anyone here NOT have back problems?

canuckeh! · Mar 16, 2006

I worked over 20 years in acute care and never once injured my back. How? I went back to school as a mature student so I had a heightened awareness(as you seem to) of the inherent dangers. Although there will always be totally unpredictable events, in some ways we can control our response.

You should not be lifting anyone. Ensure that your facility has a "NO manual lift policy" and abide by it.

Never attempt to reposition anyone without the proper training. See the physiotherapist at your worksite for additional learning if this is not part of your orientation. Do not do q2h turns until you have help.These are not emergencies- they can wait. Ensure that you have the proper equipment- turning sheets that reduce friction, transfer boards and belts etc.

Practice what your reaction will be if you are assisting a patient and they fall. Assist them to the floor- ease their fall. Do not sacrifice your back to keep them upright. Wait until you have enough help to get them up from the floor. Remenber to use scoop stretchers- should be available in ER or elsewhere in your facility.

Do not heroically lift a patient back up onto a bed if they arrest. The code team can conduct the code on the floor. After all, they are already on a good hard surface and they can't fall off it.

NICU can be difficult as leaning over bassinets and isolettes is hard on the back. Ensure that you have safe footstools to use.

If you work in the ER, check to see that guidelines are in place to assist patients from vehicles. Do you have the correct equipment and training to keep both you and the patients safe? If not, ambulance should be called to extricate the patient.

What about codes that occur on hospital property but outside the building? Do you have a policy? If you have to respond, do you have a bag of necessary equipment including a gardening type knee pad to kneel on?

Also in ER, push for all stretchers to be hydraulic and able to go low enough to enable a patient to pivot from wheelchair to stretcher. Allow patients to do most of the work. Even someone with a broken leg can stand on their good one and pivot with support.

Ask your Health and Safety Committee to do preventive safety assessments to ensure that you have an ergonomic workplace.

PeachPie · Mar 17, 2006

A good pair of orthopedic shoes can make a difference.

tridil2000, MSN, RN · Mar 17, 2006

Hi all,
I've been accepted to an ADN program at my nearby community college.
I am 41, and when I finish I will be 44. I've volunteered in hospitals, and feel that nursing will be a good fit for me at this stage in my life.
However, I'm concerned about back problems. How does one avoid getting injured? I am generally fit, healthy and know how to life things -- using my leg muscles rather than my back -- but how realistic is this when you are moving/lifting a real person and may have to lean over, thus engaging the lower back?
Are there certain specialities that have a lower rate of back injuries (I'm thinking maybe the NICU). Has anybody here NOT been injured on the job? If so, how do you protect yourself? Can you be fired for refusing to lift under dangerous or sub-optimal conditions? Please add how long you have been nursing.
If you have been injured, how did it happen, could it have been avoided, and have you recovered? Are you still in the same job?
Thank you for all your responses. I'm very concerned about this.

in school they hound 'keep the bed in the lowest position' - well that'll kill a back in no time flat.

raise the bed to waist level to do your work. also reverse trend them for a minute for a lift. 2 people can usually boost most people when they're reversed in bed!

why fight gravity? use it!

no back issues after 19 years here!

meownsmile, BSN, RN · Mar 17, 2006

I have back problems but they arent related to nursing. I am very careful about body mechanics and i know my limitations. If your head tells you not to lift or move someone, dont. Noone is ever died from being incontinent because someone needed help getting them up to a commode, but it may be the end of both of you if you try to do it by yourself.

Also there is a little trick to pulling someone up in bed if there isnt anyone readily available to you to help. Lay the patient flat in the bed and move the bed away from the wall. Move to the head of the bed, have the patient put both feet flat on the bed with knees bent. Have the patient push with their feet as you pull on the chucs pad from the head of the bed at the same time. It works like a charm with a patient that can assist.

Of course if the patient is large and cant assist because of confusion or other problem then get help. But ive found even the patients that arent strong enough to ambulate have enough strength to help by pushing with their feet while i pull.

Just be careful and listen to your body it knows what its saying.

jyoung1950 · Mar 17, 2006

in school they hound 'keep the bed in the lowest position' - well that'll kill a back in no time flat.
raise the bed to waist level to do your work. also reverse trend them for a minute for a lift. 2 people can usually boost most people when they're reversed in bed!
why fight gravity? use it!
no back issues after 19 years here!

What is reverse trending? I've been a CNA for 4 1/2 years and have never heard of that.

UM Review RN, ASN, RN · Mar 17, 2006

What is reverse trending? I've been a CNA for 4 1/2 years and have never heard of that.

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This is the position in which the head of the bed is lower than the feet. Use it VERY cautiously in elderly, and not at all if there's a head injury or stroke patient.

superbratnurse · Mar 17, 2006

Been in LTC for 17 years...1 as CNA (during LPN school) and 16 as LPN, and never hurt my back ON THE JOB.... however, I was in an ejection MVA in '97 and broke my back, but thanks to a talented neurosurgeon, and the skilled nurses at UAMS, I fully recovered, and was back at work in 5 1/2 mos. and back to floor nursing (pushing a med cart) in 9 mos. :thankya: :roll

I do have fibromyalgia (sx waaaay before accident), and resultant back pain, but, am still able to work full time, Thank God!

~Brat

CseMgr1, ASN, RN · Mar 17, 2006

I have DDD at L4-5, inherited from my Dad, and probably aggravated by improper lifting when I was the only Aide on the night shift for many nights for 18 months. My supervisor didn't care how I got those people who were deadweight and bedbound cleaned up and turned..as long as I did it, and she could take credit for it. :madface:

DallasRN · Mar 17, 2006

Counting school, I've been involved in nursing 30 years. Yes, I have some back problems, but for the most part, they are related to degeneration in my spine. With age, I've certainly become more cautious and focused on body mechanics.

You've received some excellent responses, but I wanted to comment on the benefit of daily exercises and posture. It can't be beat. First, I try to walk at least a mile or two on my days off. That helps. But the most valuable thing I've found...I do very specific stretching exercises daily to keep my abdominal, glutes, and thighs (actually, all body parts) well-toned. I started this program with a personal trainer for the specific purpose of toning, and at my age, it's a never-ending battle. However, the benefits I derived were remarkable. These stretches are definitely not the *oh that feels so good* types of stretches. When I first started, I would work up a sweat and be sore as the dickens within just a few hours.

On my days off, I work through all the exercises. On the days I work the long shifts, I just sort of work them into my day. For example, I do a few things while brushing my teeth. If I'm in the med room waiting on someone to finish with the Omnicell, I might do one or two stretches. If I drop something (and I really am clutzy), I'll use it as an opportunity to stretch the glutes and thighs as I pick it up. And seeing that I'm clutzy, I have really strong glutes and thighs. :rolleyes: I take Osteo BiFlex which seems to help greatly in spite of recent press reports. And water, water, water. Drink lots of water to keep yourself well hydrated. I have to say, I'm much stronger and physically fit than the majority of my peers, many of which are half my age.

Good luck!

pkeyrn · Mar 17, 2006

I was in nursing for over 20 years (all in long term care where there is a ton of lifting...especially in the "old days" before No-Lift programs) before I injured my back. When my injury occurred, I was doing everything right, the bed was elevated to the proper height, there were 5 other people helping me to transfer a resident from his bed to a stretcher. Somehow I still sustained herniations of the discs between L4 and L5 as well as L5 and S1.

I was sent to the clinic which is run by the nursing home I worked for, and the first words out of the clinic physician's mouth were "they like me to send you right back to work". So I went back to work the next day. I had to fight with this physician for 4 months before she would agree to send me for an MRI (the Workman's Compensation insurance carrier said I needed her referral in order for it to be covered). Then I had to fight for another 2 months with the Comp. carrier to get it scheduled. By that time, the MRI showed significant damage and the neurologist stated that there was little that could be done except try to manage my pain level. The neuro-team stated that even with surgery I would most likely have just as much pain as without it. So, I now take Celebrex and Neurontin on a daily basis, do back exercises daily and try to keep myself as mobile as possible. I receive epidural steroid injections into my lower back every three to four months for pain control. I left the job where I was injured (after 20 years!) and now am working in an administrative capacity in quality assurance and staff development where lifting is not prevalent.

OliveVinesRN · Mar 17, 2006

Hi all,
I've been accepted to an ADN program at my nearby community college.
I am 41, and when I finish I will be 44. I've volunteered in hospitals, and feel that nursing will be a good fit for me at this stage in my life.
However, I'm concerned about back problems. How does one avoid getting injured? I am generally fit, healthy and know how to life things -- using my leg muscles rather than my back -- but how realistic is this when you are moving/lifting a real person and may have to lean over, thus engaging the lower back?
Are there certain specialities that have a lower rate of back injuries (I'm thinking maybe the NICU). Has anybody here NOT been injured on the job? If so, how do you protect yourself? Can you be fired for refusing to lift under dangerous or sub-optimal conditions? Please add how long you have been nursing.
If you have been injured, how did it happen, could it have been avoided, and have you recovered? Are you still in the same job?
Thank you for all your responses. I'm very concerned about this.

I haven't been in nursing a very long time. However, I know young nurses who are already having back problems due to lifting people without help. I for one know the cardinal rule that will prevent this from happening to me if I can help it: Never lift or move anyone without help. That's the thing to remember. You will have enough to deal with in nursing as it is. You definitely don't need a bulging disk to add to the equation.

I don't care how busy we are. If I cannot find someone to help me move a patient, they will have to wait. You will run the risk of injuring them and yourself if you attempt to maneuver them alone. A lot of them cannot move at all. Some can move a little and you have to coach them to help you help them. And then there are the ones that all of a sudden become "invalids" while in the hospital even though they were just playing tennis before they came in. They will lock their knees out on you and lean back and resist. This can hurt your back, too. I refuse to let this profession run me down to the point where I won't be able to be independent again. I'm altruistic, but then you have to draw the line somewhere.

Be safe and take care of yourself because no one else will if you don't.