The overall work environment for registered nurses (RNs) is safer than it was ten years ago, according to a survey by the American Nurses Association (ANA). But nursing nonetheless remains tough on the body. Eighty percent of nurses say they frequently continue to work despite job-related neck, back, or shoulder pain. And 13% say they have been injured three or more times on the job within a year.

The survey, which drew responses from more than 4,500 RNs, reveals the same top three work environment concerns identified in a 2001 ANA survey. These are acute or chronic effects of stress and overwork (74% of respondents); disabling musculoskeletal injury (62%); and risk of contracting an infectious disease (43%).

On the other hand, the survey shows that health care providers have become more accountable in providing safety equipment and devices. Nearly two-thirds of nurses say they have ready access to patient lifting and transfer devices, compared to less than half in 2001. Ninety-six percent say that safe needle devices are provided, compared to 82% in 2001.

While concerns about on-the-job physical assault have increased since 2001 (25% to 34%), the percentage of RNs who say they were assaulted decreased from 17% to 11%.

The majority of nurses still say they have been verbally abused or threatened on the job within a year, though the occurrences decreased since 2001 (57% to 52%).

The survey also shows a trend toward healthier work schedules. The percentage of nurses working more than 40 hours per week decreased from 64% to 55%, and RNs who work some mandatory or unplanned overtime each month decreased from 68% to 53%.