Working with a bad back, light duty?? Opinions welcome

[J89Mike]

Hi everyone, I'm an experienced registered nurse who works full-time in the med-surg department at a busy hospital working with a 6 patient workload at night.

I'm only 28 and was diagnosed with a L4-L5 disc herniation last year. Since that time, I've been hospitalized multiple times for unbelievable amounts of pain and the lack of ambulation ability. I've attempted relief having 3 sets of steroid injections for inflammatory control, been prescribed lyrica, and worked with PT for management of my radiculopathy and sciatica. Unfortunately, at times, I lose sensation down my left leg for a few seconds due to the disc being fully herniated onto the spinal nerve.

My concern is to keep living with this without any viable treatment plan. My doctor is concerned and isn't one for prescribing pain medication, he more-so seeks treatment plans that don't mask problems like when prescribing pain medication.

He told me that a back brace might help to give my spine an opportunity to "realign" itself but he said if I do that, I shouldn't take part in any activity that can aggravate my back. He threw around the idea of going light duty for a few months, wearing the back brace full time, and working with PT to attempt to get back to my best self.

To anyone that has an opinion, is this something I should consider? I definitely don't want to get back surgery due to the complications and I'm not one for relying on pain meds especially at a young age. I'm worried that if I go with a back brace, I won't be allowed any patient care and that might limit my options working at night. Unsure of what light duty options there are in the hospital??

I definitely don't want to be in pain and aggravate my back any more than it has been, but I don't have any experiences with back braces. Just seems I have tried everything else (pain meds, nerve meds, spinal steroid injections, PT, chiropractor, ice/cold packs, and stretches) with no major sign of improvement and this may be my last choice before needing a consult with a surgeon.

Because I work with 6 patients a night, the idea of "taking it easy" with a back brace seems challenging. I constantly pull/push/bend/lift/reposition throughout the whole shift and if the goal is to give my back a break, I think my duties as a bed side nurse should be lifted at least for a little time.

Any thoughts from those who have dealt with back issues or been on light duty due to any unfortunate circumstances? I would like to know what to tell my manager before deciding which route to take. Thank you!

[fartjohnson]

There's almost always administrative work (audits, policy review, filing, etc) that's been piling up because nobody wants to do it. This might be available for you while you're on light duty but I'm not sure your employer would be amenable to keeping you on light duty for months at a time.

More importantly: you're 28, you have serious back issues, and you're working in a field that is notorious for being rough on the lower back. Start preparing to take your career in a different direction NOW! Your back will get worse if you continue to work on the floor--period. Look for something with zero physical labor like case manager or nurse educator and work towards landing your first job in that role.

Good luck

[Sour Lemon]

They might be out there, but I've never worked at a place that offered "light duty" for nursing staff. You either had to be able to do the job, or you were off the schedule until you could. Keep your expectations low, just in case.

[Jedrnurse, BSN, RN]

Same thing happened to me at exactly the same age. I manage to keep it at bay with everyday exercise and stretching, but when it goes out, it's like being disabled. I echo a previous poster- develop a plan to change specialties! Your med-surg career is not long for this world. Oh, and do a lot of research before having surgery; some studies show that long term results of it aren't necessarily better than conservative treatment...

[Been there,done that, ASN, RN]

I don't think your doctor is "throwing out the idea" that you require light duty. You DO require light duty. That means away from the bedside. Stuff happens on a unit where you will be FORCED to move.. in the wrong way.

Your unit manager will accommodate you as they ( and HR) see fit. For as long as they have to.

Time to get outta Dodge, take whatever you can get, for now, and find a position away from the bedside.

Peace to you.

[Rocknurse, MSN, APRN, NP]

I'm not sure that would be an option to you, to be honest. I had a similar experience. I had what I thought was severe back problems for a while (turned out to be endometriosis) but I was off work for about a month. I couldn't walk very well and certainly couldn't lift anything heavier than a frying pan, but I was not allowed to come back light duty. It was full duty or no duty and I wasn't cleared by occupational health to return to work.

[seaofclouds21, BSN, RN]

Was your injury determined to be work related? If this isn't a workman's comp type of situation, your employer may not allow a light duty. It is completely up to them, but in all the places I've worked, I've only seen them allow someone to go on light duty when it was a workman's comp situation. If it was unrelated to that, then don't go with it because they don't want the risk (liability) of someone that's already injured in a non workman's comp situation to get further injured while working (and potentially turn into a workman's comp situation).

I agree that you need to do what's best for you and it does not sound like bedside nursing is going to be a good option for the future of your career. Do everything you can to save your back now.

[ixchel]

BY LAW, your facility is required to make reasonable accommodations, which includes allowing you light duty. For more information, you can look this up under EEOC's ADA online. Any conversation you have regarding this should take place in writing. Trust me on this.

[roser13, ASN, RN]

BY LAW, your facility is required to make reasonable accommodations, which includes allowing you light duty. For more information, you can look this up under EEOC's ADA online. Any conversation you have regarding this should take place in writing. Trust me on this.

Can you elaborate on this? Any hospital I've ever worked at has denied light duty requests, as there is no such thing on a busy floor. There are no accommodations that alleviate patient care if that is the entirety of the job description.

If it is a Workers Comp case, the employee is simply off with pay. Non-Workers Comp - simply out of luck.

[roser13, ASN, RN]

I wish that ixchel would respond because I would like to believe that employers should be required to offer accommodations to lesser abled employees.

[seaofclouds21, BSN, RN]

I wish that ixchel would respond because I would like to believe that employers should be required to offer accommodations to lesser abled employees.

The are required to offer "reasonable" accommodations. That is the key aspect of it. Is it "reasonable" for one nurse to no longer be able to assist with lifting, turning, or moving a patient? How will that work load be redistributed among the rest of the staff? If a "reasonable" accommodation is not available, then the employers are allowed to let someone go on the premise that they are no longer able to perform the requirements for the position.

[Meriwhen, ASN, BSN, MSN, RN]

A lot of facilities will offer "light duty" because there's usually a ton of administrative and non-physical work that they could use assistance in getting completed. However, see your facility's P&P and talk to HR/Occupational Health, because each facility is different.

However, if you're expecting to have light duty for the rest of your career, think again. Many facilities will limit how much light duty you can be on before you are required to either get medical clearance to return to work or have to go on disability leave.