A vision of ethics in efficient occupational healthcare.

BACKGROUND:: Occupational healthcare is nowadays more and more regulated by economic demands of gain and efficiency. AIM AND RESEARCH QUESTIONS:: The aim of this study is to reach a new understanding of ethics in occupational healthcare by uncovering this from occupational healthcare nurses' own views. The research questions are as follows: (1) What is the core of an ethical value base in occupational healthcare? (2) What does it mean for occupational healthcare nurses to fulfill their ethical value base in occupational healthcare? RESEARCH DESIGN, PARTICIPANTS, AND RESEARCH CONTEXT:: The study uses a hermeneutical approach. The context of the study is occupational healthcare. The material was collected through interviews with four occupational healthcare nurses in Finland. The texts were interpreted through hermeneutical reading. ETHICAL CONSIDERATIONS:: The data storage, study participation, and data handling for research purposes were approved by the participants when they provided their informed consent. FINDINGS:: The study revealed that the core of ethical values in occupational healthcare is something universal that concerns justice, honesty, and faithfulness. To fulfill the ethical value base means to continuously strive toward the inner core of love and bravely choose to listen to the this core in the name of the client and the universal good even if it involves a struggle or a sacrifice. DISCUSSION:: The ethical value base is not primarily tied to profession but is something that is general and universal. Nor do ethics and the implementation of ethical values stand in opposition to, for example, external values such as demands for efficiency and economic gain. However, ethics may promote efficiency. CONCLUSION:: The fulfillment of nurses' ethical value base in occupational healthcare requires that ethics first and foremost is allowed to enter the leadership and is prioritized on a leadership level. Creating caring cultures that encourage openness and support ethical discussions is fundamental.

[Role of the occupational health nurse]. / Rôle de l'infirmier de santé au travail.

The missions of occupational health nurses are exclusively preventive, except in the event of emergency situations. They are involved in the prevention of occupational stress, the assessment of psychosocial risks and the improvement of quality of life at work.

[Evaluation and intervention of psychological work climate among nursing staff : a review of the literature]. / Évaluation et intervention en matière de climat psychologique de travail chez le personnel infirmier : une revue de la littérature.

This review of literature focuses on the influence of psychological work climate and job satisfaction on nurses' turnover intentions. More specifically, this review aims to explain the influence of the primary dimensions of psychological work climate - job characteristics, role characteristics, leadership characteristics, teamwork characteristics and organizational characteristics - on nurses' organizational and occupational turnover intentions. Furthermore, this review aims to explain the role of job satisfaction as a potential mediator in the relationship between psychological work climate dimensions and both organizational and occupational turnover intentions among nurses. More specifically, the mechanism by which an individual goes from having negative perceptions of psychological work climate to having turnover intentions is introduced. The review concludes by revealing evaluation and intervention practices that may facilitate the implementation of continuous improvement processes aimed to enhance nurses' perceptions of the psychological work climate and job satisfaction.

[Promoting occupational health in a Parisian department store]. / Promouvoir la santé au travail dans un grand magasin parisien.

Astrid Tellier has found her professional footing within the occupational health department of a Parisian department store. The coordinator of the nursing team, she feels fulfilled in this practice which combines various missions of organisation, prevention and care.

Bring on epidemiologic research!

It is often challenging finding time to carefully read research articles and determine how findings apply to clinical practice. Many occupational health nurses may be unfamiliar with or out of practice using various epidemiologic concepts and terms from clinical research. This article provides a brief overview of these concepts and terms. Understanding the basics of research is the first step toward using research findings in evidence-based practice.

Working at high altitude.

High altitude is not just an issue for mountain climbers. Elevation can have implications for employees ranging from laborers to office workers to scientists. Awareness is key to effective management.

Eating disorders at work.

CDC statistics reflect the dramatic increase in obesity in the United States in the past 20 years, with 33 states having a prevalence of 25% or greater. Eating disorders and obesity have major implications for occupational health nurses.

Sexual assault in the workplace.

Women are sexually assaulted at an alarming rate, and the workplace is a frequent arena for assault. However, in recent decades, attention has been given to improving responses to sexual assault. Sexual assault is a frequent cause of injury and death for women in the United States. One in five American women admit they have experienced a completed rape during their lifetime. These estimates are conservative because sexual assault and sexual violence are both underreported and underprosecuted. Fear of job loss and discrimination are frequent reasons women do not report sexual assault in the workplace. Women are entering the workplace in greater numbers due in part to more single parent families and the depressed economy. Also, women are entering work environments that have traditionally been the domain of male workers: corporate headquarters, semi trucks, health care providers' offices, rural farms, and rural factories. Employers must have a plan to protect female employees and effectively address any incidents of sexual assault or violence. Occupational health nurses and nurse practitioners can assist both employees and employers to prevent sexual assault and resolve the aftermath of sexual assault. However, to accomplish this goal, occupational health nurses and nurse practitioners must be trained in sexual assault and violence response as well as preventive interventions.

Presenteeism revisited. A complete review.

Presenteeism is defined as employees being present at work but unable to be fully engaged in the work environment. Although presenteeism is pervasive in the workplace, the effects of the condition on employee health and productivity are less well understood. The purpose of this article is to provide a comprehensive review of the concept of presenteeism, including research and management practices.

Scope of practice issues for occupational and environmental health nurses.

This article discusses scope of practice issues among various levels of professional nurses within the United States. It raises awareness that all occupational and environmental health nurses must be knowledgeable about workplace activities that may be permitted or prohibited by their state practice acts.

Preventing heat-related illness among Hispanic farmworkers.

Hispanic and Latino farmworkers are at risk for negative occupational health and safety outcomes due to issues such as their extreme work conditions, their reliance on employer beneficence, and cultural barriers. The purpose of this article is to explain the unique characteristics of heat-related illness in the Hispanic agricultural work force and to provide an overview of the problems of poor hydration and heat exposure in this population. Culturally appropriate preventive strategies are discussed because industrial-type solutions may not work in a crop production environment where language and beliefs may interfere with adaptation.

Nothing to fear but fear itself?

As radiation levels around the crippled Fukushima Dai-ichi nuclear plant in Japan increase, the Japanese people as well as individuals around the world have expressed fear of radiation that some experts say could be more unhealthy than the levels of leaked radioactive contamination. This article addresses why individuals fear radiation and provides resources occupational health nurses can consult when answering clients' questions.

The effect of oil spills on workers involved in containment and abatement: the role of the occupational health nurse.

The Deepwater Horizon oil spill is the most recent manmade disaster to challenge occupational health nurses caring for a unique worker population. The effects of oil spills on wildlife, marine life, and the ecosystem are well studied and documented, but the effects on workers who contain and abate such disasters are not. These workers can suffer from a multitude of illnesses and injuries, such as ataxia, migraines, and various lung diseases, which can be a challenge for occupational health nurses.

Borderline personality disorder and disability.

Assessing functional impairment of individuals with borderline personality disorder is challenging. This article discusses the diagnosis of borderline personality disorder, examines the most common iterations of this disorder in disability claims, explores cases in which borderline personality disorder may cause impairment, and identifies signs of the impairment due to this disorder.

Barriers to physical activity among working mothers.

Working mothers experience several barriers to physical activity. If these barriers can be identified by occupational health nurses and they can partner with working mothers to reduce these perceived barriers, the health of these workers can be improved and chronic disease risk prevented. The purpose of this study was to measure the effect of self-regulatory efficacy on physical activity among working mothers and to describe specific barriers to physical activity. The Barriers Specific Self-Efficacy Scale (BARSE) and the Kaiser Physical Activity Survey (KPAS) were used to measure the variables. Self-regulatory efficacy was found to be a strong predictor of physical activity in a diverse sample of working mothers who did not meet current recommendations for physical activity. Occupational health nurses can use these findings to design programs for groups and for counseling individuals.

A family history intervention: enhancing cardiovascular risk assessment.

This article describes the effect of individualized counseling using family history data and objective cardiovascular risk factors on intent to change and actual exercise behavior in a diverse sample of working adults. Using a longitudinal, quasi-experimental, crossover design, objective data (blood lipids, glucose, blood pressure, and body mass index) and subjective data (awareness of heart disease risk, depression, spirituality, and knowledge of family history) were collected from 91 (mostly female and with a mean age of 45 years) primary and secondary teachers in a southwestern city. The Transtheoretical Model of Change guided the study and measured intent to exercise. Objective risks in this sample mirrored national indices of risk for obesity and abnormal lipids. Although some participants increased their exercise, no significant differences were found between the groups in exercise behavior at 6 and 12 months. Using knowledge of family history to raise awareness and encourage lifestyle changes related to cardiovascular risk warrants further study.

Protecting pregnant health care workers from occupational hazards.

The safety of pregnant health care workers and their infants is paramount. The scope and variety of hazards within the health care field is profound and diverse. The occupational health nurse can identify early risks and correct them, as well as provide ongoing surveillance, counseling, and prudent policy recommendations for the multitude of hazards to which pregnant health care workers are exposed. Policy must reflect the real risks taken by these workers every day they go to work, and how those risks will affect them, their immediate families, and future generations.

Integrating results from smoking cessation drug research and development into clinical occupational health practice.

This article documents evidence-based pharmacologic interventions to promote successful smoking cessation among employees who smoke. The article also highlights supporting evidence for the use of pharmacologic agents to treat tobacco dependence and can guide successful, personalized, pharmacologic smoking cessation interventions in occupational clinical practice. Prescribing clinicians will also find information about the latest research and development of medications to promote smoking cessation, including recently implemented black box warnings by the U.S. Food and Drug Administration.

Ergonomic microscope comfort and control.

Microscope use in the inspection phase of computer chip manufacturing is a major cause of worker discomfort and injury. A two-phase ergonomics project to reduce employee fatigue and discomfort was planned, implemented, and evaluated in a microscope user environment within a high-technology manufacturing environment. Total Quality Management methodology and tools were employed by a multidisciplinary team led by an occupational health nurse practitioner to accomplish the project goals. A multifaceted approach including equipment changes, administrative changes, and focused training for behavior changes achieved the desired reduction in reports of fatigue and discomfort among microscope users. Occupational health nurses are ideal candidates to lead teams to accomplish meaningful health and safety goals consistent with corporate quality initiatives and strategic objectives.

Diabetes at work: a grounded-theory pilot study.

Diabetes at Work is a qualitative grounded-theory pilot study designed to examine the factors impacting older adults' experience managing diabetes in the workplace and maintaining gainful employment. Six working adults, 55 years and older, with Type 2 diabetes were interviewed from a symbolic interactionist perspective using grounded-theory methodology. Categories that arose from this study included minimalization, fearing the future, and taking up diabetes self-management at work. The results provide insight for occupational health nurses about the issues faced by older workers with chronic disease, a starting point for planning future interventions with this potentially vulnerable population.