifting and moving equipment
Workplaces where the occupation is common	Nursing homes; geriatric wards; hospitals for mental cases
Notes	DOT definition of general nurse: A term applied to persons meeting the educational, legal, and training requirements to practice as professional nurses, as required by a State Board of Nursing. Performs acts requiring substantial specialized judgment and skill in observation, care, and counsel of ill, injured, or infirm persons and in promotion of health and prevention of illness. Classifications are made according to type of nursing activity engaged in as DIRECTOR, NURSING SERVICE (medical ser.); NURSE, GENERAL DUTY (medical ser.); NURSE, PRIVATE DUTY (medical ser).
References	Dictionary of Occupational Titles, 4th Ed., U.S. Dept. of Labor, 1991, USA ILO Encyclopaedia of Occupational Health and Safety, 3rd Edition, Parmeggiani, L. Ed., ILO, Geneva, 1983, pp. 1480 - 1482; 1528 ILO Encyclopaedia of Occupational Health and Safety, 4th Edition, Stellman, M. J., Ed., ILO, Geneva, 1998 (various chapters) Occupational Diseases - A Guide to their Prevention. DHEW- NIOSH Pub. 77-181 (1977). 608 pp. (Multiple pages - see entry "Nurses" in index)