Nurses: You've Been LIED to about your Back and Body Mechanics - page 3
It starts in nursing school. The lie is perpetrated by management in just about every facility. They say they care about your health, your back, but is it true? Unfortunately, it is not. Many... Read More
Mar 30, '15Joined: Oct '14; Posts: 25; Likes: 64Good to be more aware of this. Lifting patients is part of the everyday workflow, and the day is always very busy, and if I spent time waiting on extra help or getting the lift from somewhere in the basement of the hospital, I would get behind very quickly. However my back hurts a lot and I've only been a nurse for 6 years. What are some good first steps to take when talking to management about this issue? It almost seems futile because most of the solutions involve $...which seems like the greatest barrier for change. I would like to bring this up at work. Any suggestions as to how to get the upper management more interested in those still at the bedside? Thanks !
Mar 30, '15Joined: Apr '14; Posts: 3,831; Likes: 11,459I don't get the statement that a person can only safe 35 lbs. (I'm embarrassed if I missed an obvious explanation)
Anecdotedly, I have men in my life who have been lifting much more all day in their and don't have back problems. They are fit and strong men. Was this article only about the average nurse?
Mar 30, '15Occupation: RN Specialty: 7 year(s) of experience in critical care ; Joined: Feb '12; Posts: 362; Likes: 1,470I don't know about anyone else, but I was never promised that anything at all would guarantee I would never have back problems or injuries. If anyone told you that, I hope everyone here had enough common sense to know it was a lie in the first place. Sure, body mechanics and lifts will reduce the risk of these things happening, but nothing will guarantee they won't happen and nobody ever told me otherwise.
Even with lifts and slide sheets you still have to get the patient on the things.
One other thing I didn't see mentioned anywhere is simply taking care of your own body. Exercise, strengthen your core muscles and your body as a whole, be healthy. This alone will help reduce your risks of injury probably about as much as lifts or proper body mechanics.
Mar 31, '15Joined: Jun '05; Posts: 8,647; Likes: 16,266Quote from Lynda Lampert, RNI'm not angry about it because I don't feel I was lied to. I honestly feel we should save the us vs them stuff for those occasions when one party knows what they are saying is false and says it anyway.There is no 100 percent solution, but people, some places aren't even trying. There are TONS of equipment solutions out there that can be adapted to any nursing floor, including isolation. Overbed lifts break, but so do IV pumps. Does that mean we don't use them? No. We get them fixed, we find a way, because they make our lives easier and everyone involved safer.
The language may be inflammatory, but that is for a reason. Nurses need to know they are in danger, and no one is saying anything. Why aren't people angry about this?
Body mechanics were taught not because something else was out there that was a secret, but just that if you are going to move or lift anything you should follow those principles.
Generally the assumption was that you got enough people to help you move or reposition patients safely. In reality, staffing cut to the bone takes away that option for most nurses and other caregivers.
Beyond that I believe you are right on the subject matter. The giant leap in morbidly obese patients is a huge risk to nurse health and safety, but if we want to be mad at somebody why not at Congress for failing to pass a federal lift law?
Mar 31, '15Occupation: Registered Nurse Specialty: ICU ; From: US ; Joined: Apr '13; Posts: 2,538; Likes: 8,618Every room on my unit has ceiling lifts. Most only have a single lift, which will support up to 500 pounds, but at least five of the rooms (I think) have double lifts, so the lifts can support up to 1000 pounds. Still, the lift doesn't slide the patient up in the bed. The lift doesn't let me change all of the linens because the patient had a code brown. Even lifts aren't perfect. They are great for turning, but nothing else. Even with them, I definitely use/abuse my back every shift. I have a lot more back pain than I used to. It sucks.
Honestly, another major back pain contributor is the height/length I have to reach to get to my keyboard when I am charting. Since starting this job, I have had persistent back pain high in my back between my shoulder blades that I can only contribute to charting.
Mar 31, '15Occupation: Freelance Medical Writer Specialty: 4 year(s) of experience in telemetry, med-surg, post op, ICU ; From: US ; Joined: Apr '06; Posts: 99; Likes: 656Hi all,
Just woke up, so I thought I would address some of the ideas expressed here overnight. The idea of 35 pounds is the maximum weight limit came from my expert at the CDC and was confirmed by Dr. Powell-Cope. It is the maximum for all jobs. Incidentally, I asked my husband the same thing, as he works in a factory, and he said that they lift far more than that, too. I guess that is the safe lifting threshold, but I didn't come up with it. It was quoted to me by experts, and I believe I read it in some literature, as well, though they said 51 pounds.
As for taking care of your back, that will be in part two of this article series, hopefully, to be published next week.
I feel I was lied to because I was taught to lift that way and not taught how important it is to lift with assistive devices. I was taught we didn't need them, but they were nice to have. According to evidenced based research that has been available since at least 2000, that's not true. I wasn't guaranteed, but I don't think that it is beyond logic to make the leap that the way I'm being taught is the best way.
Nice to hear of the lifts above the bed. You must work in a good facility. Even Dr. Collins at the CDC said that there was no way to go total hands off. Nurses will still put their backs in danger, but it will be far less danger when mechanical assistance is used. The problem is that many nurses are unaware that they are in this danger because schools and facilities don't tell you -- or you're aren't up on the current lifting research.
As for getting upper management to listen, I would say that you should start talking to lower management first. Come armed with evidenced based materials, proof from the CDC, possible reports to OSHA. Unfortunately, right now, there is nothing to force them to help you. You can try, but it is money that will decide the issue. Money and politics, unfortunately, will determine our safety.
But it isn't the first time and it won't be the last.
Mar 31, '15Joined: Apr '14; Posts: 3,831; Likes: 11,459Bedside nursing seems to have increasing physical demands and that strong and fit might start being a marketable quality in this competitive job market with increasingly common obesity. I can see a fit male having an advantage in both consideration and compensation, from an employer's perspective that would be less costly than extra staff and installed equipment.
Mar 31, '15Joined: Mar '15; Posts: 10; Likes: 20Wow! I am glad that this discussion is so rich! First, RE the evidence, it is out there. For the basic biomechanical evidence, I would suggest reading Bill Marras's work. His web site is https://spine.osu.edu/publications. He has produced much convicing evidence that the transfer, lifting and movement tasks that are common in nursing create forces in the spine that exceed injury thresholds. The problem is that damage is being done to the disk over a number of years that may not be apparent until a herniation occurs. We just published a study on the effects of the VA SPHM program on reducing patient handling related musculoskeletal injuries. [COLOR=#000000]Powell-Cope, G., Toyinbo, P., Patel, N., Rugs, D., Elnitsky, C.,Hahm, B., Sutton, B., Campbell, R., Besterman-Dahan, K., Matz, M., &Hodgson, M. (2014). Effects of aNational Safe Patient Handling Program on Caregiver Injury IncidenceRates. Journal of Nursing Administration, 44(10), 525-534. This is only one article of many in the literature. SPHM is evidence-based! Second, I was asked to comment on Lift Teams. I think the evidence is less clear, however, based on what we know about manual lifting, Lift Teams should not be manually lifting. They should be using mechanical means. Some think that we should rely on robust, muscular men to do the lifting in hospitals, yet, excessive forces will catch up with them--just like what happens with people who lift weights. When we rely on lift team to manually lift we are just increasing their exposure to risk. [/COLOR]
Mar 31, '15Joined: Apr '14; Posts: 3,831; Likes: 11,459Just to clarify, I don't think we should rely on strong men.
Mar 31, '15Joined: Mar '15; Posts: 10; Likes: 20I guess I am surprised at how many people are advocating proper body mechanics for lifting and transferring patients - a practice that has no evidence behind it when lifting/moving heavy loads. We've been using proper body mechanics for years and we continue to get injured. As Einstein is quoted - The definition of insanity is doing the same thing over and over and expecting different results.
Mar 31, '15Joined: Mar '15; Posts: 10; Likes: 20Thanks for clarification. I have heard nurses say, though, that they rely on their male colleagues for lifting patients.
Mar 31, '15Joined: Apr '14; Posts: 3,831; Likes: 11,459I would think out of necessity, if you don't have the equipment, time or staff to do otherwise.
I'm hung up on the 35 lbs, that would make it seem the average female isn't safe in doing bedside care, isn't it unfeasible to use lifts or teams in nearly every hands on intervention with today's adult patient population?
Mar 31, '15Occupation: Freelance Medical Writer Specialty: 4 year(s) of experience in telemetry, med-surg, post op, ICU ; From: US ; Joined: Apr '06; Posts: 99; Likes: 656Thank you for your time, Doctor! I was wondering if you could speak to initiating the conversation about safe lifting in your facility? That's a great question!