How NOT to get hurt at work

BEAT COLD AND FLU BUGS

Whether you work in a hospital or a doctor’s office, catching a cold or flu is an occupational hazard. And despite the fact that healthcare settings usually have bug-fighting standards in place, as a nurse you’ll need to go the extra mile to stay well. “Think about it as protecting your patients,” says Vicki Allen, MSN, RN, Infection Prevention Manager for CaroMont Health, a 400-plus-bed hospital located in Gastonia, N.C., and a spokesperson for the Association for Protection in Infection Control and Epidemiology. Here are five things you can do to fight off infection.

• Exercise regularly. Twelve-hour shifts are hard enough. Must you exercise, too? Well, yes. Taking the time to exercise—on your days off; during your breaks, even, if you can manage it; before or after work—can be an effective strategy for fighting colds and flus. Exercise (and aerobic exercise, in particular) helps increase immune cell activity, and it pays off: A University of Wisconsin-Madison study published last year found that people who exercised daily had a 40 percent to 50 percent reduction in respiratory infections.
• Get enough sleep. When researchers exposed people who’d slept less than seven hours per night over a two-week period to a rhinovirus, then did the same to people who’d slept eight or more hours a night, those who slept less were nearly three times more likely to develop a cold. Enough said.
• Practice good hand hygiene at work. You wash your hands or use sanitizer often, sure. But according to a 2009 Joint Commission report, many healthcare workers should actually perform hand hygiene several times during a single contact with a patient. All nurses would do well to reacquaint themselves with hospital hygiene policies and to make sure that their workplaces make sanitizing their hands as convenient as possible. “Often, when nurses have to go across the room to reach the hand sanitizer dispenser, they’re going to be less likely to use them,” says Allen. If these or other obstacles are standing in your way, make the case to your superiors for better access.
• Be vigilant with others. Nobody wants to be a scold, but gently reminding coworkers and patients of proper infection control practices will help everyone (including you) stay well. In 2007, a Swiss study found that pressure from colleagues was one of the determining factors in adherence to good hand hygiene practices.
• Get vaccinated. While some nurses have resisted getting vaccinations in recent years, this is still the best way to protect yourself and your patients, says Allen.

Dietary Defense

Science has yet to confirm that what you eat can help you beat flu and cold bugs. Still, don’t discount it completely:

• Common sense says that there’s value in keeping your energy up with proper nutrition. You see it in your patients; you’ll see it in yourself as well.
• Meeting the RDAs for vitamins and minerals will help ensure your immune system is on guard. Some research, for instance, shows that adequate vitamin D (available in dairy products and fatty fish—and, of course, the sun, which helps your body make it) assists in protecting against colds and flu.
• In the it-can’t-hurt-and-it-may-help department, shoring up your immune system with a daily supplement may be worth a try. (One we like: SmartMune, which has considerable research backing up its efficacy, including one study showing it helped prevent upper respiratory infections.)
• And if you do get sick? Stick to the time-honored chicken soup and citrus fruits. Studies show that they may help you get well quicker.

Masking the Problem

Masks are one of the most important lines of defense, but are you using them appropriately? “A lot of healthcare workers wear masks that don’t fit properly, reducing their effectiveness,” says Matt Conlon, vice president of research and policy at Cantel Medical, an infection control and prevention products company. Another no-no: letting masks dangle around your neck while you check out the lunch specials in the cafeteria, or using the mask in two different clinical scenarios. “There’s a potential for cross-contamination,” says Conlon.

There’s evidence to suggest that stopping infection at the source can be the best preventive action, which can sometimes mean getting patients to wear masks. Conlon recounts how he visited an emergency room during the H1N1 breakout, when he saw a box of masks in the corner, but little encouragement or instruction for patients to use them. “Sometimes,” he notes, “you have to take a polite, but more direct, approach to get patients to comply.”

BUILD EMOTIONAL RESILIENCE

Gossip. Backstabbing. Rudeness. Belittling. Unfortunately, for all the goodwill involved in the profession, being a nurse doesn’t protect you from the kind of workplace bullying or meanness that can make you an emotional wreck. You can be the victim and—if you let work stress get to you—even the perpetrator. “Hospitals can put policies in place and units can have rules, but civility comes down to individuals,” says Stacey Turnure, RN, a nurse in North Carolina and coauthor of The Real Healthcare Reform: How Embracing Civility Can Beat Back Burnout and Revive Your Healthcare Career. Some of her suggestions for making your facility a nicer, kinder place to work:

• Deflect others’ anger and bad behavior. When a colleague is on the warpath, remain calm and focus on your work. “Think to yourself: That person is doing what she needs to do and I’m doing what I need to do,” says Turnure. By differentiating their actions from yours, you’re less likely to be affected by the emotional fallout.
• Pick your battles. Naturally you’re not always going to agree with coworkers, but don’t just disagree because you want to be right—that’s a trap that will only lead to spinning your emotional wheels. Make sure an issue is important to you if you’re going to go head-to-head with someone.
• Be a good listener. If you focus on what someone else is saying, you will likely have a greater understanding of that person’s intent—and have a more civil and measured response.

How Self-Aware Are You?

One of the keys to avoiding conflict on the job is self-awareness. Understanding how your thoughts and feelings impact the world gives you an edit button, says Turnure, making it more likely that you’ll act kindly toward others—and that they’ll return the favor. Take this quiz to see how well you connect your words with their likely impact.

Here’s how to score. Give yourself a…

• 0 when a statement is “not true for me”
• 1 when it’s “somewhat true for me”
• 2 when it’s “very true for me”

1. It’s important for me to say exactly what’s on my mind.

2. I have difficulty feeling and expressing anger, and then letting go.

3. I don’t feel that it’s important to praise the successes of others.

4. It’s hard for me to communicate with people whose opinions and backgrounds are different from my own.

5. I know which people at work are weaker than me, slower than me and/or not as smart as me, and I’m likely to use that information to get ahead.

6. I often find myself speaking without thinking, and sometimes say hurtful things.

7. I tend to respond to people who are angry by becoming angry myself.

8. I feel my coworkers benefit when I point out their errors or mistakes—it helps them to learn and do better.

9. Most people know that when I’m mad, they should stay out of my way.

10. I have strong opinions about most things and often find myself in disagreements or debates with others.

Scoring:

If you got 0–6, you have a keen sense of self-awareness. You clearly understand how your words and your actions affect others, and you choose behaviors that are least likely to cause harm or unnecessary drama.

If you got 7–13, you’re doing okay, but there’s room for improvement. You know that your words and actions can have a negative impact on others, but you tend to have trouble editing yourself, especially when you are experiencing intense emotions. Learn how to better manage your moods, set clear boundaries and resolve conflicts.

If you got 14 or higher, you have trouble knowing how your words and your behaviors impact others. It’s time to take a good, long look in the mirror and decide whether your actions and attitudes are helping or harming your career, reputation and personal sense of satisfaction with life.

Adapted from In the Know, Inc., 2012. All rights reserved. 

A Bulwark Against Burnout 

Watching patients suffering day in and day out puts nurses at high risk for burnout. And the symptoms can be devastating: persistent self-doubt (“Did I do the right thing?”); emotional distancing from family, colleagues and patients; anxiety and irritability; and a tendency to self-soothe by eating, drinking or spending too much; or physical symptoms such as exhaustion, disrupted sleep or just not feeling well. Last year, Barnes-Jewish Hospital and Washington University School of Medicine instituted a compassion fatigue program specifically designed to help nurses head off burnout. Patricia Potter, RN, PhD, director of research for patient-care services at Barnes-Jewish, has these resiliency-building tips for staying sane in a pressure-cooker workplace:

• DON’T allow your self-esteem to nosedive. If you start to feel incompetent, remind yourself that you do the best you can do every day, and that’s all you can do. Know that you are making a difference.
• DON’T hold feelings inside. Talk to someone, preferably another nurse, a chaplain or other professional. “Frankly,” says Potter, “your family doesn’t want to hear about death and dying.”
• DO refuel often. Exercise or do something creative rather than sitting on the couch and eating.
• DO use relaxation techniques, especially when faced with an angry colleague or patient’s family member. In the compassion fatigue program, nurses are taught to breathe deeply and relax their pelvic floor muscles. It’s a technique you can use anywhere and you’ll feel calmer in as little as five seconds.

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