Secrets for preventing back problems?

maxandruby · Jun 7, 2011

Hi Misscherie, For all precautions I had done over the years...but still can't prevent back problem. Just had back surgery a few months ago. Don't know if there is any secret out there. While your back is still in a good shape, REALLY take good care of it. When it's gone...it's gone

Max

Turd Ferguson · Jun 7, 2011

There's no secret, but you can help yourself by exercising, stretching, maintaining a healthy weight, utilizing proper technique as much as possible, and knowing your limits.

handyrn · Jun 7, 2011

Personally, I have been saying for years that while I might have saved my back (until recently) the result was ruin of my hips and knees. In the past several years I have seen some great lifts, though, that I wish I would have had years ago as an aide when I was lifting ALL the time. Utilize the lifts! They take a little more time but it's worth it!

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jun 7, 2011

Avoid using those stretchable fabric wrap around back braces. A place I worked required them in writing of all employees as a measure to reduce back injuries. As a result of the braces, peoples back muscles began to depend on the braces, got weaker, and back injuries increased! After 2 years we were all required in writing to NOT wear those except on a Dr's orders.

Catch22Personified · Jun 7, 2011

Avoid using those stretchable fabric wrap around back braces. A place I worked required them in writing of all employees as a measure to reduce back injuries. As a result of the braces, peoples back muscles began to depend on the braces, got weaker, and back injuries increased! After 2 years we were all required in writing to NOT wear those except on a Dr's orders.

The workplace I'm in makes a big deal about saving your back so they hand out the braces for free. I do use the brace they hand out and it really does help with my back. But if I'm not doing heavy lifting I loosen the brace, as using the thing all the time is a bad idea.

lawandaluxnurse, ADN, BSN · Jun 7, 2011

pilates, core exercises, proper lifting techniques, that is the only way, and always use lifts if available, or ask for help, don't give up your back for a job that won't care about you, speaking from experiance, s/p spinal fusion. i still work as an RN, but without core strength pilates etc you are toast. swimming also is good, GOOD LUCK

j621d · Jun 7, 2011

In addition to the suggestions above, I would include keeping your weight under control. This isn't quite as easy as when I was in my 20s!

MollNick · Jun 7, 2011

I have always taken extra precautions, kept my weight down, exercised and paid close attention to technique when lifting/turning. I would have the occ. back strain, put some otc muscle rub on it, rest, then goes away. My back was the only part of me that was still really strong since my elbows, knees and one shoulder have had chronic problems (not from nursing). Recently, I did hurt my back worse than a muscle strain. I developed a lumbar facet joint inflammation on L2 and L3 far as I know for now. Turns out that it will probably happen again if I go back into bedside nursing where lifting is involved. So, critical care days are over for me. If I recover from this stuff which is going on 3 weeks now, I will not be risking my back again. I think what happened is that I had stopped exercising some months back and my back muscles had gotten weak. So, regular exercise is extremely important for back safety. But, sometimes this is not enough either. I have a friend get 2 herniations b/c confused pt. unexpectedly pulled her down on top of pt. And, she was normal weight, excercised regularly, and always always was very careful with proper technique with lifting pts. I think we have more back issues than paramedics and firefighters.

LPNnowRN · Jun 7, 2011

Use those electric beds--move the bed to a comfortable level when giving cares and then move it back to where it needs to be. Lots of times people forget to do that! In my LTC facility we don't have enough of them. I recently asked that one empty electric bed be assigned to a heavy resident to save the CNA's backs (and mine).

Ruby Vee, BSN · Jun 7, 2011

hindsight is 20/20, but here you go:

always ask for (and wait for) help before attempting to turn a patient, make an occupied bed, wash a back or get a patient out of bed. you might be strong like bull, but i've seen more than one strong person injured by a panicky (or assinine) patient flailing about when you're trying to move them.

if you were stupid and didn't wait for help before trying to get that post-op patient out of bed and said patient then decides to dfo on you, let them. i know there's an inordinate amount of paperwork to fill out when a patient hits the floor, but you make your choice: a few hours of paperwork versus a lifetime of back pain. there are those who say you can break the patient's fall by sliding them down your leg -- if that works for you, more power to you. i must be a complete klutz because when my patients have tried to fall, they didn't choose to do it in the direction of my leg and i'm not fast enough to get around them before they hit the floor.

the number of experienced nurses who have never had a patient fall is probably right up there with the number of experienced nurses who have never made a med error. when your patient hits the floor, do not under any circumstances try to pick them up by yourself. (i'm not addressing peds nurses here -- you're on your own.) if the building is on fire, roll them onto a bath blanket or a sheet and drag them to safety. if they're right in the middle of the hallway and impeding traffic, you'll probably have lots of help to move them. use it. a 97 pound filipino nurse is on permanent disability now because he tried to lift a 300 pound patient by himself. what brand of stupid made him think that would work?

most of us have electric beds. use them. keep your patient at the height comfortable for you. i'm talking to icu nurses now. many of us have a tendency to lower the bed so it's comfortable for the visitors. most visitors have a limited shelf life -- they'll arrive after the start of your twelve hour shift, leave before it is over and won't still be coming every day thirty years from now. use the bed controls to protect your back -- unless you're planning to be out of the room and away from the patient for an extended length of time. or the patient is actively dying and you're just letting them go.

do your assessment before you get them up in the chair. really, it's a lot easier than trying to squat on the floor (especially at my age) to check pedal pulses. if the previous shift left them in the chair, ask them to help you get the patient back into bed for your assessment. (floor nurses may have different and more valid ideas for their environment, but it sucks trying to do a full icu assessment when the patient is up in the chair!) even when you go into the er or the doctor's office, they ask you to get up on the table before they examine you!

ask any pt for a quick inservice on proper lifting techniques. even if you think you know it all, ask anyway. and then in a year or so, when you've gotten sloppy, ask again.

if the doctor wants to listen to breath sounds, the doctor can help you position the patient to properly listen for breath sounds. don't let some big strong doctor stand there twirling his stethescope while you struggle to turn 250 pounds of dead weight -- or even worse, resisting weight.

it's rarely back-effective in the long run to actively wrestle with a patient. we all get into a position where it's unavoidable from time to time. but if you're going to get injured preventing a patient from injuring himself, it's not worth it. you'll never see mr. jones again, but you may become quite familiar with your orthopod.

use your chair when you chart. many icus provide one chair at the bedside -- for the nurse. many nurses -- especially the young ones -- offer their chair to the visitors. again, visitors aren't going to be there as long as you are. especially in the icu, the patient needs you to be at the bedside. his wife can go to the waiting room to sit and rest when she gets tired of standing.

do not under any circumstances allow a visitor to sit in a chair with wheels. risk management takes a dim view of lawsuits involving visitors who have tried to sit in a wheeled chair and had it roll away from them. i learned that the hard way early in my career -- visitor appropriated my chair when my back was turned, fell out of it, broke her hip and sued. i kept my job because i could explain right from the start that i didn't offer her a wheeled chair, she just took it when my back was turned. yesterday, a colleague of mine who should have known better offered one of those high rolling charting chairs to a patient's elderly husband. it rolled, he fell and four people were required to get him off the floor. fortunately, he wasn't seriously injured. a few hours later, he was back in the rolling chair -- she let him sit there because his back hurt from the first fall. some people never learn their lessons! it's easier to protect your back from picking people up off the floor when you don't make it easy for them to hit the floor in the first place!

if you have lift equipment, use it. and learn to use it correctly and safely.

if a patient is too obese to fit into the shower stall, they get a sponge bath. if you put a 300 pound patient in a bathtub and they get stuck there, every one on your shift may spend the next shift in the er with back injuries! (i learned this one the hard way, too.)

make sure you disengage the brakes before attempting to move large, heavy pieces of furniture or equipment. (again -- lesson learned.)

actively discourage your alf patients from climbing on chairs to clean off the top shelf in their closet. especially if the chair has wheels or a rickety leg. if necessary, remove the chairs from their room and let them use the common areas to entertain their visitors. (got a phone call a few months back -- my mother climbed up on a chair and then fell on the cna who was trying to get her to climb down. two injuries for the price of one!)

that's all i can think of right off the top of my head. i'm sure, though, that this is more what you're looking for than generic advice to get plenty of exercise and don't get fat.