shoulder injury

ShirleyM · Mar 9, 2005

We now have four RNs put out to pasture with neck/shoulder injuries all within the past year. Two were part-time, two full-time, ages late twenties to late thirties, and no specific specialties - busy regional trauma center. And from time to time my right shoulder niggles too! (and I reckon I'm fairly fit and sensible...) Anyone else experiencing an upsurge in this injury? Any thoughts? Is this a new phenomenon related to ?extensive Casecart usage, or altered lifting procedures, or something else introduced relatively recently ...

I have to ask, what were they doing at the time of injury? where I work we've haven't had a pattern of certain injuries occur. We had a tech who pulled his back a couple of weeks ago, but it's not often when have someone injured on the job. And of course, we get the person with a needlestick injury every now and then, unless you count last week when one of the residents attacked my tech with a dirty blade while closing a crani(as we like to put it):uhoh21: . He won't hear the end of it until he finshes his residency.

Pediatric Critical Care Columnist · Mar 9, 2005

About a year ago, I had a shoulder injury. It actually started out as a torn rotator cuff in December, an injury I incurred trying to catheterize a patient who had extensive muscle necrosis and whose legs would just not move... couldn't bend at the knee, couldn't flex, extend or abduct at the hip and she was anesthetized at the time! That injury seemed to recover with rest and NSAIDs. Then in April, I was assigned for three nights to a patient who was on peritoneal dialysis. In our unit we do it manually and this little person was getting a combination of two different concentrations 20 mL of each, each hour. I was constantly raising my arm over my head to open and close the roller clamps on the bags, and hanging 3 L bags of dialysate. I ended up with shoulder impingement syndrome requiring eight weeks of physio. It still twinges once in awhile, and when it does, I start my physio again. Not fun, but I can't be laid up with musculoskeletal pain.

madwife2002, BSN, RN · Mar 9, 2005

Do you know years ago when I was doing CAPD for 3 years I has a strain injury in my right shoulder for repeatedly hanging the bag.

I work on Neuro Rehab ward and all our patients aare hoisted and my right shoulder now aches all the time. We have ten patients, sounds easy right, wrong all of them are dependent and it is so heavy.

Most of the staff are c/o of aches and pains in their back and shoulders, we have no lifting policy, so if hoists work to help save your backs why are we all suffering?

SusanJean · Mar 9, 2005

I had a torn rotator cuff that bothered me for more than five yrs, was told it could only be repaired w/ surgery. Finally saw an acupunturist and after a series of treatments have been pain free for six yrs.

The other shoulder "froze" after an injury when a horse fell on me - incredibly painful and limited range of motion. Took almost a year of PT to get pain under control and motion back. (Used TCM as part of tx too.)

SJ

Pediatric Critical Care Columnist · Mar 9, 2005

Most of the staff are c/o of aches and pains in their back and shoulders, we have no lifting policy, so if hoists work to help save your backs why are we all suffering?

Madwife2022, are your hoists the manual pump-handle type? That could be the reason for your ongoing problems with back, neck and shoulder injuries. If you're manually hoisting 10 patients several times a day, I'd call that a repetitive activity, n'est-ce-pas? There are some very nice electric models out there, but of course, they cost the Big Bucks and who has the dough in the budget? They'd rather spend 100 times the amount on Worker's Comp payouts! :bugeyes:

madwife2002, BSN, RN · Mar 9, 2005

Madwife2022, are your hoists the manual pump-handle type? That could be the reason for your ongoing problems with back, neck and shoulder injuries. If you're manually hoisting 10 patients several times a day, I'd call that a repetitive activity, n'est-ce-pas? There are some very nice electric models out there, but of course, they cost the Big Bucks and who has the dough in the budget? They'd rather spend 100 times the amount on Worker's Comp payouts!

Hi,

No we have wonderful electric hoists all singing all dancing, It is the repetition as you say, we starting counting up the amount of hoists we do per patient per shift and on one occasion last week I hoisted one woman 8 times before midday!! she was in and out of bed and on and off comode!!

Pediatric Critical Care Columnist · Mar 9, 2005

Yep that'll do it!! Our unit doesn't have a lift at all, even though some of our teen trauma patients have weighed more than 100kg! We also don't have Maxi-slides, those lovely Teflon and Goretex sliders that just slip right up under the patient like nothing and make turns, boosts and transfers so easy and safe. We do it all with muscle, drawsheets and plastic slider boards. If we have to lift a big patient we use our sling scale (which is the pump-handle type)! I'm working on having an ergonomic study of our unit done by the OH&S folks. They're likely to be shocked.

As an aside, my 21 year old son is a right hemi who ambulates fairly well with a heavy assist and is about 90% continent; when we bought this house we weren't thinking all that clearly about his toileting needs and now it's really a problem. The bathroom is very small with no room for a grab bar other than the kind you attach to the side of the tub. DH didn't like that, said it obstructed his access to the tub and shower ( :sniff: ) and one day it just disappeared. So now I find myself having to do 90 degree pivots and then supporting most of his weight while he gets seated. Our family doc says that's why my shoulder rehab-ed as quickly as it did. Gotta find your blessings where you can, I guess.

madwife2002, BSN, RN · Mar 10, 2005

Yep that'll do it!! Our unit doesn't have a lift at all, even though some of our teen trauma patients have weighed more than 100kg! We also don't have Maxi-slides, those lovely Teflon and Goretex sliders that just slip right up under the patient like nothing and make turns, boosts and transfers so easy and safe. We do it all with muscle, drawsheets and plastic slider boards. If we have to lift a big patient we use our sling scale (which is the pump-handle type)! I'm working on having an ergonomic study of our unit done by the OH&S folks. They're likely to be shocked.
As an aside, my 21 year old son is a right hemi who ambulates fairly well with a heavy assist and is about 90% continent; when we bought this house we weren't thinking all that clearly about his toileting needs and now it's really a problem. The bathroom is very small with no room for a grab bar other than the kind you attach to the side of the tub. DH didn't like that, said it obstructed his access to the tub and shower ( ) and one day it just disappeared. So now I find myself having to do 90 degree pivots and then supporting most of his weight while he gets seated. Our family doc says that's why my shoulder rehab-ed as quickly as it did. Gotta find your blessings where you can, I guess.

Good job re shoulder but hard work to get access to bathroom.

At work when we are hoisting we have such little space to manouver the hoist you are forever pulling and pushing over wires from electric beds, moving wheelchairs, shoes, wardrobes, bed tables, bags it is like war zone.

Then a visitor will leave their chairs all over the place. The best hinderence though is the pt who wants to help you whilst you are rolling to put the sling underneath, who firstly grabs you as you are rolling and then deciedes they are going to resist and pull against you with all their weight!!

Remember we are rehab, they are not confused, they have been carefully taught how to be moved but hey why listen to the OT/PT or nurse. :rotfl:

Pediatric Critical Care Columnist · Mar 10, 2005

At work when we are hoisting we have such little space to manouver the hoist you are forever pulling and pushing over wires from electric beds, moving wheelchairs, shoes, wardrobes, bed tables, bags it is like war zone.
Then a visitor will leave their chairs all over the place. The best hinderence though is the pt who wants to help you whilst you are rolling to put the sling underneath, who firstly grabs you as you are rolling and then deciedes they are going to resist and pull against you with all their weight!!
Remember we are rehab, they are not confused, they have been carefully taught how to be moved but hey why listen to the OT/PT or nurse. :rotfl:

I've often wondered why the facility planners can't predict these issues when they're planning a space. Our unit is fairly roomy, but the variety and sheer number of large pieces of equipment we use rapidly overtakes what free space we have. We have almost no storage spce, so we tend to store our extra vents and other such equipment in an empty iso room. Lately we've been running over census consistently, and so this stuff gets pushed out into whatever space is unoccupied. So we're having to climb over or around STUFF all the time. Our O2, suction, light switches, monitor and other important gear are all on the headwall at each bedside. Put a vent, a nitric tank, a cooling blanket and 20 IV pumps at the head of the bed and an ECMO circuit at the foot and you know you're going to get a workout. As for the families, don't even get me started!! We have a patient who has been with us now more than 2 months, a toddler whose parents are never far from the bedside. They also have an infant that Mom is breastfeeding, so she has her stroller and diaper bag etc. Some of the staff (not the ones who care for this child) dote on the infant and have gotten an Exersaucer and a play pen for her so that she can start being a baby. Where are we supposed to put all that crap? Our unit is an open ward with 10 beds in the main area and 6 separate rooms around two sides. We don't have spce for things we need!

Sorry, vent over.

daisee · Mar 11, 2005

I have to ask, what were they doing at the time of injury? where I work we've haven't had a pattern of certain injuries occur. We had a tech who pulled his back a couple of weeks ago, but it's not often when have someone injured on the job. And of course, we get the person with a needlestick injury every now and then, unless you count last week when one of the residents attacked my tech with a dirty blade while closing a crani(as we like to put it):uhoh21: . He won't hear the end of it until he finshes his residency.

ShirleyM, thanks for answering. What were they doing? Thats the point: there is no one thing. Our unit is +++occ health & safety conscious, and it seems this injury is replacing ye olde back strain. I'm interested that some people mention the 3 litre fluid bags, we do a few of them for pulse lavaging dirty wounds, but the people involved haven't have done many of those. Pulling heavy metal instrument cases off shelves and trolleys by handles might be one repetitive action; perhaps hauling people around on hovermats and slide sheets is transferring stress to our shoulders from our lower backs. Women mechanically are weaker in upper body strength.