I'm 66 and on Occupational Health Nurse Manager at a Fortune 500 company. In November one morning I woke up unable to stand on my right leg. Subsequently I was hospitalized, had a MRI then a CAT and given an spinal epidural of steroids whereupon I recovered over the next two months. I have severe bilateral neuroforaminal stenosis. This was quite to my surprise as I work out regularly in the gym (aggressively which may have caused the issue) and my lumbar radiograph is none to pretty.
I returned to work half days and my doc said: "What do you want for restrictions?" I answered: "Stand no more than one minute; Walk no more than 5 minutes and No lift/push/pull greater then 7 lbs. Well, I was at work for about two hours and someone came running into my clinic: "Come quick, someone is having a heart attack."
Indeed, that appeared to be the case. I said to one of our first responder team: "I can't do compressions, you do compressions, I'll bag." We did exactly that. The person giving compressions did an excellent job, we ventilated him, I shaved, slapped on the pads, analyzed and shocked. I thought we might save the fellow because of "shock advised," but it wasn't to be. It was great teamwork and I'm proud.
However, my CPR card just expired and now I must get a AH CPR card but I should not do compressions. Since CPR is an essential function of the job, I could be terminated because of this. So I wonder, am I covered under ADA?
I'd argue yes, as I would never be doing CPR one on one and there would always be another first responder to do compressions.
Any thoughts? Anyone face this sort of issue before?
An update on my friend, I talked to her yesterday. Yes, she tried a stool, she said she even stood on the mannequin. She was in the room 2 hours. She said she tried everything, her wrists and hands were just too weak.
I told her we should make a video of this , it actually sounded like a fantastic physical comedy skit. We could be YouTube stars! "Push harder, push faster!" the mannequin kept saying.
The education director helped her and the other tiny gal from her unit who also weighs less than 100 lbs by completing the mannequin portion for them.
Realistically, a 90 lb person will not be able to do effective solo heart compressions on a 350 lb man for the prescribed length of time, and should be aware enough to hand that task over to the stronger members of the team.
An update on my friend, I talked to her yesterday. Yes, she tried a stool, she said she even stood on the mannequin. She was in the room 2 hours. She said she tried everything, her wrists and hands were just too weak.
I told her we should make a video of this , it actually sounded like a fantastic physical comedy skit. We could be YouTube stars! "Push harder, push faster!" the mannequin kept saying.
The education director helped her and the other tiny gal from her unit who also weighs less than 100 lbs by completing the mannequin portion for them.
Realistically, a 90 lb person will not be able to do effective solo heart compressions on a 350 lb man for the prescribed length of time, and should be aware enough to hand that task over to the stronger members of the team.
This confuses me. If a person is too small and weak to do chest compressions, aren't they too small and weak to meet the physical demands of everyday hospital nursing? My job descriptions have required defined lifting skills of 40-70 lb, and the true demand was often more than that.
I'm not exactly sure I'm understanding, so forgive me if I misread. But, I think the question would be, you shouldnt do compressions, or you can't? Could you, even if uncomfortable, do compressions if a patient's life depended on it? Could you, even though uncomfortable, do compressions effectively until you get relief from a coworker even if it's difficult for you? If you absolutely cannot, even if someone's life depended on it, do compressions effectively because it's physically impossible for you, then I would say that there's probably going to be an issue. But, if you can do compressions effectively if you have to and are willing to do it for a few brief moments, even if it's painful or uncomfortable, then it might work. If your coworkers know your situation and understand that you're willing and able, but would for medical reasons prefer not to, then it should be fine. Are you the only CPR certified person in your clinic? If not, since you're the nurse manager, then you can (and I would even argue, should!) delegate. Any issues should be able to resolved with communication, which is what you did when EMS came. "you do compressions, I'll bag." Perfect! I teach CPR and at my job we occasionally get someone with a back or wrist injury take the class. If they let us know that they can, but it's uncomfortable, and they demonstrate that they can physically do it and test it off once, then we pass them. This is just my work's policy... I'd be interested to see if any other people have any exposure to this
This confuses me. If a person is too small and weak to do chest compressions, aren't they too small and weak to meet the physical demands of everyday hospital nursing? My job descriptions have required defined lifting skills of 40-70 lb, and the true demand was often more than that.
that's exactly what I was thinking as well! my job requires me to reposition unconscious patients and move stretchers with patients on them. I'm not saying she should give up on nursing but it seems like a very tough career to pursue if you cannot do chest compressions. Also, as someone mentioned, the mannequin is SO MUCH easier than a real person!
Interesting. I just did my re-certification for CPR/BLS and there were a number of people in this class who were unable to do regular chest compressions for one reason or another. Nobody was turned away because of that. Some were offered a stepping stool to make it easier on their back. Don't know how this would work in a real life situation. Either way, they all passed the entire class/course and will be getting their certification. This was a mixed group of professionals through a large hospital.
I would think that if it is a temporary restriction, you should be fine, but you have to report it to your employer. The one I'd be concerned about is standing no more than one minute. Doesn't every job require the ability to stand more than one minute? Either way, temporary restrictions shouldn't cause a long term issue.
This seems strange to me. I have always been taught, and performed, compressions with my body weight instead of my arms.
The idea was not to push with your arms which requires arm strength but to lift your body with your core, lock your arms like a piston, and drop your body weight to compress. Using your arm muscles seems like a great way to get tired.
I've seen kids and women around 100lbs be able to compress easily using their body weight. Many times things like step stools were used to help gain the height needed.
I'm short too (just under 5'2") I always have hopped up on the bed and straddled the patient. I've even done chest compressions while a catheter was being inserted behind me! Lock my elbows, shoulders directly over the hands, keep my back straight and pivot from the hips puts my whole upper body weight (which is considerably more now then it was when I became a nurse...) into a piston type action and compressions are not a problem for the couple rounds before switching off.
My former coworker had to take medical leave, then was terminated when that was up and she still couldn't return, because of CPR. She is morbidly obese and was dx with pulmonary HTN and physically couldn't bend down without becoming very short of breath. She was not cleared to perform CPR so she couldn't work. This was an allegy clinic, so the risk of severe reactions and airway issues are pretty high. She was finally able to come back part-time coudln't be the only nurse on duty.
I worked with a nurse who became unable to do compressions and she was not allowed to do direct patient care and had to leave her job. Some of the restrictions you had would have made you leave the bedside anyway but add in the inability to perform CPR and you would not keep your job.
Many nurses save lives every day without doing CPR. Is the nursing profession willing to cast these valuable nurses aside just because they are physically unable to exert a certain amount of force to push a manikin's chest two inches deep? The AHA and many employers are completely unreasonable about CPR requirements. I've been a nurse for 19 years and have NEVER been required to do CPR. I've worked as an ER nurse, ICU nurse, Flight Nurse, and now a clinic nurse. During the war, I injured both elbows and am now unable to do "acceptable" chest compressions. My CPR expires in 2020. Thoughts of SI over losing my livelihood? Absolutely. Great job saving my life.
I am in CPR training for Progressive Directions (PDI). It was me and 2 other girls. They already passed and got certified. I'm the only one that didn't and it's a requirement to have this job. My knees are bruised and hurt. I feel like I don't have enough strength either. I keep wanting to use my arms to push instead of using my body weight. Does anyone know of anyway I can practice and make sure I get this? I need this job. We have to do 30 compressions, breathe into the mouth twice, do 30 compressions again, breathe into the mouth twice again and do 30 more compressions. VERY DIFFICULT. I got to 25 and that was the most I could do. I tire out to where I'm not pressing down enough. I try to press down more and lose the strength to do it
) into a piston type action and compressions are not a problem for the couple rounds before switching off.
Emergent, RN
4,302 Posts
An update on my friend, I talked to her yesterday. Yes, she tried a stool, she said she even stood on the mannequin. She was in the room 2 hours. She said she tried everything, her wrists and hands were just too weak.
I told her we should make a video of this , it actually sounded like a fantastic physical comedy skit. We could be YouTube stars! "Push harder, push faster!" the mannequin kept saying.
The education director helped her and the other tiny gal from her unit who also weighs less than 100 lbs by completing the mannequin portion for them.
Realistically, a 90 lb person will not be able to do effective solo heart compressions on a 350 lb man for the prescribed length of time, and should be aware enough to hand that task over to the stronger members of the team.