Enduring the Pain (long-ish)

[EleRico]

The following is a personal concern I have been mulling over for about a year now. I can't sort it out without some good advice from professionals like you.

A couple of years ago, my budding Army career was cut painfully short when I suffered a back injury during training. MRI confirmed a bulging disc (T8/9) and a 10mm herniation at L5/S1 with significant impingement on the S1 nerve root. To boot, I was diagnosed with degenerative disc disease - all at the age of 21. In the Army, a soldier who cannot carry a 100 lb. ruck sack is worthless (apparently), so I was discharged and sent on my (un)marry way.

I have finally coped with the fact that I will never have a career as a soldier, so, given my innate compassion, intellectual curiosity, and desire to help others in need, I am considering a career in nursing instead (feel free to laugh at the irony - I have done so many times). Unfortunately, the pain in my back has scarcely lessened since initial injury despite PT, pain management, and drug therapy. As a result, I experience constant pain when standing in one place for extended periods of time. Walking about is quite fine, and so is sitting, but I am frankly terrified of nursing school - not so much because of the academic rigor, but rather because of the prospect of my not being able to hack it during clinicals (pain-wise).

I am committed to making it through nursing school no matter how severe the pain, and I know that my desired career as an up-to-the-elbows-in-the-muck bedside nurse may have to be cast aside out of sheer medical necessity for the "comforts" of a desk job (is there even such a thing as a nurse in a desk?). The question is, how much in-place standing does a typical nurse do (obviously taking out of account the operating room setting)? I have this image of a nurse as a sort of honey bee floating (with a purpose, of course) from room to room, which is definitely something I could manage. A man/woman constantly on the move. Is this just a fantasy?

I realize that this may seem naïve, and some of you may be thinking, "A nurse who can't stand in one place for more than an hour or two is about as useful as a nurse with no hands." I just have a serious problem with allowing a disability to prevent me from pursuing an honorable, rewarding career in nursing. I want to help in any way I can. Thank you in advance for any advice/comments/wake-up calls you may have to offer.

[morte, LPN, LVN]

From morte: "iam between sue and the majority, the getting of a job would not so much be the issue..GETTING INTO AND THRU nursing school is.....i would aggressively pursue PT, chiro if this fits with you belief system.....the prob in the thorax concerns me, not an easy area to injure and tough to tx,surgery there is not something to be under taken lightly......pain in and of itself is not an indication for surgery, neuro loss is......has any one addressed with you the mechanics of standing and why this would cause you pain?........have you done the PT to improve the abd muscles,,,,or is it possible the pain is coming from the thoracic area???? good luck"

I haven't tried a chiropractor yet. Perhaps I should dabble in that direction. I haven't been to PT in quite some time, so there is certainly room for improvement on my part. I exercise frequently (including a fairly typical low back routine) to try to strengthen my core, but clearly I could stand to do more there as well. I have one leg that is 3/4" shorter than the other, and my GP suggested that perhaps this may be throwing my alignment off, particulrly when I walk fast or run. Perhaps I should invest in a heel lift? Thoracic is not really as much of an issue (pain-wise) as the lumbar. I really only notice the thoracic pain when I slump over my keyboard at work (abominable for the back, I know).

Thank you for the suggestions!

PLEASE be well eval'ed before usuing a heel lift, that may be a SYMPTOM rather than a cause!!!!

[MB37]

I have a chronic pain condition, and I just completed nursing school. Mine isn't with my back, it's neuropathic, but it made my third semester awful (Med surg 1 & 2, accelerated program). I'll be starting directly into adult critical care at a hospital in which we are not expected to move patients by ourselves. I did all my clinicals at this hospital and precepted in one of the units. We actually have to sign something at employee health that states if we do move a patient on our own (in a non-emergency situation) and get hurt, we don't get workman's comp. We are required to call the lift team anytime we need to move/turn a pt, or else use assistive devices. From what I've seen, most hospital nurses do very little standing still. In med surg you're more likely to assist a pt with ambulation or help them move to a chair than in any ICU, where your pts are usually bedridden. Vito Andolini wrote a great post, with tons of suggestions. Many do require a year or two of hospital experience, but not all. You should definitely go for a BSN right away - it will open more doors to the nontraditional nursing jobs and management - and consider getting your master's as well in whatever area interests you. School will be your toughest challenge. ALWAYS get help when you move a pt and use proper body mechanics - it's not perfect, but will reduce your risk of injury. Be careful who you tell in school - you're unlikely to get special treatment, and may be asked to withdraw until you can participate "safely." Good luck to you, I don't think nursing is an impossible goal.

[bagladyrn, RN]

You may want to consider, even if on your own dime, having a consultation with a physical therapist with the specific purpose of evaluating your limitations with emphasis on the usual dutues/exertions of a nurse. Inquire when setting up the appointment whether the PT is familiar with the demands of the job. You might look for someone who is working with nurses with work related injuries. This may give you a realistic evaluation of whether or not you can meet the physical demands well enough to get through school.

As others have said, once through school there are many options. I work as an L&D nurse (terrible on the back) and am finding that as my back (and the rest of me) ages, High Risk Antepartum is a much less physically demanding option, as is nursery.

[casi, ASN, RN]

You need to ask yourself why you want to be a nurse and if it's really worth the pain. There are a lot of areas of nursing where you won't have to lift, but you have to still go through nursing school and in most cases a couple of years of bedside nursing to get there.

If you want to get into nursing because the helpping profession appeals to you why not look into other healthcare jobs. What about respiratory therapy, radiology, lab tech, ultrasound tech, etc?

[EleRico]

Thank you so much to everybody who offered comments, opinions, and suggestions on this thread. Over all, my mind is much more at ease, though I admit that I have much work to do to improve my physical well-being before I enter a nursing program. I am extremely fortunate to have free access to the VA health care system, and I certainly plan on using that which my time in service has afforded me.

Again, I am deeply grateful to all of you for your overwhelming support and encouragement. Your sound advice and professionalism remind me why I am choosing to enter nursing. I am hopeful that one day I will be able to assist others as you have assisted me.

Rico