chapter 12 | Promoting a Healthy Workplace 181supervise other employees, regularly review your
agency’s policies and procedures. Seek appropriate
guidance from your Human Resources personnel.
If an employee approaches you with a complaint,
then a confidential investigation of the charges
should be initiated. Above all, do not dismiss any
incidents or charges of sexual harassment involving
yourself or others as “just having fun” or respond
that “there is nothing anyone can do.” Responses
such as this can have serious consequences in the
workplace (Outwater, 1994).
The ANA cites four tactics to fight sexual harass-
ment (nursingworld.org/dlwa/wpr/wp3/htm):
- Confront.Indicate immediately and clearly to
the harasser that the attention is unwanted.
If you are in a union facility, ask the nursing
representative to accompany you. - Report.Report the incident immediately to
your supervisor. If the harasser is your supervi-
sor, report the incident to a higher authority.
File a formal complaint, and follow the chain
of command.
3.Document.Document the incident immedi-
ately while it is fresh in your mind—what
happened, when and where it occurred, and
how you responded. Name any witnesses. Keep
thorough records, and keep them in a safe place
away from work.
4.Support.Seek support from friends, relatives,
and organizations such as your state nurses
association. If you are a student, seek support
from a trusted faculty member or advisor.
Additionally, your employer has a responsibility
to maintain a harassment-free workplace. You
should expect your employer to demonstrate
commitment to creating a harassment-free
workplace, provide strong written policies
prohibiting sexual harassment and describing
how employees will be protected, and educate
all employees verbally and in writing.
Latex Allergy
A nurse developed hives in 1987, nasal congestion
in 1989, and asthma in 1992. She was diagnosed
with latex allergy. Eventually she developed severe
respiratory symptoms in the health-care environ-
ment even when she had no direct contact with
latex. The nurse was forced to leave her occupation
because of these health effects (Bauer et al., 1993).
A midwife initially suffered hives, nasal conges-
tion, and conjunctivitis. Within a year, she devel-
oped asthma, and 2 years later she went into shock
after a routine gynecological examination during
which latex gloves were used. The midwife also suf-
fered respiratory distress in latex-containing envi-
ronments when she had no direct contact with latex
products. She was unable to continue working
(Bauer et al., 1993).
A physician with a history of seasonal allergies,
runny nose, and eczema on his hands suffered
severe runny nose, shortness of breath, and collapse
minutes after putting on a pair of latex gloves. A
cardiac arrest team successfully resuscitated him
(Rosen et al., 1993).
Latex products are manufactured from the
milky fluid of the rubber tree. Latex allergy was
first identified in the late 1970s. It has become such
a major health problem in the workplace that both
the OSHA and the ANA have devoted Web sites
to the problem. It is estimated that currently
8%–12% of health-care workers are sensitive to
natural rubber latex products. Table 12-2 lists prod-
ucts commonly produced with latex.
Since the 1987 CDC recommendations for uni-
versal precautions, use of latex gloves has greatly
increased exposure of health-care workers to natu-
ral rubber latex (NRL). The two major routes of
exposure to NRL are skin and inhalation, particu-
larly when glove powder acts as a carrier for NRL
protein (OSHA latex alert: cdc.gov/niosh/latexalt).
Reactions range from contact dermatitis, with scal-
ing, drying, cracking, and blistering skin, to allergic
contact dermatitis in the form of generalized hives.
More serious reactions can progress to generalized
urticaria, rhinitis, wheezing, swelling, shortness of
breath, and anaphylaxis. According to the NIOSH,
the most common reaction to latex products is
irritant contact dermatitis, the development of
dry, itchy, irritated areas on the skin, usually the
hands. This reaction is caused by irritation from
wearing gloves and by exposure to the powders
added to them.
Allergic contact dermatitis (sometimes called
chemical sensitivity dermatitis) results from the
chemicals added to latex during harvesting, pro-
cessing, or manufacturing. These chemicals can
cause a skin rash similar to that of poison ivy.
Neither irritant contact dermatitis nor chemical
sensitivity dermatitis is a true allergy (cdc.gov/
niosh/98-113).