Each accredited HEI has a duty of care to ensure that you are safe while undertaking PLEs
During a programme of pre-registration nurse education each accredited HEI has a duty of care to ensure that you are safe while undertaking PLEs. The HEI and practice providers work collaboratively to support all students. According to current Health and Safety legislation (Management of Health and Safety at Work Regulations, 1999) some groups of student nurses must be aware of particular hazards in the practice setting. Students under the age of 18 (young workers) and those who are pregnant or breastfeeding, may need additional consideration to ensure that they are not exposed to undue risk. Students from these groups should be risk assessed on arrival in the PLE.
If you fall within any of these categories whilst a student, it is your responsibility to:
Read below for more information about:
Definition: The term ‘Young Worker’ means a worker who has attained the age of 16 but not the age of 18. A number of nursing students particularly at the beginning of their programme will be aged 17.
Background: Young workers are afforded all the protection of general health and safety law – the right to information, training, supervision and to a safe and healthy workplace. There are however specific restrictions that apply to workers aged under 18 years.
Restrictions: Management of Health and Safety at Work Regulations 1999, regulation 19,(5) requires that persons under 18 years of age should not be employed to undertake work that is, beyond their physical or psychological capacity, exposes them to radiation or harmful substances, involves a risk of accidents they are unlikely to recognise because of a lack of training or experience or involves a risk to their health from extreme heat, noise or vibration.
Hours The Working Time (Amendment) Regulations 2002 limit the hours per week and per day a child or young person (under 18) can work, and set out minimum rest periods. Workers aged 16 and 17 are entitled to 12 consecutive hours of rest in any 24 hour period. They are also entitled to a rest period of no less than 48 hours in each seven day period, compared to 24 hours for an adult worker. The UK opt-out from the Working Time Regulations does not apply to under-18s. Young workers are never allowed to work more than 40 hours a week and must have a 30 minute break away from their work if the work exceeds 4.5 hours.
Night Shift Due to the restrictions young workers should not work night shifts within hospital and health care settings.
Risk Assessment Young Workers
In order to comply with the Management of Health and Safety at Work Regulations 1999, a specific young worker risk assessment must be completed.
details are shared with relevant PLE manager and practice assessor for purposes of completing a risk assessment prior to practice
The guidance requires you to identify the hazards in your workplace and determine whether your existing risk control measures are adequate for a young worker
During pregnancy, nursing students must be particularly aware of potential health and safety hazards in the workplace as they face many risks to their health and the health of their unborn child.
For Pregnancy or Breastfeeding
Cytotoxic medicines. These are highly potent materials; some might have a more serious effect upon the foetus or the breastfed infant. Pregnant or breastfeeding students should not be involved in cleaning spillages or dealing with extravasation and should only be involved in administration if the risk of splashes has been virtually eliminated.
Solvents. High exposures to solvents produce a greater risk to the foetus or infant than to adults. There is little such work in the health service. Seek advice from health and safety if you are pregnant or breastfeeding during prolonged work with solvents e.g. prosthetics.
Ionising Radiation. The foetus is more susceptible to ionising radiation than are adults. Staff routinely exposed to x-rays or to radiation from radioactive substances are subject to exposure monitoring. The results of this monitoring show that for most staff exposures are much less than the statutory limits that apply during pregnancy. Nevertheless, further precautions may be advised to reduce still further the risk of accidental exposure. Therefore, exposure of pregnant women should be as low as reasonably practicable, and certainly below the statutory dose limit for pregnant women. Nursing mothers should not be allocated a practice learning experience where the risk of contamination from ionising radiation is high. Working conditions should also ensure that pregnant women do not receive accidental exposures to radioactive contamination (IRR 1999). Students who are pregnant, may wish to make sure they leave the controlled area while X-rays are being taken.
Mercury. Mercury is toxic to the central nervous system; the CNS of the foetus (and infant) is more vulnerable than that of adults, especially during the first trimester. The exposure to mercury that may arise following the spillage of mercury in a thermometer or sphygmomanometer is negligible if the guidelines are followed. If there is a large or awkward spillage from a sphygmomanometer, the student should be discouraged from cleaning this and should get someone who is not pregnant to follow the clean up procedure.
Infection Risks. Some infections (Rubella, Listeria, Toxoplasmosis, Hepatitis, HIV, VZV and CMV) are more serious for pregnant or breastfeeding students. If any of these are known to be present among staff or patients, or are often present in the patient group, consult the Occupational Health Service for further advice or consider alternative practice learning allocation.
For Pregnancy only
Manual Handling. The ability to handle loads is not diminished by pregnancy except in two respects. 1) as the size of the abdomen increases, the load is displaced further from the spine so the maximum load the person can safely handle diminishes. If heavy work is expected, consult the manual handling adviser
2) In the final weeks of pregnancy, the ligaments become looser so the risk of injury from manual work is increased. Often this would occur during the maternity leave but students who are keen to work as long as possible may need to be excluded from heavy work during the later stages. Consult the manual handling department if in doubt.
Inhaled antibiotics and Nitric Oxide. Pentamidine, ribavirin, and perhaps nitric oxide, are suspected of having a greater risk for pregnant staff/ students than for others. Local guidelines should be in place for students allocated to practice areas where exposure to these substances occurs. Pregnant staff/ students should be excluded from routine administration except for short term relief during lunch breaks etc.
Violence. The foetus is physically well protected but is nevertheless vulnerable to kicks and punches.
Night work and long hours. The Management of Health and Safety at Work regulations require employers to adapt the hours of pregnant staff (including avoiding night work altogether) if their GP or Occupational Health Service inform them in writing that this is necessary. It is reasonable to suggest that the same opportunities be afforded to students on practice. Any student who is pregnant, that appears to be experiencing difficulties, should be encouraged to consult their GP to identify whether there is a requirement to adapt their pattern of work.
Anaesthetics. Some years ago there was concern that the risk of low birth weight or spontaneous abortion was increased with exposure to nitrous oxide or the volatile anaesthetic agents. These fears have been shown to be invalid (at least so far) for the anaesthetics exposures experienced nowadays. There is no reason to exclude pregnant or breastfeeding staff from any theatre work or recovery room work unless there are doubts about the efficacy of the ventilation. Seek advice from health and safety if in doubt.
MRI.
It is recommended that pregnant staff should not:
Details of the pregnancy pre-practice learning checklist can be shared with the relevant PLE manager and practice assessor for the purposes of completing a risk assessment prior to practice learning experience
The HEI places a student who is also an expectant Mother in a practice setting is required to undertake a risk assessment to ensure the safety and wellbeing of the student