 2003 AJN Table of Contents
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Health & Safety
American Journal of Nursing -
April, 2003 - Volume 103, Issue 4
Prejob Screening
Evaluate the ‘Environment of Care’ before you take the position.
How can I assess potential health and safety threats
and the effectiveness of the occupational health and safety program at a
facility during a job interview?
Nearly 90% of nurses who responded to a 2000 ANA survey indicated
that health and safety was an important consideration in choosing a job.
Management’s commitment to the issue can be measured by assessing how
health and safety needs are prioritized in the budget, how an occupational
health office is staffed, and how frontline workers are involved in the
program.
Begin by observing and inquiring about threats or
hazards most likely to occur within the work area, including biological
pathogens, sharps injuries, respiratory exposures, violence,
hazardous drugs and chemical exposures, back and musculoskeletal
injuries, stress, and physical injuries. Also ask much broader questions,
such as the facility’s response to acts of terrorism,
catastrophic disasters, civil unrest, major weather events, and massive
utility failures.
Assess the general environment of the facility. The
Joint Commission on Accreditation of Healthcare Organizations
(JCAHO) terms this evaluation the “Environment of Care”
(EOC), and it includes everything from how clean the facility appears and
the routine noise level to adequate staffing patterns and emergency
preparedness.
Prior to your interview, drive by the facility at
night and observe it for adequate lighting of the parking area and
walkways. During the day see how well the grounds are kept, including
the amount of litter, and in winter months take note of snow removal. Poor
lighting, unkempt grounds, and uncontained garbage could be a sign of
inadequate facility support staff.
On the day of the interview, arrive early to observe
the condition of the interior of the facility. Were you required to stop at
a security checkpoint? Lack of security at entrances may indicate
vulnerability to thefts or workplace violence. Are ceiling tiles cracked,
stained, or missing? Are fire extinguishers easily spotted? Are hallways
clear, particularly at exit points? How is the overall noise level?
The mechanism and process for monitoring these and
other issues should be outlined in an EOC manual (safety manual, disaster
manual, or similar document). Ask if there is a written manual on how the
facility monitors the EOC, and what is the facility’s process for
resolving deficiencies. Test the answers you get by asking to see a
monitoring tool for an area that you directly observed. Are the results
reported similar to your own observations? A great disparity between what
you observe and what is written may indicate that the monitoring process is
not carried out routinely or comprehensively.
Another important issue to inquire about is your
ability as a frontline caregiver to participate in standing committees on
health and safety. The employer should name several committees, including
those for EOC, sharps safety, and emergency preparedness. Participation
should be from all areas and levels within the facility. If representation
on these committees is uneven, it could mean that key health and safety
issues are being overlooked or ignored.
Finally, ask about health and safety orientation and
ongoing training. Orientation should include fire safety, right to know,
bloodborne pathogens, respiratory hazards, evacuation procedures,
ergonomics, security, and any health and safety issues pertinent to your
assigned area. The facility should also provide an annual in-service report
on its health and safety program. In addition, ask about the use of
specific safety equipment, such as devices for lifting and safe needle use.
Lack of a formal health and safety training program and safety equipment is
indicative of a lack of commitment from the administration to protecting
and enhancing the health and safety of their employees.
If you are satisfied with your observations and
answers to your questions and decide to accept the position, ensure that
health and safety issues continue to be addressed by becoming involved in
the committees, the orientation process, and continuing
education.
Resources
The ANA Workplace Health
and Safety Guide for Nurses: OSHA and NIOSH
explains the underlying federal authority, the resulting rights and
responsibilities, and focuses on how to collect and analyze data in a
health care facility. For more information, visit
www.nursingworld.org.
Thomas J. Lowe is an occupational health and safety representative at the New York State Nurses Association and
president of the Hudson Valley New York Association of Occupational Health Nurses, Inc.
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