Back injuries

Nursing Students CNA/MA

Published

Like probably most CNAs, I am continually straining my lower back at work, some of this is just the reality of the job. But there is one resident who is a constant back killer for everyone I work with. We all dread transferring this resident because they are a two person transfer but completely dead weight.

We have been given the option of using a mechanical lift if the resident is unable to bear weight, but management knows full well this resident is never able to bear any weight, ever. To my knowledge no one has ever used a lift on this resident. To even suggest it would result in a massive temper tantrum every time, and would be extremely time consuming. For the past year we have just lifted them, but now with 2 people having to quit with back problems and my back about reaching its breaking point, I personally have had enough. Neither person got any workmans comp as it was claimed they had pre existing problems or some other excuse. The problem is the CNAs wont make a stand, everyone is afraid of getting fired. One person did complain I believe and was immediately fired, over a supposedly unrelated "incident".

We have a few CNAs who try to be big tough guys and act like lifting the resident is no big deal, but Ive noticed a couple of them have been showing visible pain and even missing work. I'm wondering how I can put a stop to this. I have documented many times that resident cant bear weight but nothing is done. Most of the CNAs are with me, but its a couple of these idiots that want to be the heros that are screwing it up for the rest of us. They believe using the lift is too time consuming and isnt fair to the resident. Unfortunately these two are loved by management and one is even going to be the night shift boss when they finish their LPN soon.

We have a union but its completely worthless apparently.

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Right now you better think of yourself first. Hurting your back is no joke and it could end your career as a CNA and possibly ruin your life. Being denied workman's comp from the facility you work for is going to cost you much more than resigning your position there and seeking another. A former CNA where I live has had 5 back surgeries to date........that's the thanks she got for her work. It's good that you have documentation about the do-nothing management's actions in the face of practices that are not only dangerous to you who work for them, but also for the resident !!! If you feel a sense of responsibility and want to do something about this situation, seek out advice about the best course of action. Hard for me to believe that a Union can be so impotent in such a situation!!! Don't try and be a 'lone wolf'......get some backing and legal support.

The facility I work (long-term care) is more likely to fire people for doing dangerous transfers such as you described than it is to force their employees to put their health at risk. We've had many difficult, combative, and even violent residents who resisted using lifts. What's hilarious is that the very worst one we had, a 300 lb lady, when faced with the prospect of using a lift -- well, she suddenly became a one-person transfer and was easily able to stand on her own. She still was combative and horrible to work with, but at least she decided she'd rather bear her own weight than let people use a huge crane to get her in and out of bed.

Please seek out independent advice what to do with your situation. Don't be afraid, there are laws prohibiting people being fired for whistle-blowing. I wish you wellness and success in doing something proactive at your job. Let us know what comes of this.

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Specializes in 6 yrs LTC, 1 yr MedSurg, Wound Care.

Seems like you could anonymously call state (or whoever) and have them come in. Management would love that! ;)

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Specializes in Critical Care, Trauma.

I agree that you need to be first... I have had 2 back surgeries including a recent fusion on december 30th 2010... not 4 months later and im in the mri scanner... bad news is my "pre existing injury" and apparently new from surgery is giving me issues and now i'm looking at a third surgery... I was told to get out of cna work... My suggestion is possibly look for a desk job or something different all together... if you want to go for nursing go.... I tell people it is a very broad field... If not I would definetly be using whatever machine/lift is available... the only problem with being a cna is we come a dime a dozen...

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This is what scares me about my job. Today I took care of a very large heavy lady with dementia and who has some kind of hysterical mental fixation on being toileted constantly. In the course of my 8 hour shift today, she was toileted 11 times........most of which she didn't even go at all. She refuses to stand up straight when I transferred her, and each time I did I felt that pull in my lower back. Now that I'm home from work tonight, I am the one having trouble standing up straight because of the resulting lower back pain. We also had one of our best aides taken off the schedule recently. This guy is like 6 feet tall and solid muscle -- but the other day he ended up on his knees in one of the residents rooms, in agony after re-injuring his back from a pre-existing condition -- they took him out in a wheelchair. All it took was a simple transfer and he's out of commission for who knows how long. My pay is not worth this risk !!!

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Specializes in LTC/Rehab.

I've been working as a new CNA for around 6 days now but I fear back injuries because understaffing in nursing homes force you to life people by yourself because your coworkers are helping other residents. It's sad when you know a person should be a "two person assist" and your assisting the person by yourself, especially the heavy residents who act(because sometimes they are not really) totally dependent.

They tell us to raise the bed to a comfortable level.... but that can only do so much. Either way... your going to strain.

But I'm remaining hopeful that I will find techniques to decrease the amount of strain that has been placed on my back. I will seek more help more assertively if I have to...

Best wishes to me and you both.

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Specializes in Geriatric.

Does the person have some balance in their upper body? Do y'all have a sit to stand lift? To me, the sit to stands are so much quicker and less scary to the residents. I :redbeathe using the sit to stand - the added bonus is that for some reason, where the hoyer is a 2 person assist at all times (no using the hoyer by yourself), we are allowed to use the sit to stand with just one CNA.... I would imagine the rules on that probably vary from place to place....

There are certain residents that other aides lift as a 2 person transfer without a lift, but I won't do it. If they ask for my help, I tell them only if we get a lift. Mostly because, if they are totally deadweight, and particularly if they are heavy, gait belts don't help that much. You know how gait belts tend to shift and become unaffective once you get the person standing? That always ends in a *arm under the armpit, grab the pants transfer* to keep from dropping the resident. One of my biggest fears is popping someone's shoulder out of socket in a transfer - the physical therapists tell us it's very easy to do, unfortunately.

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Specializes in Critical Care, Trauma.

Physical Therapists go to college for how long to learn proper techniques in lifts and slides... my unit has the hoyer lift which for some reason no one uses it... being the only guy na i get alot of can you help with this heavy dead weight patient... we need to stand and pivot him he is a contact guard even though you know he is dead weight... or to even turn patients... I would rather a dead weight compliant patient over one that pushes back and fights you every step of the way... lifting the bed kinda helps me and my back... there is some strain but i use the bed to support myself using my legs on the bed and arms agaist the bed rails... Then I get the patients were it would be a two person boost up to the top of the bed for comfort go to the door to holler for help and of course no one is around or is to busy talking, which is another issue I have were I work... we have certain people who are favorites and no matter what you talk to management about them it just gets brushed off. I end up doing their work or when next shift comes in they are the ones to get in trouble because rooms aren't stocked... I have also noticed with some that they will stand and talk and make the nurses answer their own call bells... It is all supposed to be teamwork so no one gets injured... personally I try my best to help my co workers because they are family and I don't want to see them get hurt and be in the position I am in... I unfortunetly was advised to leave nursing assistant because of back issues... all the staff knows this and I am still lifting... something other hospitals and LTC's could look into to help you guys is a LIFT TEAM... we have I believe 5 members who are on call from 8 in the morning to 9 at night... they are there to help with lifts, transfers and they even said to help turn and reposition patients however staff doesn't ever want to wait for them... Since I am close with them they have told me to call when I need them they would be there for me... it is their job and its what they are there for... please take my advice I am 27 with 2 back surgeries looking at a possible 3rd in the near future after having a complicated fusion on december 30th... take care of your back... in emt class we have learned that though the patient may suffer your safety and your crew safety is number 1... if you don't agree you could become part of the problem... back could go and you could have a 500 lb patient fall on top of you... not a good site but it could definetly happen... I am bad at that advice I put the patient ahead of me but now I don't know what to do... any suggestions???? have a good night all I will try and get on tomorrow at work... nice talking to you and let me know if there is anything else we can talk about... even if it is what I have experienced with my surgeries and injections in my back...

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that is nuts. Use the lift. Tell the resident you cant lift them as you are hurt... or something.

When you are hurt and can not work and are in constant pain no one is going to be there to watch out for yourself you have to watch out for YOU!

Be smart. dont pay for it later

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Use the cotton-pickin' lift.

Who cares if the other aides pitch a fit?

Hot diggity!

How is everyone's body mechanics?

I'm appalled by the lifting techniques and body mechanics I've been seeing.

Talk the pt through the transfer process.

Keep your back straight, abs in and knees apart and flexed.

Use a gait belt. Yes, they can make a difference.

Think about the immediate area in which you are transferring. Is there enough room? Should the chair be repositioned better? Which direction will work best?

Don't twist.

Take the arm rests off the chair, if you fear the pt won't clear the arm rest. It can make the difference.

Take the foot rests off.

Stand in FRONT of the pt when you are helping someone lift. Why do I keep catching people trying to stand behind the chair? You aren't helping from back there.

Keep your load close to you.

Consider your pt's center of gravity.

USE THE LIFT!!!

Use the cock-a-doody lift!!!

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Thank you everyone for your thoughts on this. I am a very new CNA and am getting some push-back from others by my insisting using a Hoyer is a two person effort with one person to spot. Talked with the DON about this and she said that the Hoyer should be a two person operation and I said that using the word "SHOULD" doesn't work. The Hoyer either is a two person or it is not. "Should's" don't belong in the CNA world because (as you know) there are plenty of CNA's who take short cuts and the word "SHOULD" does not apply with tight time frames. Anyway lots to learn and yes, after a month and a half of this work, my lower back is telling me to be more careful. Just started doing exercises to strengthen the core muscles and have been reading on the internet various posts on the various ways to prevent back injuries.

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I have been dealing with the same issues...Sorry, but I can't move a 200 lb, contracted, total care resident by myself! I ask for help, and the people I work with would rather fling people around by themselves then help....At my facility, all lifts are to be two person, but nobody follows the rules. Yet, if a resident falls/gets hurt during a lift, if only one CNA is in the room, you WILL get fired and reported to the Department of Health, thereby putting your certification in serious risk...But the halls are staffed at an inadequate level, so everyone is too busy to help. There are 60 residents in each hall, and only 2 CNA's per hall :-( !!!!!!!! My body hurts and I am burnt out! Help!

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