1. Hess, Andrea K. BSN, RN, CEN

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What questions about workplace health and safety should I ask during a job interview?


Health care ranks as the second highest industry for occupational injury and illness in the country, according to the U.S. Bureau of Labor Statistics. Major concerns are needlesticks, back injuries, workplace violence, and exposure to respiratory agents.


Nurses have the right to a secure and safe work environment and to request information on workplace hazards without fear of recrimination. Also, nurses should be offered training and education about workplace safety, and the opportunity to participate on a safety and health committee. One effective approach to ensure a safe work-place begins with the job interview. The following is a list of questions that nurses should ask when interviewing for a job:


Does the facility have a safety and health committee, and are frontline staff nurses encouraged to participate?


Involving frontline nurses in hazard identification and decision making is vital. Such involvement reflects the fact that management values employee input.


Does the facility have a safe patient handling or no-lift policy and equipment to prevent injuries among nurses? Manual patient handling places nurses at great risk for back and other musculoskeletal injuries. Safe patient handling programs using lifting equipment greatly reduce this risk because nurses don't have to bear the physical stress of handling. And equipment offers a more secure, comfortable, and dignified way to handle patients.


Does the facility use safer needle and sharp devices and needleless systems? The Occupational Safety and Health Administration (OSHA) requires the use of safer sharps devices to protect employees from becoming infected with HIV, HBV, and HCV. Health care facilities must have a blood-borne pathogen exposure control plan and review it at least annually. Asking frontline nurses to evaluate safer sharps devices helps to ensure that the purchased devices match clinical needs.


What kind of fit-testing program does the facility have for respiratory protection? OSHA requires respiratory protection and calls for annual medical screening and fit-testing for health care workers who risk respiratory agents such as exposure to tuberculosis. An annual fit-test ensures that nurses are protected from unanticipated exposures to other respiratory agents, such as SARS and biological agents used in terrorism.


What precautions does the facility have to limit or remove latex? Health care workers are at high risk for developing latex allergies following sensitization. Exposure occurs primarily from wearing latex gloves or using other clinical products such as IV tubing that contain latex. Facilities have been successful in going latex free, eliminating risk of exposure.


What is the facility doing to become mercury-free? Medical waste incinerators are one of the largest sources of environmental mercury contamination. Mercury is a potent neurologic and reproductive toxin that affects the central nervous system, liver, and kidneys. It can be found in old-style thermometers and blood pressure devices, but alternatives without mercury exist.


What policy is in place to address workplace violence? Violent incidents among nurses can involve patients, their families, visitors, and coworkers. The physical environment, including isolated rooms and hallways, poor lighting, and locked doors, also plays a part in the risk. A comprehensive violence-prevention program involves training and educating employees to recognize potentially escalating situations.


What systems are in place for emergency preparedness? Nurses play an important role in emergency situations such as bioterrorism, mass casualties, or natural disasters. A flexible plan that can be applied to all types of unanticipated hazards is most effective. It's important to ensure that staff needs from personal protective equipment to physical and psychological issues are met.


Effective safety and health programs are directly correlated to fewer illnesses and injuries. Programs should include training and educating the employee while addressing worksite hazard analysis and prevention. Frontline staff participation is crucial. By working together, nurses can make a difference and ensure safe and long careers for themselves and their colleagues.