First, do no harm. It’s the overriding principle of healthcare. While it applies, of course, to the patients you treat, you should also apply it to yourself.
As a nurse, if you don’t stay healthy and safe, it’s going to be difficult to give your patients the care they need.
What follows is a comprehensive guide from the Fall 2013 issue of Scrubs to staying well and out of harm’s way in the workplace. Use it to reinforce what you learned in nursing school and remind yourself of how your patients’ health and safety is dependent on yours.
BACK OFF! AVOID MUSCLE ACHES AND PAINS
The patient is 250 pounds; you’re 125. When you encounter him, he’s struggling to get from his wheelchair into bed. Do you: a) lift him back into bed, b) give him a shoulder to lean on c) go get the lift down the hall? Logically, you know c is the right answer. However, in the heat of the moment, are you going to be more likely to choose a or b? “Nurses have little computers in their heads and they know how long it takes to do something. If that something adds 10 seconds, they’re not going to do it,” says Nancy Menzel, PhD, RN, an associate professor of community health nursing at University of Nevada, Las Vegas. All the more reason to keep assistive devices—such as mechanical lifts—convenient to the bedside, says Menzel, whose research focuses on prevention of work-related musculoskeletal disorders in nurses.
Not surprisingly, nurses and other healthcare workers are second only to firefighters in work-related injuries. And nurses in some units are at greater risk (particularly for back injury) than others. One 2012 study, by researchers at Boston University School of Public Health, found that operating rooms, float pools and step-down units had the highest rates of nurse injuries (pediatric/neonatal and non-inpatient units had the lowest).
Contrary to what’s often thought, musculoskeletal injuries don’t generally happen because you make one wrong move. “It’s usually cumulative trauma, caused by many small microtears,” says Menzel. “If those tears aren’t allowed to heal, they can cause permanent damage and eventually put you out of work.” So don’t wait for the straw that breaks your back. Put our preventive measures into place now.
No Heavy Lifting
Safe patient handling isn’t about body mechanics—even with your knees properly bent, transferring a 200-pound patient with a draw sheet puts you and your patient at risk—it’s about taking an ergonomically appropriate approach to moving, positioning and assisting patients. Research from the National Institute for Occupational Safety and Health puts the limit on safe lifting at 35 pounds, above that, forgo manual labor for mechanical equipment and assistive devices such as powered lifts and lateral transfer devices. Other guidelines to keep in mind:
- Avoid awkward positions—if it feels strange, it’s not safe.
- When attending to a patient, be sure the bed is adjusted to a comfortable height for you to work.
- Request proper equipment for obese patients, but also be careful about ordering a bed that’s too big. If it’s too large, you could strain your back reaching across to assist the patient.
- If turning a patient, reduce damage on your own body by flexing the patient’s knees and hips and using his thigh as a lever.
- Take breaks throughout the day to recover from lifting and other taxing maneuvers.
Can Exercise Help?
There are all many great reasons to exercise, but being fit doesn’t provide a free pass on muscle injuries—or license to disregard safe patient handling guidelines. However, core-strengthening exercise in particular can help ward off muscle fatigue. Then there’s this: Some research indicates that stretching can help relieve the pain of injuries that have already occurred. In a 2012 study, Taiwanese researchers compared nurses with lower back pain who stretched to a group that did no stretching. After six months, they found that the stretchers were in much better shape than the non-stretchers—81 percent reported moderate to high levels of relief.
Advocate for Safer Conditions
What’s most critical to your muscular health is that you have the right tools for the job. If your workplace doesn’t have proper lifting equipment and a safe patient handling program in place, exercise your right to speak up.
- Check in with the employee safety committee to make your concerns known.
- Contact your local union if you’re not getting any traction at work.
- If you’re interviewing for a new job, ask about their safe-handling programs. If they don’t have one, seriously consider passing.