Changing nursing practice in response to musculoskeletal l pain and injury in the emergency nursing profession: What are we missing?

Abstract

Background: Musculoskeletal disorders in emergency nurses result in physical, psychological and financial strain. Contributing factors include: environmental, organisational, patient-related, medical emergencies, nurse's knowledge and health status. Stress and moral distress impact on nurses changing manual handling practices.

Methods: Part of a cross-sectional survey of Australian emergency nurses, this study used content analysis to identify occurrence of change to practice and enablers to reporting injury. Secondary interpretive analysis using moral distress theory informed an alternative understanding of why nurses may not change their practice in response to injury.

Results: Most respondents made practice changes and reported pain/injury; 23% did not change, and 45.7% did not report. Respondents considered change impossible due to high demands and lack of resources; a position where nurses may have felt pressured to carry out unsafe manual handling practices. When conflicted between reporting a perceived insignificant injury, with feelings of guilt, nurses can feel devalued. Moral distress can occur when nurses and managers are conflicted between providing care and caring for self.

Conclusions: A culture of trust, respect and open communication decreases stress/moral distress, enables safer manual handling and reporting of pain/injury. Moral distress is an invisible workplace challenge that needs to be met for staff wellbeing.

Keywords: Change; Emergency nursing; Moral distress; Musculoskeletal pain and injury; Nursing practice; Stress.