Neurosciences registered nurse David Nguyen has worked for three years in his current role within the 46–bed ward specialising in acute care of neurology, neurosurgery and stroke patients. He previously held a concomitant secondary role as a neurology research nurse (coordinating clinical trials) at Monash Health for a year.
A Health and Safety Representative (HSR) with Monash Health since June 2020, David has always had an interest in safety. Over the years, he witnessed injuries in the workplace and heard recounts of injuries his friends and family endured in their respective workplaces.
“Consequences ranged from minor annoyances and a couple of days off work to traumatic brain injury, loss of physical function and social isolation,” David said. “The burden of workplace injuries is therefore not only immediate, but possibly long-term, and involves not only health but extends to family and friends.
“Realising that these incidents were preventable if the appropriate precautions were in place sparked my desire to undertake the HSR role.”
David has some previous formal background in volunteering for a few years with the VicSES (State Emergency Service) where safety was paramount and taught systematically.
“For example, safety in search and general rescue operations, using and maintaining equipment, such as chainsaw, power generator, lighting, ropes, pulley systems and ladders,” he said. “I believe these skills, including situational awareness, are transferrable to my work as a registered nurse.”
David’s personal vision in Occupational Health and Safety (OHS) as an HSR is that 100 percent of employees return home safely to their loved ones at the end of the day and he wants to help contribute to an even safer and healthier workplace in Monash Health, without denying “it is already a safe and great place to work at”.
David has been fundamental in achieving health and safety improvements for his colleagues and Monash Health patients in the few short months of his tenure as a representative on the Monash Health Occupational Health and Safety Committee.
With regard to OHS issues, the first he identified was eye strain associated with poorly illuminated keyboards on night shifts and initiated the implementation of USB lights as a solution. Secondly, he noted that nurses enter patient rooms multiple times on night shift with WOWs (a portable computer workstation) and tend to avoid turning on bright lights as they interfere with patients’ sleep, especially in 4-bed rooms, can cause agitation in some neuro patients and possibly delays recovery. When he first started, he heard from a few colleagues of eye strain problems and experienced this himself too, so he investigated further and found the issue to be much more prevalent across the ward.
“There were even complaints about headaches and the use of eye drops to counteract the effects,: he said. “Given these effects and that we frequently rotate through night shifts every 4-6 weeks, this was a moderate risk hazard that needed to be addressed.
“Options included permanent dimmable lighting in all rooms or continued use of mobile phone lights and other personal lighting. But, the solution that came out on top was USB lights – economical, long-life, minimal energy use.”
David involved his unit manager Paul Ratcliffe along every step of the way, who was very supportive in the move to improve the OHS for staff. They also involved the OHS Advisory Team and EMR Team.
A post-implementation online satisfaction survey was conducted, and it showed a result of overwhelmingly supportive intervention. A secondary benefit of USB lights is that they can dimly illuminate workspaces, not just for keyboard typing, and assist when attending to bedside patient care.
David isn’t just happy to rest on his laurels now that he has implemented that change. He sees other risk factors that need addressing. His next OHS project is clearing his ward’s corridors of linen bags and skips, which he sees as trip hazards due to confined space and also unsightly. He has also conducted workplace inspections in conjunction with Paul, with whom he believes it is essential as an HRS to have a very good working relationship.
“HSRs are the vital link between employees and management,” he said. “Management does not always see the day-to-day OHS issues faced by employees in the clinical setting and few employees are aware of how to escalate OHS issues and incorporate knowledge of OHS legislation to management.
“As a HSR, I can help make OHS changes more efficiently. Of course, this is dependent on having a good working relationship with my colleagues, but most importantly my manager, who ultimately has the capacity to make any local changes.”
He said Paul, as his manager, prioritises OHS issues on the ward and “cares about the wellbeing of our staff”.
“He has actively listened to our concerns and has been quick to implement any necessary changes to ensure safety is met, such as addressing quarterly audit issues found,” David said.
Paul Ratcliffe’s praise for David Nguyen’s consistent effort in identifying OHS risks is high indeed.
“David works with me on our quarterly safety audits,” he said. “He has taken an active role to ensure the gaps have been addressed. He identified the broken venation blinds in the north single rooms, which appear to have been long-standing, he has engaged the staff on the night visibility concerns with great success in outcomes, and he is currently looking at how we can clear our corridors of full linen bags and linen skips.”
Paul said he sees the role of an HSR representative as a great opportunity for his staff to develop their leadership and change mechanism skills.
“I promote an elected HSR every three years who the staff feel will advocate for their safety and productive working conditions,” he said. “As a manager of a large service, I rely heavily on our HSR who works daily in the clinical area and has an understanding of employees’ needs in providing exceptional care to our patients.
“The staff elected HSR has an in-depth knowledge on work flows on the ward, who escalates concerns for improvement through staff engagement and quarterly audits.”
Paul said David identified damaged blinds in the ward’s single rooms, where staff had adapted them with tape to keep them open, and these ware all now being replaced.
With regard to his attitude to OHS issues and risks, what makes David so integral to Monash Health, according to Paul, was is approachable and friendly demeanour; someone who actively listened to staff on their concerns.
“He is looking at other mechanisms to allow to voice suggestions on safety improvements on the ward,” Paul said. “I rely on the HSR to work independently with enthusiasm and passion in workplace safety, which David as 10–fold. He is very engaged with innovative ideas to solve short-term and long term issues.
“The night lighting is an example where he introduced an economical short fix until the ward could financially support all WOWs with laminated keyboards and keeping within our means.”
Ensuring a safe work environment with the trial of the USB WOW light has been David’s main OHS achievement to date in his HSR role, according to Paul.
“This was audited with great feedback from the staff, so we rolled out the device to every Nurse WOW on the ward,” he said. “We also spoke with the EMR IT group, who advised us of the laminated keyboards ($90 each). We are now replacing the WOW keyboards as required. It has been noted the letters fall off or the cable to the boards snaps over time. “
Paul said David’s current challenge was to clear the ward corridors of linen skips, full linen bags, inflating air mattresses, and abandoned WOWs in the corridors of the ward.
“This will require practical and financially neutral innovative,” he said. “(But), in a short time, David has implemented great improvements to the ward. He is developing trusting communication channels with the staff, which builds on our supportive and inclusive ward culture. Staff are happy, feel safe and enjoy coming to work in their pursuit in exceptional care delivery.”
Approved by Karen Lowe