Safety in Nursing Tips: Challenges and Opportunities

A nurse with a clipboard stands in a patient’s hospital room with a medical team.

Nursing in the 21st century is not for the faint of heart. Staff shortages, sicker patients and a focus on patient satisfaction above all else have created a situation where nurses sometimes sacrifice proper technique and safeguards to provide faster service.

Luckily, there are simple steps you can take to improve safety. Whether you work in a hospital, an outpatient setting or elsewhere, these 10 tips for nursing safety will keep you out of the occupational health office.

Why Is Safety in Nursing Important?

Safety in nursing is crucial for a variety of reasons. Not only do safety protocols promote patient well-being by minimizing the risk of errors, but these types of protocols also help minimize the risk of slips and falls, infections and cross-contamination and medication errors, among others.

Taking steps to foster and maintain a safe workplace can also help improve patient outcomes, reduce the prevalence of nurse burnout and minimize staff stress levels. Lastly, safety in nursing is of paramount importance because it minimizes RNs’ risk of professional and legal repercussions — such as license suspension and loss of licensure — that can arise from errors made in patient care.

Top Safety Issues in Nursing

Registered nurses face significant safety issues in the workplace. For example, nurse burnout and inadequate staffing levels not only impact working RNs but also pose hazards within the workplace.

Other top common safety issues in nursing include the following:

Nurses assisting with patient falls are at risk of developing musculoskeletal injuries.
Needlestick injuries can place nurses at risk of various pathogens, such as hepatitis and HIV, among others.
Physically demanding tasks, such as lifting patients to transfer them to different beds, can cause sprains and strains.
Nurses are at risk of verbal, emotional and in some instances, physical abuse from their patients and patients’ families.
Errors in medication administration place patients at risk of serious consequences, such as allergic reactions, hospitalization and in severe cases, death. Nurses who make medication errors can face disciplinary action from their state board of nursing or loss of employment. In some instances, they may also face civil and/or criminal penalties.

Nursing Challenges Today

Countless challenges, such as the nationwide nursing shortage, trickle down into other day-to-day challenges nurses often face and impact overall safety in nursing. Prior to the pandemic, nurses were already facing issues in the workplace including:

Nursing shortages
Long working hours
Workplace hazards
Physicality
Bullying and harassment
Advancements in technology

Learn more about these and other challenges nurses face on a daily basis in our blog “Challenges in Nursing: What Do Nurses Face on a Daily Basis?”

Challenges and Safety in Nursing in Different Clinical Environments

Nursing challenges vary based on clinical environments. The challenges mentioned above continue to be relevant in every position. Still, nursing professionals also experience unique trials depending on their clinical setting.

Hospitals

Financial challenges: Hospitals often lack financial resources, equipment and training spaces. Delayed payment from insurance companies can lead to financial challenges, which in turn can result in nursing personnel not being paid on time as funds are reallocated to treatments.
Personnel shortages: The nationwide nursing shortage has required hospital RNs and NPs to work overtime. Significant numbers of nurses continue to report experiencing burnout, increasing the probability of severe physical and mental health consequences for nursing staff, while also putting a strain on the nursing profession.
Behavioral health and addiction: Hospitals lack the necessary programs and facilities to address addiction. This rise in hospital admissions related to opioids has increased the demand for nursing professionals.
Nursing safety concerns: RNs working in hospitals are not only at risk of developing musculoskeletal and overuse injuries, but in some instances, they’re also at risk of encountering physical and emotional abuse from patients and their families.

Independent Practices

Reaching patients in rural areas: NPs struggle to treat and monitor patients that live in rural or remote areas. This is because the supply of primary care typically does not meet the demand in these areas. Depending on location, some patients may reside over 20 miles away from the nearest healthcare setting.
Transitioning to virtual telehealth visits: NPs are experiencing a learning curve as they assess more patients using telehealth technology. Although some may have used telehealth prior to the pandemic, the sudden shift to remote care to promote safety has proven difficult for others.
Reducing the prevalence of chronic diseases: Chronic diseases are the leading causes of death and disability in the United States and the primary drivers of $3.5 trillion in annual healthcare costs. Primary care AGNPs are on the frontlines, helping prevent chronic disease through screening and health promotion.
Safety concerns: NPs and RNs working long hours in private practice may have an increased risk of developing nurse burnout. Additionally, nurses working at offices with insufficient staffing levels are at a higher risk of making mistakes in patient care.

Long-Term Care Facilities

Higher acuity: Patients in long-term care facilities require higher levels of attention and routine service from AGNPs.
Nursing shortages: Safe nurse staffing ratios are difficult to maintain in long-term care facilities during widespread personnel shortages, which affects patients’ safety and health.
Harassment: Residents in long-term care facilities can experience fear, confusion and agitation, which can sometimes lead to the assault, verbal abuse and harassment of nursing staff.
Safety risks: Nurses working in long-term and residential care facilities are frequently tasked with administering patients’ medications. Mistakes in medication administration can have dire consequences for both nurses and the patients they care for.

Challenges of Nursing Roles

Various nursing roles present different challenges for individuals based on roles, responsibilities and the healthcare system's state. For example, the day-to-day experience of an FNP delivering primary care is different from that of an NP working in an acute care setting.

RN vs. NP

A registered nurse is typically responsible for more administrative tasks than NPs, such as patient monitoring, maintaining patient records, communicating with patients and assisting physicians. The top issues facing RNs include unsafe staffing issues and mandatory overtime. Healthcare facilities must maintain a specific nurse-to-patient ratio and often require RNs to work overtime to meet this need.

A nurse practitioner has a higher level of education (MSN degree) and more work experience (5+ years minimum of nursing experience) than an RN, while an NP’s role more closely resembles that of a physician. A recurring issue for NPs is the need to collaborate during care delivery. NPs must practice to the fullest extent of their education and work with physicians to improve patients’ quality of care.

FNP vs. AGNP

Family nurse practitioners provide care for patients of all ages in hospitals, clinics and long-term care facilities. FNPs can prescribe medication and work in a primary care or acute care setting. A major challenge FNPs face is monitoring scope of practice (SOP) restrictions and navigating state regulations. Since a breach of SOP could lead to civil liability, FNPs must be familiar with their state’s SOP, prescribing limits and when referrals to specialists are needed.

In contrast, adult gerontology nurse practitioners work with young adults (13+), adults and older populations to optimize their health. AGNPs provide geriatric and end-of-life care to aging populations and face the considerable baby boomer population aging and seeking more intensive care.

The American Association of Nurse Practitioners (AANP) reports that older adults and aging baby boomers are already the largest consumers of healthcare services, adding that many older patients have been diagnosed with chronic conditions, such as arthritis, diabetes, heart disease or high blood pressure, among others, all of which require ongoing care. AGNPs are responsible for delivering regular, quality care to this population.

Acute Care NP vs. Primary Care NP

Acute care NPs work in emergency care settings, urgent care, trauma care and other immediate healthcare needs. These settings are often time-sensitive and stressful due to the risk of complications in vulnerable patient populations.

Primary care NPs help patients with disease prevention and health promotion and are integral in reducing chronic diseases. Primary care NPs monitor and treat patients with one or more chronic conditions, regularly checking in with patients.

Overcoming Challenges of Nursing

Without a doubt, nurses are owed everlasting respect and appreciation for their tireless commitment to promoting health and well-being for all.

Aside from personal resilience, numerous factors have helped nurses overcome nursing safety risks and challenges, helping them practice to the fullest extent of their capabilities, such as:

Supportive nursing educators, faculty, mentors and alumni from nursing schools
Healthcare reform that increasingly focuses on preventative care and health promotion
The development of organizational resiliency strategies to create a work-life balance for nurses and prevent burnout
Nurses becoming patient advocates for higher quality care and engaging in healthcare policy reform

10 Tips for Safety in Nursing

Nurses must be proactive in maintaining safety protocols for both themselves and their patients. Below are just a few of the steps that RNs can take to minimize risks in the workplace.

1. Use Needles Safely

Accidental needlestick injuries are a shockingly common threat to nursing safety. High-stress situations, being in a hurry and unpredictable patients all contribute to the occurrence of needlestick injuries.

Be sure to utilize the safety features of the needle, keep your fingers behind the needle when inserting it into the patient and place the syringe and needle directly into the sharps container. And remember - under no circumstances should you recap the needle by hand. If you must recap it, use the scoop technique you were taught on the very first day of nursing school.

2. Handle Patients with Care

Another common nursing safety issue is patient handling and patient transfer. By the time patients are admitted to the hospital, they are often acutely ill and likely unable to manage themselves. This can increase the likelihood of nurse injury.

If your hospital/unit doesn’t have them already, advocate for lifts and transfer devices to ensure patient and nurse safety. If you have them, utilize them. It may take a little longer to get the patient in the sling, but it’s still quicker than battling for a workman’s comp claim if you get injured.

3. Administer Drugs Carefully

Be aware of any special handling requirements for drugs you are administering to your patients. Some drugs require wearing double gloves and a mask when administering them. Unintentional exposure could seriously compromise nurse safety. Other drugs are excreted in the urine, which requires more than standard precautions to handle safely. Speak with a pharmacist about unfamiliar drugs to ensure that you, your coworkers and your patients are safe.

4. Prevent Repetitive Motion Injuries

Another aspect of nursing safety is preventing repetitive motion injuries. It is difficult to overstate the importance of investing in high-quality shoes. Consider having multiple pairs and rotating them to give the foam insoles a chance to recover; they’ll break down more slowly. Wear compression socks or stockings when you work. Your feet, legs and the rest of your body will thank you at the end of each day.

If you’re noticing something is regularly causing pain at the end of each shift, go see a doctor. It’s far better to manage any injuries that occur earlier than to let them fester or develop into a huge problem.

5. Encourage Physical Nursing Safety

If you’ve watched the news or scrolled through social media lately, you’ve no doubt seen the media coverage of physical attacks on nurses. Patients and families in high-stress situations can pose a serious threat to nursing safety. It’s not always possible to know the triggers or know how a person will react, so it’s important to have strong situational awareness. Additionally, never let anyone or anything come between you and the door; always give yourself an exit. If you’re uncomfortable with a situation, back away and out of the room; do not turn your back.

6. Prevent Infection

A hallmark of nursing safety is avoiding contamination from your patients. If they’re in the hospital recovering from the flu, don the appropriate personal protective gear every single time or risk getting sick yourself and carrying it home to your family. Speaking of the flu, get your flu shot early. As they teach in nursing school, treat every substance as if it’s contagious and protect yourself as such.

7. Navigate Social Media

A new threat to nursing safety is social media. While this threat is not necessarily physical, missteps online could lead to the loss of your job and/or your nursing license. Strictly follow your employer’s guidelines for how to conduct yourself online. Do not post content that could identify one of your patients. Identifying information is more than just a name; you shouldn’t post about your patients at all, but posting detailed descriptions can be a HIPAA violation.

8. Discourage and Report Bullying

Each nurse must make the commitment to mentor and build up fellow nurses, providing them with support rather than chastisement. The life of a nurse is hard enough without being bullied. Encourage your coworkers to treat less experienced nurses with respect and compassion. If you are being bullied, reach out to your nurse manager or educator.

9. Maintain Personal Health

It’s not always realistic to think you will be able to drink all eight of your recommended glasses of water each day. However, dehydration and neglecting to empty your bladder can have some serious consequences. Urinary stasis can lead to urinary tract infections, bladder infections and kidney infections. Take the extra minute to rehydrate and relieve yourself, such as before taking your patient to the bathroom.

10. Prevent Burnout

There’s a reason that flight attendants tell parents to put on their own oxygen masks before putting on their children’s masks: you must take care of yourself to care for others. Burnout can occur for a variety of reasons and has serious ramifications for safe patient care. One way to prevent or treat burnout is to engage in self-care — take a little time for yourself.

Consider giving away that extra shift and binge-watching old TV episodes. Engage with your church community. Engage in whatever activities allow you to regain perspective, combat burnout and be present at work.

Safety in Nursing: Become an Expert

The first step toward becoming a nursing safety expert is to develop the knowledge and skills needed to be successful in a variety of clinical environments. Registered nurses interested in improving workplace safety are likely to find that completing an advanced education, such as a Master of Science in Nursing, can provide them with the education and tools they’ll need to promote nurse safety in the workplace.

Those interested in advancing their nursing careers benefit from SAU’s faith-based education, delivered with flexibility and support. As an MSN student, you can:

Earn your degree while continuing to work full time
Enjoy a week off in between classes and recharge with the 7-1-7 model (7-week courses, 1-week break)
Learn from engaged faculty as you join a caring community
Grow professionally, personally and spiritually through a faith-based curriculum
Receive personalized support every step of your journey until graduation
Join other inspiring alumni and graduates
Prepare to earn your national certification (ANCC or AANP) with strong licensure pass rates (88% for first-time test takers, 100% for second-time test takers)

Are you ready to take the next step toward becoming an expert regarding safety in nursing? Discover how completing an online Master of Science in Nursing from Spring Arbor University can prepare you for the next step in your career.

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