Healthy nurses are essential for a healthy nation

May is recognised as Nurses’ Month in some parts of the world. Against this backdrop, I have dedicated this week’s instalment to raising awareness regarding the plethora of health challenges linked to the noble profession of nursing.

The majority of nurses innately have hearts of gold. They unselfishly dedicate their working lives, respectively, to caring for the rest of us while being oblivious to the profusion of hazards that lurk in their working environment.

The following factors play varying roles in the aetiology of the health challenges that our nurses encounter throughout their careers:

• Emotional attachment to their patients
• Tremendous physical demands
• 12-hour shifts
• Schedule changes at short notice
• Night shifts
• Exposure to infectious agents and toxic chemicals
• Nursing shortages
• Excessive patient load
• The working conditions of the physical plant are often unsatisfactory
• Harassment from patients and their family
• Equipment failures
• Out-of-stock medicines and supplies
• Job politics and favouritism
• Minimal contribution from some team members
• Placing patients ahead of themselves
• In some instances, little support from superiors
• Limited upward mobility
• Sleep deprivation
• Needle stick injuries
• Continuously evolving treatments, protocols, and technology
• Suboptimal remuneration.

Nurses’ Health Challenges

Infectious diseases: Nurses are at an increased risk of contracting from their patients infectious microorganisms – e.g. viruses, bacteria, fungi, parasites, and prions. Infections they can contract include respiratory tract infections, COVID-19, Hepatitis B & C, chicken pox, measles, skin infections, MRSA infections, tuberculosis, scabies, HIV (in rare instances), and more.

Injuries: Having to lift and handle patients who are in many instances bedridden and overweight, nurses have an increased chance of suffering musculoskeletal and other injuries.

Muscles, nerves, ligaments, tendons, cartilage, spinal disc, trunk, upper and lower extremities can be injured. Being overworked, and overexerted increases the risk of injury. Nurses, especially those over 45, have an increased chance of tripping, slipping, and falling at work when compared to persons of other occupations. Accidental needle sticks can expose nurses to Hepatitis B, C, and HIV.

Stress/ depression/ anxiety/ clinical burnout: Nurses most likely to be stressed are more likely to work with the terminally ill, in ICUs, ERs, or ORs. Working long hours, having irregular schedules, becoming emotionally invested in their patients, confrontational patients/families, short-of-staff departments, challenging working conditions, and the politics- especially promotional, within the profession, often contribute to suboptimal mental health. A Canadian study showed that over the course of their career, 33% of nurses experienced a major depressive disorder, 26% reported a generalized anxiety disorder, and 29% suffered clinical burnout.

Cancers: Female nurses who worked six or more night shifts per month for five years or more, especially if they started in their younger years, had a 58% increase in the incidence of breast cancer. They also had an increased risk of developing lung and gastrointestinal cancers.

Sleeping disorders: Among nurses, sleeping disorders are 50% higher than in the general population. The reasons are job stress, anxiety, depression, irregular and nighttime shifts.

Ionizing radiation exposure: Nurses working in the radiology department and emergency room have the highest risk of exposure. The consequences of long-term exposure can include miscarriages, babies born with birth defects, and cancer.

Chemical exposure: Nurses who work with chemotherapeutic agents may experience irritation of the skin and eyes, allergic reactions, and cancers. Their babies may be born with congenital anomalies. Sterilizing agents (e.g. ethylene oxide) can cause birth defects and cancer. Long-term exposure to anaesthetic gases can cause kidney and liver disorders and in some instances lead to birth defects and miscarriages.

Besides skin and eye irritation, formaldehyde can cause occupational asthma. Glutaraldehyde used for the cold sterilization of instruments (e.g. endoscopes, dialysis) may cause liver toxicity.

Some measures that can be taken to protect the health of our nurses

• Empathetic, considerate, and approachable nursing leadership is essential.
• Nurses should be encouraged to exercise regularly. This mitigates stress and improves physical fitness.
• Caffeine intake and sugary drinks should be limited.
• Remain well hydrated at all times.
• Home-prepared meals should be taken to work. Avoid unhealthy foods. • At work, mealtimes should be scheduled.
• Regularly planned meetings between the nurses and their leadership are vital for amicably tackling outstanding issues.
• The workplace should ensure that nurses have free access to confidential mental health counselling services.
• Nurses should have ready access to resources that outline various self-stress mitigating techniques.

To all our wonderful nurses, while it may not often be said, however, your dedication, skill, commitment, stamina, professionalism, and compassion are tremendously appreciated. A profound and heartfelt thank you for looking after all of us, especially in our time of greatest need. Keep up the excellent work and please take care of yourselves.

Author: Dr. C. Malcolm Grant – Family Physician, Family Care Clinic, Arnos Vale. Former tutor in the Faculty of Medical Sciences, University of the West Indies, Cave Hill, Barbados. For appointments: 1 (784)570-9300 (Office), 1(784)455-0376 (WhatsApp)
Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.