Wednesday, May 07, 2003

First Do No Harm

I don’t know if employee health specialist quoted in this article was misquoted or what, but she seems to have taken a few steps backwards in the struggle to fight back injuries in the nursing profession.

Responding to the fact that, as the American Nurses Association quotes, “the occupations of nurse's aide and registered nurse rank first and sixth, respectively, among U.S. occupations at risk for strains and sprains, outranking construction laborers and stock handlers,” Carol Hickey, RN, BSN, and case management specialist for employee health at KU Medical Center misses the boat when it comes to the solution
"Our employees go through safety training every year. We also have an Internet program that presents appropriate lifting techniques and the importance of getting help when necessary.

"And it doesn't stop at the work site - it's important 24/7. A large percent of back injuries occur because people are not in good condition. Being overweight can aggravate a lot of back problems. Good posture and good abdominal muscles can minimize back injuries, and routine exercise is one of the best things you can do for a healthy back.

"Another important issue is the aging population that works in medical professions. The natural aging process causes degenerative changes in the spine, which may contribute to back injuries."
So back injuries are so common among nurses because the don’t know appropriate lifting techniques, they’re in bad shape and they’re old?

In my many years of working with health care workers I’ve met too many young, conscientious, skilled, caring nurses (and who seemed to be in pretty good shape) who have had to leave their profession because they had to lift too much, too often

Even OSHA’s rather anemic nursing home guidelines state that “Manual lifting of residents be minimized in all cases and eliminated when feasible” and that mechanical lifts be used as much as possible.

Hickey admits that the reasons for many back injuries is that nurses “may know good lifting techniques and the importance of using the devices available to assist in lifting heavy patients, but they get busy and rushed, and they try to do it themselves,"

Workers get busy and rushed for a reason and the response is not to work more carefully, but to find the root cause of why they are busy and rushing. In nursing homes it’s generally because they are understaffed and/or they don’t have enough working lifting devices. The solution is more staff, fewer patients and/or more lifiting devices, not learning better lifting techniques.

The problem with this kind of misinformation is not only that it is inaccurate and can lead to more injuries, but it also encourages nurses to blame themselves for back injuries instead of their working conditions. (“I must not have been lifting properly.” “I should have lost weight and gotten in shape.” “I guess I’m just too old for this kind of work.” “I just should have been more patient and waited for help.”

For some real help on preventing back injuries, check here:

A Back Injury Prevention Guide for Health Care Providers, Cal OSHA

Safe Patient Handling and Movement, VHA Patient Safety Center

Preventing Back Injuries, American Nurses Association