The most dangerous health occupation

Occupations in the U.S. with the highest rate of work-related fatalities are primarily physical: commercial fishing, logging, mining, farming.

But if you concentrate on the incidence of nonfatal injuries that happen in the workplace, health care is far more injury-prone than perhaps the public realizes – and the highest rates of all for getting hurt on the job are among certified nursing assistants who work in nursing homes, a category that also happens to be the lowest-paid among the health professions.

A report published earlier this year contained some eye-opening statistics. Using data from the National Nursing Home Survey and the National Nursing Assistant Survey, the researchers found that 60.2 percent of CNAs who participated in the survey had experienced a work-related injury in the past year. Three out of five had been hurt more than once and about one-fourth had to quit working because of their injury.

There’s more: Although scratches and cuts were the most commonly reported injury, back injuries and strained muscles were frequent, accounting for almost two in every 10 work-related injuries. Workers who were younger or older (those under age 30 and those older than 45) also had higher rates of injury.

In one of the more startling facts contained in the report, the incidence of nonfatal injuries among nursing assistants was one of the highest of any occupational category, including trucking and construction.

Here’s another concerning statistic: Nursing care assistants working in skilled care facilities often experience violence from the residents they’re trying to help. A report by the U.S. Centers for Disease Control and Prevention found that 12 percent of the CNAs in a nationally representative sample had sustained a human bite wound within the past year. The incidence of assaults and bites was greater for those who worked in units caring for people with dementia.

I was reminded of this when I visited Johnson Memorial Health Services in Dawson, Minn., this past week for the staff’s celebration of earning MnSHARP status from the Minnesota Department of Labor and Industry. The program recognizes organizations that go above and beyond the standard in creating a workplace that’s safe for their employees.

One of the things I learned was that it’s not easy to qualify for this designation. In fact, very few health organizations have made the cut. Johnson Memorial is the first nursing home and only the second hospital in Minnesota to earn certification.

It took three years and continual hard work to get there. As the staff readily admitted this week, it’s going to take ongoing hard work to stay there. But the payoff is fewer work-related injuries for everyone who’s employed at Johnson Memorial, employees who are happier, more productive and better able to provide good care, and lower costs for workers’ compensation, leaving more money to plow back into other priorities.

There’s a growing sense that occupational injuries among nursing assistants have been underrecognized in the past and that more needs to be done to reduce their likelihood of getting hurt at work.

Research has identified a number of factors that seem to make a difference. Nursing assistants are more likely to get hurt when there’s a shortage of staff or when the workload is highly demanding. The probability of injury also tends to be higher among nursing assistants who are new on the job and/or feel they weren’t adequately prepared for the job.

Why does it matter? The U.S. population is aging and it’s becoming increasingly critical to have a good workforce to provide direct care to older adults, many of whom need intensive daily help. Occupational safety, notes the CDC report, “is an important factor for retaining trained, motivated, and capable nursing assistants in long-term care… It has been shown that nursing personnel who were subjected to work-related violence on at least a monthly basis reported higher intent both to leave the nursing profession and to change institutions.”

It might be impossible to achieve zero work-related injuries for certified nursing assistants, but supportive policies and better training – in short, creating an institutional culture that fosters a good workplace environment – seems to go a long way toward making this riskiest of health care occupations more safe for the workers.

One thought on “The most dangerous health occupation

  1. I am a CNA at a long term nursing home. Dealing with combative residence is a daily thing. In the seven years I have been working as a CNA I have had sprained my wrist, pulled muscles in my shoulder and back, and now I have knee problems from the constant squatting/ bend at the knees method for lifting. I am only 25 yrs old. I wish we were recognized more often for the hard work we have to do and injuries we often get. Work through the pain is our method. We are often short staffed so we have to work many days in a row. Sometimes I wish there was a resident to staff ratio.
    Thanks for this article. I hope many people read this and understand how hard our job really is.

    Please don’t release my name.

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