Saturday, February 16, 2013

Safety on the road

 Relative risks of an accident based on activity while driving
Relative risks of an accident based on activity while driving
(based on data by the National safety Council)
*texting includes dialing, looking up email/phone number, 
or any other cell phone activity with visual distraction > 3 seconds

How dangerous can it be, to be a hospice care provider?

By “dangerous,” I mean hazardous to the health and safety of the hospice nurse, social worker, chaplain, or hospice aide providing care to patients and families in their homes, or at facilities.

According to the National Institute for Occupational Safety and Health (NIOSH), the Bureau of Labor Statistics (BLS) at the U.S. Department of Labor, and others, the answer may surprise you. We work in an industry, specifically the home health care subsector, which poses significant ongoing risks to us for serious illness, injury, and death.

I only recently began to appreciate the scope and severity of these dangers, as I researched the topic to prepare an orientation class at my agency.  Maybe I didn’t already understand the risks because I didn’t listen closely during my own orientation, or perhaps the topic wasn’t presented effectively.

The potential for serious bodily harm, or even death, merits our undivided attention. Let’s look at just one of the dangers we face, namely driving to and from the places we visit and give care.

A study conducted by BLS between 1995 and 2004 reported 154 job-related deaths among home care paraprofessionals - nursing, psychiatric, and home health aides. The majority of these deaths resulted from motor-vehicle accidents.

Research conducted on behalf of the National Association for Home Care and Hospice (NAHC) found that home care and hospice workers in the U.S. drove almost five billion (5,000,000,000) miles in 2006, to provide four hundred and twenty-eight million (428,000,000) visits to nearly 12 million patients.

The NAHC study showed Massachusetts home care and hospice workers drove 77,737,289 miles to conduct 13,182,930 visits that year – an average of 6 miles per visit in this relatively small and densely-populated state.

Take a moment to consider the time and distance associated with your own work-related travel in the course of a normal week. Better yet, consider how you drive during those trips, and what other tasks you try to accomplish behind the wheel – particularly those that involve your cell phone.

Work by the National Safety Council (pdf), and by researchers at the University of Utah (pdf), and the American Automobile Association (pdf), among others, concludes that driving while talking on a cell phone increases the risk of an accident at least four-fold, equivalent to the risk of driving drunk.

The researchers find it makes no difference whether we hold our cell phones while talking and driving, or use a ‘hands-free’ device like a speaker phone or Bluetooth earpiece/microphone (pdf). The problem is one of simple neuroscience – our brains are not wired to do two things at the same time.

Driving a car is a complex cognitive task, no matter how routine is may seem. Conducting a conversation is just as challenging when the rich mix of subtle nonverbal cues we depend on while taking face to face is absent.

The brain can switch between the two tasks, but it can’t do both at the same time. In other words, multitasking is a myth (pdf), at least when it comes to people.

More complex cell phone tasks pose an even greater hazard, and increase accident risk by over twenty times, because looking up a phone number, checking an email, or texting diverts visual attention. Lots can happen in the distance covered in just three seconds at 55 miles per hour.

There were 33,808 deaths attributed to automobile accidents in the U.S. in 2009 (pdf). Sixteen percent of those deaths – 5,474 to be exact – were caused by distracted driving, which includes cell phone use.

The National Safety Council is actively working for laws banning cell phone use while driving. They’ve also established four simple ways to increase driving safety:

1. wear your seat belt
2. drive sober
3. focus on the road
4. drive defensively

We’re on the road because we’re committed to helping our patients and families achieve the optimal outcome of hospice care - a peaceful death.

It’s frightening to contemplate how our actions while driving could instead result in another family’s sudden and traumatic loss. Perhaps even our own.

by Jerry Soucy, RN, BSN, CSS, CHPN
An edited version of this piece appeared in the HPNA Boston Winter 2013 newsletter

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