Barriers to reporting a workplace injury

Nevada RNformation, Nov 2003 by de Castro, A B (Butch)

Recognizing the difficulties and encouraging a determined approach.

Q. My lower back has been extremely sore and I can't lift patients without help. I'm pretty sure I was injured working all these years as a nurse. How can I report my injury without any negative consequences to my employment status?

A. Reporting a work-related injury or illness is not always easy. Many workers hesitate to reveal that they were injured or became sick while on the job. According to the American Nurses Association's Health and Safety Survey in 2001, 75% of nurses who responded did not report injuries that occurred on the job. While nurses' exposure to the many hazards in health care is well recognized, why are so many unwilling to report incidents that cause injury or illness?

There are numerous barriers to reporting a work-related injury or illness. Many fear repercussions such as disciplinary action, stigmatization as a complainer, harassment by supervisors and coworkers, denial of opportunities for promotion, and termination of employment.

Some may work under circumstances that make it more difficult to report injury or illness. For example, many nurses work through an agency as temporary employees. These contingent workers may fear losing future assignments or the opportunity to be hired as permanent staff. Also, those who have limited rights to work, such as foreign nurses, may fear that reporting can threaten their employability.

The connection between a particular injury or illness and workplace exposure may not be clear. Nurses may not realize their injury or illness can be attributed to their jobs or work environments. The length of time between exposure and onset of symptoms can be long and variable. Others don't consider reporting because they are not aware of their legal rights.

Nurses often blame themselves for acts or situations that lead to a work-related injury or illness. They may believe that if they had been more careful the incident would not have occurred, or mistakenly think that safe alternatives are not available.

Also, workplaces may institute incentive programs that reward departments or units for the lowest number of reported injuries and illnesses. Although intended to improve workplace safety and health conditions, this approach may backfire because it can discourage reporting among staff motivated to win the prize for being the safest.

Report injuries for your safety

Thorough reporting of injuries and illnesses ensures an accurate profile of workplace hazards. Reported cases help pinpoint trends and areas of need in health and safety. Unreported cases limit insight into the nature of occupational injury and illness in a work setting. For the injured or ill worker, prompt reporting allows for necessary treatment and follow-up.

A determined approach to reporting workplace injury and illness includes:

* a clear policy and mechanism for reporting injuries and illness.

* protection of confidentiality.

* designation of a health and safety committee or employee health department.

* management support of a nonpunitive attitude.

* employee efforts to escape a self-blaming mindset.

* contract language for collective bargaining units, if applicable.

Under OSHA's Recordkeeping Standard, employers are required to show employees how to report a workplace injury or illness by using the OSHA 300 Log, which must be made available if requested. The Occupational Safety and Health Act prohibits discrimination against employees who report a work-related injury, illness, or fatality.

A healthier and safer work environment relies on surveillance of injury and illness through reporting. Employers and employees must actively foster a supportive and determined approach to expose workplace hazards and their impact on worker well being.

Resources

The ANA Workplace Health and Safety Guide for Nurses: OSHA and NIOSH Resources

The ANA Occupational Health and Safety Series: Your Health and Safety Rights nurslngworld.org/osh/rights.pdf

U.S. Department of Labor-Occupational Safety and Health Administration Recordkeeping Web page www. osha.gov/recordkeepingl

by A.B. (Butch) de Castro, PhD, MSN/MPH, RN

Butch de Castro is a senior specialist of occupational health and safety at the American Nurses Association.