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NURSES WALK UP TO 6 KILOMETERS ON A 12HR SHIFT

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Nurses form the core of the healthcare system. The role of the nurse expands far beyond the bedside. The nurse coordinates the client’s care by interacting with the multidisciplinary team. It is therefore not surprising that the nurse runs a lot of errands during the entire shift. This role of the nurse means that the nurse will be walking most of the time during the entire shift.

A 2006 study published in MEDSURG Nursing, “How Far Do Nurses Walk?”, found that the 146 nurses studied walked an average of 4–5 miles (6.4 to 8 km) during a 12-hour shift. Even though walking is healthy, the kind of walking nurses cannot be considered healthy as it is excessive and can lead to fatigue. This may therefore affect the quality of care delivered.

According to Herman Miller Healthcare, there are two major components influencing the total distance nurses walk during their shift:

1.    Physical design – The first component includes the actual distances between destinations such as patient room to medication room, patient room to documentation station(s), and soiled linen to clean supply. Several factors influence these distances including the size of the unit, the mix of single-patient rooms and semiprivate rooms, the amount of decentralization of nursing support spaces, and unit shape and traffic configurations.

2.    Frequency of activities – The second component is the frequency of activities that require the nurse to walk. This frequency determines the total distance traveled on a given shift. Several operational factors affect the total frequency, such as the nurse-to-patient ratio, staffing, the type of patient population, and the shift whether day, evening or night.

While this study was not conducted in Ghana, the situation is the same, especially where most hospitals are understaffed. More often, nurses go beyond their scope of work in delivering care for the patient.

According to John Welton, Ph.D., RN, professor, and senior scientist for health systems research at The University of Colorado College of Nursing, and lead author on the “How Far Do Nurses Walk?” study, it is very essential for nurses to wear good fitting shoes and two pairs of socks. Even though may not be a practical solution for many nurses it may help reduce potential orthopedic problems with frequent walking on hard surfaces.

Also, changing shoes regularly at least every 8 – 12 months helps. Even though the shoes may look neat and ok, the support they offer weakens over time.


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NIGHT SHIFT NURSES AT RISK OF HEART DISEASES

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To some nurses, the night shifts are something they hate and that they in no way like seeing on the duty roster. The thought of leaving the comfort of your home makes one sad. But what are you able to do? That is the job we have chosen. As long as you remain a nurse night shifts are unavoidable.

To others, night shifts are like winning a lottery. Going for 4 days and getting 3 days off and sometimes seven days night duty and seven days off seems a good deal.

Sometimes you may get all the weekends off. Some nurses even go to the extent of requesting a month of night shift and a month off. But what is the risk?

A study conducted on a total of 115,535 women (nurses) shows about 9% of them developed heart diseases over the period of 24 years follow-up. Women who work at least three-night shifts in a month were found to be 27% more likely to develop heart disease than those who did not.

The study also indicated that women working night shifts for longer periods of time were at the higher end of the risk spectrum than those with less experience. Women working night shifts for ten or more years had a 13–27% greater risk for heart disease than those with no night shifts, while women with less than five years of night shift experience had up to 10% increased risk.

The good news was that the risk of increased heart disease reduces over time once nurses stop working night shifts.

Source: https://jamanetwork.com/journals/jama/fullarticle/2516715


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Working With Difficult Colleague Nurses

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There are a lot of things about nursing that your school, lecturers, and books might not have warned you about. Aside from difficult patients, there are also difficult nurses.

Whether it’s stress or just their personalities that make them difficult to deal with, here are a few recommendations you can use to respond better to the situation and their personalities.

#1: The Complainer

What you should do: Avoid taking things seriously.

Your co-worker’s behaviors and actions in the hospital are reflections of what goes on inside her and not of you. She may be acting like that because she’s experiencing some issues at home or she could be just as tired as you are.

If she snaps at you about a small problem, you can just acknowledge what she said. Acknowledgement doesn’t necessarily mean you agree, but it’s a good way of showing your co-worker that you understand her, her point of view and where she’s coming from.

If she starts complaining about her schedule or her patients, acknowledge her feelings and excuse yourself. As simple as that.

#2: Mr. Know-It-All

What you should do: Limit your words.

Talking back and persistently reasoning out can’t do the situation any good. As a matter of fact, the more you talk, the harder the situation becomes to resolve. Instead on focusing on words, you need to be more aware of your actions. Pick your battles to avoid spending unnecessary energy.

Choose your words appropriately when conversing with this coworker. Use direct and concise statements to deliver your point across. You should also set a time limit on how long you’ll be discussing the issue.

“Sometimes, not talking is better than talking. If you keep on supporting your opinion, it just puts the other person in defensive mode and the argument will just go on and on. Problems aren’t solved that way,” a veteran nurse explained.

#3: The Bully

What you should do: Establish boundaries.

Yelling and shouting should not be tolerated, particularly if you are in the presence of your patients. These actions limit the credibility and the authority of your hospital and those who work inside it.

If such an incident happens, simply remove yourself from the situation. Assess the capability of your co-worker to engage in a constructive discussion first before confronting her. Approaching her when she’s still enraged can only lead to more problems.

#4: The Gossip

What you should do: Lessen complaints and gossips.

Constant complaining and gossiping will only make your working environment more negative. Instead of digging a deeper hole, try to be more proactive in finding a solution to the problem.

It’s not necessary that you exert effort on changing the person, but it could help if you can give her the opportunity to express herself, without people talking behind her back. Bullies are often victims of bullying, too. If you’re going to make her feel like she needs to defend herself to everyone in the area, the more likely she’ll snap and spread gossip about everything and everyone.

#5: The Backstabber

What you should do: Exert more effort in knowing your co-worker.

Making your colleague feel isolated and neglected will only make matter worse. Instead of leaving him behind, you can invite him over to lunch with your other colleagues or to your next dinner party.

Creating a sense of belongingness can help lessen his need to backstab anyone. Once “the backstabber” feels that he’s an integral part of the team, the less time he’ll spend in destroying it.

“We usually set an annual date for team building activities. I believe these opportunities allow the nurses in my area to get to know each other well. Since we started this tradition, there were fewer reports of workplace misunderstandings,” a head nurse said.

How do you handle a difficult co-worker? Did some of these insights apply to your situation?

Source: nurseslabs.com


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MINOR AND MAJOR OFFENCES UNDER THE GHS CODE OF CONDUCT

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The Code of Conduct and Disciplinary Procedures for Ghana Health Service (GHS) was developed in 2003 to regulate the conduct of all managers and employees at the respective levels of the Service in their normal relations and dealings with patients, clients, and fellow employees, and the public. This was to address the pertinent issues relating to general administrative rules and regulations, professional codes of ethics, staff conduct and policy guidelines. In 2018, the code was revised to conform to international best practices, and changes in the law and policy.

According to GHS, offences shall be categorized as minor or major and shall be dealt with and managed under the various provisions of this code and shall attract corresponding degrees of punitive action.

Minor Offences

Minor offences shall include:

  1. Reporting late for work or leaving or closing earlier without permission.
  2. Absence from duty without reasonable cause/excuse
  3. Any attitude or act(s)of rudeness and insubordination to his/her superiors, colleagues or clients at the workplace.
  4. Inappropriate and unauthorized use of office, medical and other equipment being the property of the Service for unofficial/personal jobs.
  5. The use of materials, stationery, medication and other supplies belonging to the Service without authority.
  6. Providing false information to discredit the Service or cause disaffection from the public.
  7. Withholding vital information with the intention of misleading management, clients or the public.
  8. Pre-empting clinical and other decisions or actions.
  9. Disclosure of official/client information to unauthorized persons.
  10. Sexual harassment.
  11. Sleeping while on duty.
  12. Use of abusive language.
  13. Loafing.
  14. Undue interference with other people’s jobs.
  15. Occasional intoxication or drunkenness while on duty.
  16. Non-compliance with official dress code.
  17. Taking part in illegal demonstration(s) or industrial actions
  18. Unnecessary noise making.
  19. Failure to handover administrative duties and official properties properly.
  20. Quarrelling within official premises.
  21. Failure to submit requisite data and reports.
  22. Illegal or unauthorized collection of fees from clients/patients.
  23. Misuse of corporate computing and networking equipment, internet access and network resources.
  24. Failure to put in place /ensure appropriate safeguards for the physical security and monitoring of computing devices assigned to employees for corporate use.
  25. Circumventing certain minor aspects of human-subject requirements in the course of research.
  26. Inadequate record-keeping related to research projects.

Penalties for Minor Offences

The under-listed are a range of penalties that could be selectively used as disciplinary measures for minor offences.

  1. Verbal warning in the first instance.
  2. Warning in writing.
  3. Suspension from duty without pay and allowances for not more than ten (10) working days.
  4. Reduction/forfeiture of annual leave.
  5. Temporary change of schedule to a less responsible one.
  6. Refund of illegal/unauthorised money from clients/patients.

Major Offences

The under-listed offences shall be considered as major offences.

  1. Theft, embezzlement, fraud, or any other situation of negligence leading to financial loss to the Service.
  2. Rape or sexual harassment of co-workers, patients/clients or their relations.
  3. Physical assault of co-workers, patients/clients.
  4. Persistent /habitual intoxication while at the workplace.
  5. Trafficking in and use of narcotic drugs.
  6. Smoking at the workplace.
  7. Improper demand or collection of unauthorized fees.
  8. Falsification of official/client’s records.
  9. Criminal conviction by a court of competent jurisdiction.
  10. Gross insubordination or refusal to perform an authorized duty.
  11. Negligence and misuse of equipment, vehicles, buildings, and furniture of the Service.
  12. Divulging confidential information without lawful authority to other staff, clients, or any member of the general public.
  13. Persistent/habitual absence from duty without permission or reasonable cause.
  14. Refusal to attend to or responding late to an emergency duty/call.
  15. Unauthorized absence whiles on emergency duty.
  16. Indecent exposure of parts or all of the body while on duty.
  17. Failure to adhere to official dress code.
  18. Vacation of post, refusal to go on posting and desertion of station or post.
  19. Impersonation.
  20. Professional misconduct, malpractice, and negligence.
  21. Breaching financial policies and procedures.
  22. Disclosure of official information to unauthorized persons which brings the Service into disrepute.
  23. Wilful destruction of official documents/property.
  24. Seduction of patient/client or their relations while under the care of the institution.
  25. Refusal to handover or improper handing over of official responsibility when required.
  26. Failure to appear before a disciplinary committee without prior permission in writing.
  27. Failure to comply with disciplinary penalties/awards.
  28. Persistent failure to answer queries despite reminders/warnings.
  29. Circumventing or subverting ICT and other security systems within the Service.
  30. Failure to comply with the country’s legislative framework governing the use, storage and transmission of healthcare electronic data.
  31. Misuse of corporate computing and networking equipment, internet access and network resources.
  32. Use of Illegal copyright or intellectual property right materials (electronic and manual).
  33. Failure to put in place /ensure appropriate safeguards for the physical security and monitoring of computing devices assigned to employees for Corporate use.
  34. Failure to adhere to policies and procedures governing the privacy, confidentiality and integrity of electronic medical records, other official electronic records, and ICT systems.
  35. Use of suggestive, vulgar and/ or obscene language when using the Corporate ICT system.
  36. Use of corporate email or other messaging services for private business activities.
  37. Use of corporate ICT systems for cybercrimes.
  38. Use of corporate ICT systems to create, view, publish or transmit pornographic materials.
  39. Use of unauthorized/illegal software (purchased or downloaded) including browser toolbars or hardware.
  40. Falsifying research data.
  41. Ignoring major aspects of human-subject ethical requirements.
  42. Using another’s ideas without obtaining permission or giving due credit (plagiarism).
  43. Unauthorized use of confidential information in connection with one’s own research.
  44. Failing to present data that contradict one’s own previous research.
  45. Publishing the same data or results in two or more publications.

Penalties for Major Offences

  1. Suspension of salary for one month
  2. Deferment of due promotion for 1 to 3 years depending on the gravity of the offence.
  3. Dismissal and subsequent forfeiture of end of service benefits (if any) with exception of social security contributions.
  4. Removal from office. (termination of engagement without loss of end of service benefits)
  5. Reduction in rank. (immediate demotion in grade and accompanying salary reduction)
  6. Change of work schedule or place.
  7. Postponement or cancellation of training and any awards.
  8. Refund of monies lost to the Service.
  9. Refund of monies illegally collected from patients/clients.
  10. Withholding of salary increment for one year.

In all cases of vacation of post the employee’s salary must be immediately suspended and indicated in the report sent to the higher authority.

In case of suspension or reduction of salary or suspension of salary increment, written information must be submitted to the Controller and Accountants General’s Department to effect the needed action.

Without limiting or contradicting the provisions of this section and for the avoidance of doubt, the persistence and gravity of the offence shall form the basis of determining whether it is a minor or a major offence and the right to determine such cases shall be the prerogative of the disciplinary authority. Any act of misconduct by an employee of the GHS not expressly mentioned in this document or any regulations operating within the Service shall be reported to the Director-General, who may, after consultation with the GHS Council and other authority/authorities, issue instructions as to how it should be dealt with.


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