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The health problems of nurses and midwives

Discussing problems and ways to ensure the safety of nurses and midwives in the workplace author started in the last issue of the magazine to define and systematize the most important concepts in medicine and health turn of the regulations in this area, primarily concerning the rights and obligations of workers and employers.

Among the legal provisions on measures to prevent adverse health effects of the work role was played by the Act on occupational health service. Its purpose is to protect health workers from opposed conditions associated with the work environment and the way it is carried out, and the exercise of preventive health cared for working.

Partner of the occupational health services (SMP) in achieving its mission of prevention, inter alia, the State Sanitary Inspection (SSI), which is the body appointed to the sanitary supervision of the hygiene conditions of the environment, jobs, schools and other educational establishments, health conditions of food and nutrition.

PIS has preventive and ongoing medical supervision, operates a obstructive and total anti-epidemic in infectious diseases and other diseases caused by environmental conditions (e.g., professional) if their presence is an epidemic, and conduct health promotion activity.

The State Labor Inspectorate (PIP) is the regulatory body, assessing the compatibility conditions of the law. You can ask them for assistance with problems or complaints (even anonymously) to break in the establishment of workers' rights (as defined in Labor Code and implementing rules).

Their assistance in solving problems of professional nurses and midwives involved in their professional self, whose task should be to all the representatives of the profession not only known but also by cooperation implemented, according to the principle: "Nothing about us without us."

Labour Code Act
Referring to the Universal Declaration of Human Rights adopted by the UN in 1948, setting out the basic rights of the individual, the Constitution of 1997 includes the following records:

  • Work is under the protection of the Republic; 
  • The State shall exercise supervision over the conditions of work; 
  • Everyone has the right to safe and healthy working conditions (...).

Law Labour Code (LC) sets out the basic rights and obligations of employers and employees. From the perspective of health workers is particularly important Kp Section VIII contains the right of employees related to parenthood and X, dedicated to health and safety.

Labor Code requires equal treatment for men and women in employment, prohibits discrimination and obliges the employer to prevent harassment.
An employer shall provide employees with safe and healthy working conditions, and the employee is obliged to comply with laws, rules, and safety and fire regulations.
public health nurses and midwives state award

The employee has the right to rest. It shall have the right at all times to at least 11 hours of continuous rest in each week - for at least 35 hours of uninterrupted rest. If the daily operational hours the employee is at least six hours, the employee is entitled to time off work lasting at least 15 minutes, reflected the working time. Employee is entitled to an annual, ongoing, paid leave.

The working time of employees in workplaces where there is cross NDS or MPD (maximum permissible concentrations and intensities) of factors detrimental to the health of pregnant workers, workers caring for the child to complete their fourth years of age, without their consent cannot exceed eight hours.

Rights of employees related to parenthood has a section VIII of the LC, and it will include the following records:

  • Do not employ women for particularly arduous and harmful to their health.
  • An employer who employs a pregnant or breast-feeding a child at work prohibited to be obliged to transfer the employee to another job, or release it for the time required from work, and employing a worker who is pregnant or breast-feeding a child with the other work is required to adjust working conditions to the requirements specified in the regulations that limit the time or work to eliminate risks to health and safety of workers or transfer the employee to another job or the time required for release from work;
  • An employer may not terminate or terminate the contract of employment during pregnancy and maternity leave (with reservations - Art. 177);
  • Employees in pregnancy may not be employed in overtime work or night work;
  • Without the consent of employees are not allowed to delegate its permanent place of work outside;
  • Employee of caring for a child to complete their fourth years are not allowed without his permission to employ in overtime, at night, in the system of periods of work, as well as delegated outside of work; employees are entitled to maternity leave: 20 weeks after giving birth to one child at one time, 31 - in the birth of two children, 33 weeks - three, 35 weeks-four and 37 weeks after giving birth five or more children at one time A worker who is a child shall be entitled to two half-hour breaks included in the working time.

Health and safety department discusses the X Kp. There are: the basic obligations of employers and employees in health and safety, the duties related to securing jobs, machines and technical equipment, work processes and factors posing a particular threat to life or health, preventive health care, industrial accidents and occupational diseases; training about health and safety, personal protective equipment and clothing and footwear.

Compliance with safety rules and regulations is the primary responsibility of the employee.

Superior employees are required to: organize the workplace in accordance with the provisions and principles of safety; efficiency of care for personal protective equipment (...) organize (...) work, taking into account protection of workers against occupational accidents, occupational diseases and other diseases associated with working environment, ensure safe and hygienic condition of the work premises and technical equipment (...) to enforce compliance by employees of safety rules and regulations, to ensure compliance with recommendations of the healthcare doctor on staff.

Do not allow the employee to work (...) without sufficient knowledge of safety rules and regulations.

Health Care
The following articles relate to the protection against Kp carcinogens or mutagens, biological and protection against ionizing radiation. When hiring an employee in terms of exposure to these factors, it is necessary to take restrictive measures, including drawing up a list of these factors, record of all work by the employer and employees in touch with these factors, keeping on the exposure of workers, use protection and health monitoring of workers exposed.

The employer shall assess and document the risk arising from work performed and shall take the necessary preventive measures to reduce the risk, inform workers about him and the rules of protection against threats.
The employer is required to: take measures to prevent occupational diseases and other disorders associated with work, in particular, kept a constant efficiency device reduce or eliminate the harmful factors of working environment and equipment for the measurement of these factors, carry out, at its own expense, research and measurements of unhealthy factors, capture and store the results of these tests and measurements and make them available to employees.

The Decree of the Ministry of Health on health surveillance identified to include: harmful or nuisance factors (divided into physical, industrial dust, toxic agents, biological and other), the scope of testing (pre-medical and auxiliary periodic), and their frequency; range of the most recent periodic test; organs (systems) critical.
For example, if an employee is exposed to harmful factors, such as cytotoxic drugs, the extent of initial and periodic tests (including the most recent periodic survey) includes a medical examination, with emphasis on liver and skin, and aids: complete blood count with differential, liver function tests, urinalysis the recommended frequency of testing overall - every 2-4 years. Critical organ is the liver and blood forming organs.
Initial medical examination shall be: employed workers, youth workers transferred to other jobs, and other employees transferred to posts where there are factors harmful to health or nuisance conditions (...). The employee is subject to periodic medical examinations. In the case of incapacity for work lasts longer than 30 days due to illness, the employee shall also be given a medical examination to determine his capacity to perform work at the current position.

An employer cannot afford to work without a valid medical certificate stating no counter to work on a specific workstation. The employer of workers in terms of exposure to carcinogenic substances and agents or dust causing fibrosis is obliged to provide them with periodic examinations also after cessation of work in contact with them after their work (on demand). These studies are carried out at the expense of the employer. The employer shall also bear other costs of preventive health care for employees, as necessary due to working conditions.

It shall keep reports issued based on medical examinations.
If the employee is an occupational disease (or unable to perform previous work due to accident or occupational disease), the employer shall, assuming the medical report, the date and time specified in this decision to transfer the employee to another job, it impaired the agent who caused these symptoms.

Personal protective equipment
An employer shall provide the employee free of personal protective equipment (meeting the requirements for conformity assessment), protection against dangerous and harmful factors in the work environment and to inform him on how to use those funds.

The employer provides the employee free of clothing and footwear that meet the requirements of Standards, if the employee's own clothing may be damaged or soiled and significantly due to technological requirements, health or safety. He cannot allow an employee to work without protective equipment and clothing and footwear (...).

Entrusting laundry worker, maintenance, dust removal and decontamination of personal protective equipment, clothing and footwear, which have been contaminated by chemical or biological materials, radioactive or infectious, is unacceptable.

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