Introduction
This chapter will look at some of the common issues in relation to health and safety and the environment in the workplace. The legislation that has been put in place to protect employees will be discussed, along with practical advice about assessing and avoiding risks in the first place. There are activities throughout the chapter along with weblinks which you will find useful.
Assessing risk
A risk assessment ensures that everything possible has been done to stop anything harmful occurring. It is a legal requirement for employers to assess all potential risks in the workplace. It is equally important that we each take responsibility by routinely carrying out risk assessments in our work environment to prevent injuries, accidents and ill health. The Health and Safety Executive (HSE) (2006, 2011) has a simplified five-step guide to carrying out risk assessments, which should be used in any area in which you work. Use the acronym HAZDERR to help you remember these:
Follow steps 1 and 2 above, looking out for areas where hazards could exist and therefore what you need to check. It is not anticipated that you will identify risks but the exercise should enhance your observations of potential risks. An example of avoiding a potential risk would be the testing of all electrical devices and plug sockets.Within the maternity services there are potential risks everywhere, as there are in any workplace, for example a blocked emergency exit; equipment left in corridors, such as beds; a hostile partner; lone working; or driving in poor weather conditions for those working in the community. Those at risk include:
- midwives
- healthcare assistants/team support workers
- domestic or portering staff
- new and expectant mothers
- all visitors
- any contractors working in the environment
- doctors and other allied healthcare professionals.
In the event of a fire or for any other reason to evacuate any healthcare premises, an obstructed exit will impede the safe evacuation of those present and could be life-threatening. This is a high risk and the emergency exit will need to be unblocked as legislated by the Regulatory Reform (Fire Safety) Order 2005 which dictates the responsibilities of the employer and employees in prevention of fire hazards.
Equally all of the other examples above will need to be considered with solutions to limit the risks they pose.
You need to reduce the possibility of any risk occurring, therefore you may wish to think of measures to prevent the same event recurring by educating staff, finding suitable storage for the object(s) blocking the area and putting up notices. You may be able to think of other ways to achieve this.
To control risks, the following principles should be applied:
- Try an alternative option which will be less risky.
- Prevent access to the hazard, for example by guarding.
- Reduce exposure to the hazard by organising work accordingly.
- Issue personal protective equipment (including goggles and gloves).
- Provide facilities to aid welfare in the event of an occurrence, for example first aid and washing facilities to enable the removal of substances on the skin.
You need to record what you found during your risk assessment and what you did about it. You must tell your employer/the employees about your findings. Adverse incidents are usually caused by a chain of events so by completing risk assessments competently, you are reducing the risk of these happening. There are risks in everyday life and they cannot all be completely removed, but every possible means should be taken to reduce any risk.
Wearing the protective goggles you are issued with will stop any splashes from amniotic fluid (that you may not even be aware of) getting into your eyes. Glasses do not offer the same degree of protection. Next time you facilitate a birth, take a look at the goggles afterwards.
Find out who conducts the risk assessment in your clinical area. You may find it helpful to discuss with them how they conduct the risk assessment and look at any paperwork that they use.Slips, trips and falls
Slips and trips account for a third of all accidents in the workplace (HSE 2002). Avoiding them is everyone’s responsibility so we need to ensure that our working environment is as safe as it can be. Often where serious accidents or falls occur, someone else has first slipped or tripped in the same place. Although avoiding slips and trips may seem like common sense, it may be easy at times to overlook these when we are in a hurry.
All members of staff and students are responsible for:
- attending any training sessions that are offered
- following health and safety procedures and policies within their working environment
- tidying up as they go.
- being aware of potential hazards at all times.
Follow the link below to complete an online package devised by the Health and Safety Executive: www.hse.gov.uk/slips/step/You should:
- look at what is going on around you and be aware of where you are going and what you are doing
- look where you are going and never run or rush
- use any safety equipment provided
- be especially careful on uneven ground and steps, using handrails where provided (for example, when you are walking down stairs)
- follow safety guidelines in your area
- use lighting in dark areas (it is surprising how many people walk around in dark or dimly lit storage areas)
- not attempt to carry out any activity beyond your capability; ask for assistance if you need it
- conduct yourself in an appropriate fashion. Playing a practical joke on colleagues may seem like fun, but can be a serious risk to you and your colleagues if it results in an accident.
Find out how you would deal with a blood spillage in your area, including where you would go to find cleaning equipment.Preventing slips
- Deal with any spillage (e.g. blood, liquor or vomit) immediately; do not wait for someone else to clear it up, it’s everyone’s responsibility.
- Take care on slippery surfaces, including those which have recently been waxed or washed.
- Non-skid mats should be used around washing areas, such as showers and baths.
- Ensure that mats and carpets are secured to the floor surface; maintain any areas which are frayed, worn or curled up.
- Flooring may have uneven surfaces or be damaged in some way; take extra care when walking on these surfaces. Similar hazards exist on pavements and walkways around your workplace, so take care here too.
- Be aware of your footing as the level may change unexpectedly, for example when you go round a corner.
- Be cautious when walking on icy surfaces and alert your employer to enable precautions to be implemented.
- Wear shoes that are fit for your job. They should offer support, have enough grip on them and should not be open-toed.
As newly cleaned surfaces have caused so many slips in the past, the HSE (2009a) has put together a leaflet examining a case study and discussing appropriate methods of cleaning. To find out more, follow the link below: www.hse.gov.uk/pubns/web/slips02.pdfPreventing trips
- Get into a daily routine of ensuring that your working environment is kept tidy, with items returned to where they belong.
- Keep floors free from rubbish and any other debris such as swabs, incontinence pads, wrappers, and so on.
- Do not leave anything on the stairs.
- Keep drawers and cupboard doors closed.
- Store equipment such as cardiotocograph machines, stools and ventouse apparatus safely out of the way.
- Make sure that electrical leads and cables attached to resuscitaires, cardiotocograph machines and ventouse apparatus do not trail across walkways or where anyone can trip over them.
- Have a place for everything and keep it there. Do not store anything in corridors.
- Be mindful of where any furniture is placed, allowing easy access for anyone needing to come into the area.
- Move obstacles out of the way; do not attempt to step over them.
Preventing falls
- When going up or down stairs, do not carry anything that obscures your vision and use the handrail.
- Ensure that adequate lighting is available. Stair lighting especially should be bright.
- Ask for help when carrying heavy loads.
- Do not stand on chairs. If you need a stepladder, use one.
- Make sure that chairs are fit for purpose and use them appropriately, for example not standing on them or rocking.
- Use a ladder to get down from a height, such as when getting out of a store room or closing a high window.
- If you are using a ladder, for example to get to equipment out of your reach, know how to use it properly.
Remember, it is your responsibility to:
- dress appropriately. You should not wear jewellery, long hair should be tied back and you should ensure that your footwear is sturdy with closed toes
- only carry out the work that you are trained to do
- take time to organise and plan how you are going to do your work. For example, if you need anything which is out of reach, ensure that you can reach it safely using the appropriate equipment.
Reflect on your work in the last week. Can you recall any incidents when you took unnecessary risks? If so, think about how you could reduce the risk in future. If not, think of a risk activity that you have undertaken in the past and how you would prevent yourself being in that situation in the future. An example could be using a chair to get something that is out of your reach.
Don’t be tempted to take short cuts to save time – it could change your life forever.
Visit the following link for the HSE’s ‘Shattered Lives’ campaign: www.hse.gov.uk/shatteredlives/index.htmMental health and stress
Under the Disability Discrimination Act 1995, employers may not discriminate against people with a mental health disorder (including depression or schizophrenia). This means that they cannot deny someone a job or career progression on the grounds of mental ill health. It also means that the employer is legally obliged to make ‘reasonable adjustments’ to prevent the employee being disadvantaged by their illness.
Reflect on a time when you experienced a stressful situation – a new job, a house move, bereavement or a busy day at work when you felt pulled in many directions. Think through the following points.- How did you deal with the situation?
- Did you feel that you dealt with it adequately?
- How did you feel about it?
- Who supported you?
- Were you able to take time out for yourself?
- Did the situation change your perceptions in any way?
It is recognised that stress affects the smooth running of any business, including an increase in staff turnover, and is therefore costly. Thus, it makes good business sense to reduce stress in the workplace. The employer has a legal obligation to protect employees against ill health, including the effects of stress. A risk assessment should be conducted and precautions taken to avoid unnecessary stresses (Amicus 2006). Stressors in the workplace include:
- boring or repetitive work
- too little to do
- too much to do or too little time to do it in
- inadequate or excessive work-based training
- uncertainty about roles within the team
- having responsibility for others
- lack of flexible work schedules
- the threat of violence
- poor working conditions
- lack of control over work activities
- lack of communication and consultation between managers and staff
- negative culture, for example a blame culture
- lack of developmental support.
Many of us experience stress outside work, which will equally have an impact on our health and standard of work. When dealing with stress, it is important for the employer to listen to staff. The following measures can be taken to prevent stress from becoming a problem (Amicus 2006):
- Take stress seriously.
- Show an understanding attitude to those affected.
- Make sure that staff have the appropriate skills, training and resources to enable them to carry out their job confidently and competently.
- Allow staff to have a say in how they do their work.
- Where possible, vary working conditions.
- Treat all staff fairly and consistently.
- Deal effectively with bullying and harassment.
- Ensure good communication in the workplace between managers and staff, paying particular attention in times of change.
- Design and implement an effective mental health policy, taking into account the view of all sectors of staff.
Within the maternity unit, many pressures are put on staff which may cause stress. In current practice, the massive changes that maternity units are undergoing, such as hospital mergers, are a good example. Mergers cause anxiety due to the uncertainty that they cause and changes within the team, such as a change of management; shift times; working environment; and working with different staff who may have different working practices.
