Nursing's roots are in military and religious settings, where self-sacrifice is expected and encouraged. Altruism is certainly admirable, but nurses who insist upon giving their all to everyone are headed for burnout or injury. Our profession is physically and emotionally demanding. The Canadian Federation of Nurses Unions (http://www.cfnu.ca) reports that nurses are more likely to be assaulted on the job than are prison guards or police and have the highest risk of exposure to infectious diseases, allergens, sexual harassment, and abuse of any professionals. We are also at the highest risk for musculoskeletal injuries to the upper and lower body, and 68% of nurses report feeling burned out after as little as two years. The American Nurses Association confirms that nurses number among those with the highest incidence of musculoskeletal injuries, substance abuse, and stress-related illnesses such as obesity, cancer, and autoimmune diseases.
British labor and social policy researcher Ursula Huws's studies of gender roles in employment led her to conclude that selfsacrifice results from women's traditional roles as caretakers. Many female nurses (perhaps subconsciously) comply with that ideology by subjecting themselves to hazards on the job.
Self-sacrifice isn't required to be a "good" nurse, however. Few others in the health care industry harm themselves in the performance of their duties. During a 12-hour shift patients often get three meals while nurses get one-if that.
Nurses must advocate safe working conditions. Although much of this requires change at the administrative level-reducing shifts to manageable lengths, for example-we can protect our own health and challenge the public's (and our own) assumption that nurses should sacrifice their well-being in the service of their patients. If we practice, teach, and model these five steps daily, we will be able to give our best to others without sacrificing ourselves.
Raise beds and overbed tables before performing any task. It may be inconvenient to squat to raise the bed, but the strain on your back will be much less if you are not bending to perform assessments, change dressings, and so on. Remember to lower the furniture after you have finished.
Wear gloves for patient care. If gloves in your size aren't available in the patient's room, get them from the supply room. Preserving your health may occasionally require taking the time to protect yourself.
Adopt a no-lifting policy. Use patient-handling equipment whenever possible, and corral colleagues for help when assistive devices are not available. Volunteer for a task force at your facility to ensure that safe patient-lifting and -movement procedures are established-and followed.
Mentor new nurses. Experienced nurses must lead by example, not only by performing competent and compassionate patient care, but also by projecting positive attitudes about their profession and its importance. Tend to the young, and they will shake off the assumptions and habits that harm nurses today.
Be politically active. Vote for politicians who support adequate nurse-patient ratios. Lobby health care facilities, agencies, and officials for standards to protect patients and personnel.
According to a Veterans Health Administration task force position paper on patient handling and movement (available at http://www.rehabnurse.org/profresources/whitepaper.pdf), nurses are taught to focus on patients' safety rather than their own. "Recognition that the culture of self-sacrifice contributes to the risk of injury in nursing is a necessary first step in the paradigm shift to accept self-preservation and safety as high priorities," the report says. "With the shortage of RNs, health care organizations need every nurse to be injury free." If we continue to sacrifice ourselves, our patients will suffer, too.