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Hospitals fail to protect nursing staff from becoming patients

Posted

Specializes in LTC, Psych, Med/Surg.

The below is a link to the first in a series of stories by NPR on the dangers of nursing. We all know these things to be true and it is high time the powers that be are held accountable for caring only about the bottom line and not about the health of employees. :mad:

Hospitals Fail To Protect Nursing Staff From Becoming Patients : NPR

What do y'all think?

Catmom :paw:

Gooselady, BSN, RN

Has 23 years experience.

At my previous hospital job, every single patient room had a 400 pound-capable lift. Well, four rooms had the lifts installed, and the rest of the rooms had the gear on the ceiling and a few portable lifts in the store room.

We were basically ORDERED to use these lifts . . . or else. The 'or else' part was mainly hearsay and background grumblings about being fired or denied workman's compensation for injuries that 'wouldn't have happened if proper 'safe patient handling' and lifts were used".

I'm getting old enough that just bending over a bed to fluff a pillow gives me a moderate back ache in the course of a shift. No discs blown out here, just routine bending and stretching. I wondered if it was a matter of time that this back stress would 'become' a more serious injury, like when I bent down to pour catfood in the cat's dish.

Nursing is hard on the ole body, for sure. We use our bodies (mainly our backs) the way railroad builders used up theirs, just a bit slower perhaps.

I won't go into the 'complaints' made about our edicts to use the lifts and 'safe patient handling'. We also had a "Fall Team", a select group of CNA's and transport staff who came running with a C collar and a giant Hoyer lift.

Hopefully the series will discuss the lip service that hospitals provide while continuing to run nursing units with the minimum staffing they can manage.

catmom1, BSN, RN

Specializes in LTC, Psych, Med/Surg.

The piece I linked to does discuss how the so called "lift team" was never available when needed because they had been assigned other duties. This is an example of the unmanageable, low staffing that goes on all the time.

Catmom :paw:

This has been a known problem since I've been a nurse, so I'm not really sure why they're bringing it up now. I'm glad, though. I think it should be shouted from the rooftops until we have ceiling lifts and turn assists in every single inpatient room.

I worked in an ICU that had ceiling lifts in every room, which we were required to use for turns and repositioning. Once I got over the perceived time constraint, it was awesome. I didn't realize how much time I wasted looking for lift partners. It also covered the entire room so the patient could be lifted from the bed to the toilet and back without me having to lay a hand on him, just guide the sling. LOVED IT!

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

I have a relative who works for Kaiser in upper management. Their mandate seems to be "screw the nurse."

brandy1017, ASN, RN

Specializes in Critical Care.

At my previous hospital job, every single patient room had a 400 pound-capable lift. Well, four rooms had the lifts installed, and the rest of the rooms had the gear on the ceiling and a few portable lifts in the store room.

We were basically ORDERED to use these lifts . . . or else. The 'or else' part was mainly hearsay and background grumblings about being fired or denied workman's compensation for injuries that 'wouldn't have happened if proper 'safe patient handling' and lifts were used".

I'm getting old enough that just bending over a bed to fluff a pillow gives me a moderate back ache in the course of a shift. No discs blown out here, just routine bending and stretching. I wondered if it was a matter of time that this back stress would 'become' a more serious injury, like when I bent down to pour catfood in the cat's dish.

Nursing is hard on the ole body, for sure. We use our bodies (mainly our backs) the way railroad builders used up theirs, just a bit slower perhaps.

I won't go into the 'complaints' made about our edicts to use the lifts and 'safe patient handling'. We also had a "Fall Team", a select group of CNA's and transport staff who came running with a C collar and a giant Hoyer lift.

I wish every hospital had lifts in every room. By the way 400 pounds is not enough. Nowadays we get 500 even 600 pound patients on a too regular basis! How can anyone move a person that size safely! We don't have a lift team, have I think one hoyer for the whole unit and a couple different types of sit to stands. They do keep the slings on hand in the storage room which is new and was overdue. Hover mats are rarely used, but I will make it my duty to order one whenever I have a bariatric patient, no more flimsly garbage bag liner. You have to turn the pt back and forth to get them on the liner and then you are supposed to turn them to take it out after. Ridiculous! It was just turning a 400 pound patient that injured me in the first place!

I can remember having PT come in and do inservice after inservice about how the nursing staff was to lift, turn, and reposition appropriately. That somehow, we were not using "proper body mechanics" therefore, should we sign off on these mandatory inservices and then got hurt whilst repositioning/moving/transferring a patient it was due to lack of proper procedure. And that because it was a "patient safety issue" it was the nurse who took the literal and figurative fall.

And that makes workman's comp difficult, that makes unemployment benefits difficult....it just makes it difficult.

One floor was then replaced with nurses who were former college athletes.......and would do the work for less wages.....

LadyFree28, BSN, RN

Specializes in Pediatrics, Rehab, Trauma. Has 10 years experience.

I worked in an ICU that had ceiling lifts in every room, which we were required to use for turns and repositioning. Once I got over the perceived time constraint, it was awesome. I didn't realize how much time I wasted looking for lift partners. It also covered the entire room so the patient could be lifted from the bed to the toilet and back without me having to lay a hand on him, just guide the sling. LOVED IT!

Agree!!

I worked in a hospital where there were hoyers from the ceiling; I got so spoiled from that!

I'm glad that the information is being presented; the general public has NO idea what nurses face-and it's about time that they did. :yes:

GrumpyRN, NP

Specializes in Emergency Department. Has 39 years experience.

I'm glad that the information is being presented; the general public has NO idea what nurses face-and it's about time that they did. :yes:

I've told this story before; I was once asked to by a family to lift their father up the trolley. This man was bigger than I am and weighed a lot more than I do so of course I refused, but before I managed to say "I will go and get some help" they came back with "well, can one of the girls do it?" I got annoyed and pointed out (not all that diplomatically) that I as a male was not going to lift so what made them think a female half my size was going to do it?

My point is the general public don't care about what nurses are faced with, all they want is what they want when they want it.

Have to say I love the sound of these built in hoists. In UK we are seeing our population getting larger and larger and we are going to need something like these.

I work as a CNA in a memory card unit, since we are categorized as an AL facility we are not allowed gait belts or hoyers. :down: oh the bureaucracy! We have multiple 250+ lb. patients and aggressive patients who are given sedatives but the doses are not high enough to calm them down. I absolutely love the work but have legitimate fears of back injuries especially after reading everyone's experiences. Has this made any of you consider changing your speciality/ getting a nursing desk job? I talk with my nurse and she shares similar stories. You all have tough skin! I hope it's alright if I post here. I am nursing student.

brandy1017, ASN, RN

Specializes in Critical Care.

I work as a CNA in a memory card unit, since we are categorized as an AL facility we are not allowed gait belts or hoyers. :down: oh the bureaucracy! We have multiple 250+ lb. patients and aggressive patients who are given sedatives but the doses are not high enough to calm them down. I absolutely love the work but have legitimate fears of back injuries especially after reading everyone's experiences. Has this made any of you consider changing your speciality/ getting a nursing desk job? I talk with my nurse and she shares similar stories. You all have tough skin! I hope it's alright if I post here. I am nursing student.

I can't believe they are not allowed. I think more likely they don't have to provide the equipment. We need a national no lift law imposed on all care facilities. It is possible the VA system already does this! It just takes the will to do it. Unfortunately most healthcare facilities don't care enough to spend the money for the necessary equipment since it's not required. Apparently they think staff is replaceable and paying workers comp premiums is preferable to protecting their employees. I would look for a different job where there was the necessary lift equipment if I were you. You have many years to work and must protect your back and body. The employer won't do it, but you have to protect yourself. I don't take any chances and have learned my lesson from being injured wish I had protected myself sooner!

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

Hospital To Nurses: Your Injuries Are Not Our Problem

February 18, 2015

The case of Terry Cawthorn and Mission Hospital, in Asheville, N.C., gives a glimpse of how some hospital officials around the country have shrugged off an epidemic.

Cawthorn was a nurse at Mission for more than 20 years. Her supervisor testified under oath that she was "one of my most reliable employees."

Then, as with other nurses described this month in the NPR investigative series Injured Nurses, a back injury derailed Cawthorn's career. Nursing employees suffer more debilitating back and other body injuries than almost any other occupation, and most of those injuries are caused by lifting and moving patients.

But in Cawthorn's case, administrators at Mission Hospital refused to acknowledge her injuries were caused on the job. In fact, court records, internal hospital documents and interviews with former hospital medical staff suggest that hospital officials often refused to acknowledge that the everyday work of nursing employees frequently injures them. And Mission is not unique...

... It was in the afternoon on her 45th birthday. A large patient had just had a cesarean section, and Cawthorn was helping move her from the gurney onto her bed — a task that nursing employees perform thousands of times every day.

"She kind of had one cheek on the bed, one cheek on the stretcher, and we [were] trying to help her," Cawthorn says.

To demonstrate, Cawthorn bends her knees and crouches, keeping her back straight. She extends her arms like railings, as though she's holding them out for the patient to grip.

"And the second she grabbed on, almost instantaneously I felt like hot tar was just going down my spine, into my butt," Cawthorn says.

By the time she left work that day, she could hardly walk — or drive. Her husband had to lift her out of her car and carry her into their home, and lay her on the floor...

... Cawthorn took painkillers and made it back to work the next morning, and reported the injury to her supervisor. Then she hurt her back again barely a week later when she lifted another patient. She injured her back a third time a few days after that. And nine months later, Cawthorn herself became the patient in the hospital where she worked: She had a "lumbar interbody fusion," an operation in which the surgeon built a metal cage around her spine...

... officials at Mission refused to help Cawthorn. According to court documents, the hospital's own medical staff concluded that she was hurt moving patients. But the hospital's lawyer disagreed, arguing that Cawthorn actually hurt her back partly while lifting a dinner casserole out of her oven.

Mission hospital officials also said that as a result of Cawthorn's back injury she was no longer fit to work.

Cawthorn and her husband say she was lying in her hospital bed two days after back surgery, when a hospital representative walked into her room and handed her a document.

It announced that Mission was terminating her job...

... Klaaren says it also was "commonplace" for hospital officials to ignore what their occupational medical staff said.

In fact, Klaaren and other medical specialists from Mission's staff clinic — who talked only on condition that we withhold their names, for fear of retaliation — told NPR that whenever they examined injured employees, they were required to fill out a form with the employee's name, date of injury, and diagnosis, followed by a section with two boxes: "In our opinion, injury or illness is" or "is not work related."...

... Hospital officials ordered the occupational health staff not to check either box, Klaaren and other sources told NPR. Instead, hospital administrators filled them out — even if they had not seen the injured employee.

The doctor who ran the staff health clinic, J. Paul Martin, warned Mission's executives for years that the hospital was mistreating injured employees, according to dozens of internal hospital emails and other documents obtained by NPR. The doctor's emails went to Mission's vice president and general counsel, the chief of staff, a member of the board of directors, and others.

... the court ruled in 2002, in the case of an injured employee named Jennifer Rosenfelt, that Mission's refusal to cover some of her medical care was "based upon stubborn, unfounded litigiousness." The court ruled in 2004, in the case of another injured employee named Jeanne Chellis, that hospital officials "acted in bad faith" by not sharing evidence.

In Cawthorn's case, the workers' compensation court declared in 2011 that the way key officials at Mission Hospital treated her "constitute[d] fraud" — because they refused to pay her workers' compensation benefits "when they knew she was entitled to the same." In 2012, judges on the workers' compensation court got so upset with Mission in the case of an injured employee named Cathy Goff — they said the hospital had given the court information that was "not credible" and even "false" — that they said Mission should be investigated for fraud...

... "The view is, for every dollar I prevent going to a worker, that's more dollars for the company," Berger says. "Every [penny] I spend on a worker is less money I can spend elsewhere in the hospital."

Mission Health's own reports show that the corporation has been spending millions of dollars to expand its business. During the past decade,

Mission has taken over or merged with five other hospitals.

It has taken over doctors' practices, and other medical firms.

A Mission spokesman told a national meeting a few years ago, "We're kind of the 500-pound gorilla" in the region...

http://www.npr.org/2015/02/18/385786650/injured-nurses-case-is-a-symptom-of-industry-problems

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

Model Program to Provide Ins. Benefit for 12,000 California, Nevada RNs

May 03, 2014

A landmark program to provide supplemental insurance protection for registered nurses injured in workplace assaults or injuries went live this week for 12,000 RNs who work in 28 California and Nevada hospitals that are a part of one of the nation's largest hospital systems, Dignity Health.

Under the RN Accident Prevention Program, Dignity hospitals commit to joining with the nurses, represented by the California Nurses Association/National Nurses United and National Nurses Organizing Committee-Nevada/NNU to work to eliminate workplace violence, accidents and injuries, such as needle stick injuries - and to back it up financially with a landmark supplemental insurance plan.

The policy provides RNs with benefits of up to $200,000 in the event of accidental death, felonious assault, contraction of HIV or hepatitis from needle sticks, as well as other indemnity benefits and trauma counseling.

The program covers Dignity hospitals in Northern California, Southern California, the Sacramento region, San Bernardino, the Central California Coast, and Las Vegas...

Bad Request

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

At VA Hospitals, Training And Technology Reduce Nurses' Injuries

... Umoffia didn't try to lift Valencia using her own muscle. Instead, Umoffia attached the hook dangling from the ceiling to a fabric sling wrapped around Valencia's body. She pushed the button on a control box, and a gentle whir filled the room. The machine slowly hoisted Valencia in his sling a few feet over the bed, swung him until he was dangling in midair over a waterproof wheelchair, and then gently lowered him. "I'm comfortable," Valencia said, adding that he felt "like a little baby" hanging from a stork's beak...

At VA Hospitals, Training And Technology Reduce Nurses' Injuries : NPR

nurses-va-91-edit_custom-64cfb8c6dee5b04485ef2c9bb3207ad3a206593e-s800-c85_zpspn6fvfhu.jpg

Here is a scenario, what do think? I monitored the Nursing Board in my State for about 4 years (recently). Understand, there is a true need for the Board, but some cases should be dealt with at the "business" level. Many times there were cases where a staff member, in this instance Nurses, did not let the person down properly while the patient was caught in a mid-air fall. The "business", states that the Nurse should have grabbed the policy and performed the function as the policy stated. Now, patient falling, Nurse there...attempting to catch in mid-air fall. My thought; "are you people crazy?" Seriously, let the patient fall, say..."one moment while I read the policy." Our minds and bodies react to what? Split second decisions, catching a patient, then lowering them down. Oh, and don't forget, as they are falling, grab your gate-belt, place around the patients waste, to ease them to the floor or best scenario, a chair. These really do happen at BON hearings! The "businesses" well being, keep the cost of injuries down. I truly get that, as I helped to write policies and worked on decreasing injuries, designed Fall Risk Assessment, etc. Now, my thought is can it be handled at the "business" level? Now, negligence another animal. But, these "businesses" that throw a Nurse to the wolves to protect their assets need a realization of what happens at that point. Nurses need to be proactive, being part of the solution and not the problem. Hard I know, but until we let our voices be heard, this will keep happening. Boards make a decision based on the information given, it could lead to a domino effect motion. Aweright, we all know there are policies in place. We make split second decisions. Not perfect, but for myself, I would and have reached out catching the person to prevent any possible injury and did strain my back. I never thought in that split second to 1) grab the policy and read it, 2) To grab a gate-belt. 3 seconds from the start of the tumbling motion, to the landing. Maybe a possible solution is to ask the powers that be, who get the complaints, to change the "Standards" of how they deal with those complaints. Working on that in my State. What's your thoughts?

Nurses need to be proactive, being part of the solution and not the problem. Hard I know, but until we let our voices be heard, this will keep happening. Boards make a decision based on the information given, it could lead to a domino effect motion.

I have been nursing for almost 40 years. Nurses have always worked to improve safety for patients and for themselves. I wonder about this part...

"until we let our voices be heard, this will keep happening"

To me this implies that nursing is NOT speaking out and it is our fault that our voices are not heard. I beg to differ. Nurses do speak out and have been for some time. For a spell when nurses spoke out some would lose their jobs...then we passed some laws about whistleblowers.

We don't "let" our voices be heard...we speak out so that those who WOULD hear COULD hear. It is the choice of the listener to decide what they will hear or not hear.

Clearly there are a number of very important issues for which nursing has good commentary and potential solutions, but big money health care systems are just not that interested and as a result, don't listen very closely.

Edited by toomuchbaloney