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Table 1 Tasks and challenges in hospital ward settings that have become more difficult with age

From: Beyond 50. challenges at work for older nurses and allied health workers in rural Australia: a thematic analysis of focus group discussions

Tasks impacted by age-related factors Reported reasons why each is more difficult
1. Reading drug labels and information sheets Age related factors:
2. Reading other print communications ▪ Deteriorating vision
  Exacerbated by:
  ▪ Poor light at night, environmentally friendly light bulbs
  ▪ Small print (eg. drug labels, information sheets, ampoules, imprints on foil packs)
  ▪ Colour of print (eg. orange or red writing on ampoules)
  ▪ Reading through plastic sleeves
  ▪ Losing glasses - continually taking them on and off
  ▪ Increased computer work - associated eye strain
  ▪ Size of phones, keypads, text messages
3. Administering medications Age-related factors specific to these tasks -
Including: ▪ Reduced strength in hands and wrists
▪ Cracking ampoules ▪ Pain in hands and wrists
▪ Administering IV medications and removing IV lines ▪ Fine motor co-ordination reduced
▪ Openning packages - lids, jars, plastic overwrap, boxes with tape, dressing packs, seals, child proof packages, IV fluid bags ▪ Reduced dexterity
  ▪ Increased cramping of fingers
  Exacerbated by:
  ▪ Smaller, more secure packaging
  ▪ Environmentally friendly gloves
4. Hearing in the hospital ward or unit Age related factors:
In particular: ▪ Deteriorating hearing
▪ Hearing patients ▪ For some, noise induced hearing loss
▪ Hearing at the work- station  
   - Drug orders, other instructions and conversation over the phone Exacerbated by:
   - Other staff ▪ Accents of some non-English-speaking staff
   - Alarms and distinguishing between them ▪ High background noise level of wards with open office
  ▪ Distractions - constancy of phones ringing, others talking
  ▪ Anywhere where there's a crowd
  ▪ Speech of younger staff
5. Manual handling - lifting and/or moving patients and equipment Age-related factors:
In particular: ▪ Musculo-skeletal changes affecting strength, muscle tone, flexibility
▪ Examining patients ▪ Stability and balance
▪ Dressing patients - shoes & socks, adjusting clothes/attire ▪ Increased pain, stiffness (+/- osteoarthritis) in:
▪ Holding limbs and draping surgical patients    - Joints - hips, knees, hands, feet
▪ Pushing/pulling equipment - eg. beds, chairs    - Neck and shoulders
▪ Showering patients    - Back
▪ Toileting patients in difficult areas ▪ Manoeuvring more difficult when older; fuller figures of both patients and staff
▪ Squatting or kneeling - for procedures, picking things up off floor Exacerbated by:
▪ Doing dressings ▪ Manoeuvrability and maintenance of equipment
▪ Making beds, adjusting bed heights ▪ Workplace ergonomics and design of facilities (old)
▪ Walking up and down steps ▪ Narrow bathrooms and doors don't allow room for lifting aids
▪ Transporting objects, records ▪ No shelves or poor position of shelves
  ▪ Unco-operative patients
  ▪ All-in-one gowns - difficult for examining patients
6. Shift work Age-related factors:
In particular: ▪ Tiredness, especially after lunch
▪ 10 hr shifts, longer shifts, more shifts, double shifts, early shifts, split shift ▪ Reduced stamina from physical demands on body
▪ Rigid roster ▪ Longer recovery periods - "takes 2 days to get over a double shift"
▪ On call ▪ Lack of sleep, disturbed sleep patterns, "waking at 3 am"
▪ Long working days ▪ More anxious, not dealing with lack of sleep as well as before
  ▪ Strong work ethic of older workers - "if you were younger, you would just go off"
  Exacerbated by:
  ▪ Inflexible work hours
  ▪ Lack of staff - "can't go off sick, no one to replace you"
  ▪ Unable to take time out to recover
  ▪ Poor recovery after inconsistent shifts; insufficient rest times between rotations and being on call
  ▪ Some older workers more resistant to shift changes
7. Long periods of standing, walking or sitting Age-related factors:
In particular: ▪ Manoeuvring more difficult when older, fuller figures of both patients and staff
▪ Sitting down for long periods eg. data entry ▪ More difficult to get mobile quickly after sitting, due to stiffness and back problems
▪ Standing/walking, being on your feet for long periods or all day. eg. in operating theatre  
▪ Unnecessary walking Exacerbated by:
  ▪ Past surgical procedures
  ▪ Design of facilities - long distances to medication rooms, utility rooms
  ▪ Running phones up and down to patients, "have to leave what you are doing"
8. Midwifery Age-related factors:
In particular: ▪ More difficult to lean, bend, stand for long periods now older
▪ Delivery of babies - long periods of: ▪ Back pain and stiffness
   - Leaning over beds (As above for manual handling)
   - Bending  
   - Being on your feet Exacerbated by:
   - On floor with mother ▪ New options/positions for birthing & birthing chairs
  ▪ Presentations now more complex, with more requirements
9. Physiotherapy Age-related factors:
In particular: ▪ Back pain and stiffness
▪ Patient exercises - bending/reaching over beds leading to back-strain (As above for manual handling)
  Exacerbated by:
  ▪ Allied health workers in rural areas are often sole practitioners with no help