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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