51 yrs old with spinal fusion-should I pursue nursing?

[Nurse Beth, MSN]

Given your circumstances, deciding whether to pursue a nursing career requires a thoughtful evaluation of your physical capabilities, career goals, and the various opportunities within the healthcare field.

Are you medically cleared to work without any restrictions? What shape are you in? Most employers for direct bedside care jobs require passing a physical exam and the ability to lift around 50 lbs.

Considerations

It is possible that your doctor clears you, you pass the pre-employment physical, and you practice safe lifting techniques. Planned lifts with several other people helping are not a problem.

But what catches you off guard are the spontaneous movements and sudden lifts, like bending and twisting to plug or unplug an infusion pump into an outlet in an awkward position during an emergency or lunging to prevent a patient from falling to the ground.

Then there's the amount of time you spend on your feet on hard floors, which translates to pressure on your spine. Your nervousness is also a concern, and perhaps a warning.

Challenge

A typical career pathway is bedside nursing and then on to non-bedside roles.

While hospital experience is valuable, it's not the only path to a successful nursing career. Many nurses start in different settings and transition into roles that suit their skills and physical capabilities.

The challenge is landing a non-bedside role with an ADN and no experience.

Here are some nursing roles that are less physically intensive:

• Outpatient clinics. These positions often have more regular hours and less physically demanding tasks as patients are ambulatory.
• Telehealth nursing. This involves providing care and advice over the phone or through video calls.
• Case management. Coordinating patient care without direct physical involvement.
• Nursing education. Teaching future nurses, either in academic settings or in hospitals.

Alternative Healthcare Careers

If you're concerned about the physical demands, numerous other roles in healthcare can be fulfilling.

• Medical coding and billing. Administrative roles that involve managing patient records and insurance claims.
• Health informatics. Working with healthcare data and electronic health records.
• Patient advocacy. Helping patients navigate the healthcare system and understand their care options.
• Health coaching. Providing guidance and support for patients to manage their health and wellness.
• Nurse Practitioner. You would have patient contact without the physical demands. A successful NP career could take you into retirement.

Final Thoughts

Your passion for nursing is a significant motivator and can drive you to find a niche within the healthcare field that aligns with your physical capabilities and career aspirations.

If nursing remains your dream, explore the various specialties and roles that might fit you well. 

On the other hand, if physical limitations are a significant concern, investigating other healthcare-related careers might provide a fulfilling alternative without compromising your health.

Ultimately, the decision should balance your physical well-being, professional aspirations, and personal fulfillment. 

Best wishes on your decision,

Nurse Beth

[Susie LPN]

I am almost 51  (8/13) been an LPN since 2009, I have had 5 back surgeries (1996 to 1999) with an l4 l5 fusion being the last one.   Currently working in a longterm care facility specializing in mental health.  I am currently the MDS coordinator but I do pull 12 hours sometimes nightshift on the floor when needed.  I cant say it doesnt cause me problems but I know my limits and so does my team.  My back gives me more trouble right now cause im overweight than if I work the floor.  Know your limits a dream is a dream only you can make it happen.  There are plenty positions where the physical part of nursing is less. GOOD LUCK in your future endevours......

[aliciach]

I am 51 (this last February) and I am starting a job next week in Labor and Delivery. I just finished my Master of Nursing degree (basically an ABSN) and I took the NCLEX today.  I had fusion spinal surgery about 18 years ago and I have had no issues working my clinical shifts while in nursing school. I do suffer from some arthritis, but it hasn't been an issue so far. Like Susie said in the previous response, I also know my limits. Also, there are so many different kinds of jobs in nursing. My niece works as a nurse in telehealth and has a great salary and benefits. It is completely doable for you and if it is something you have always wanted to do--then go for it!! This was one of the best decisions I have ever made. 

[brandy1017, ASN, RN]

I'll be the devil's advocate and caution you against nursing especially given a recent spinal fusion.  You don't want to harm your back more and need more surgery.  Yes there are non-bedside roles, but even these require standing which can be hard unless you are totally healed and pain free.  My experience as a nurse has seen that back surgery patients often needed additional surgeries down the line as it puts pressure on the vertebrae above or below the surgery.  I'm not an ortho nurse, but it was what I've seen.

Now I've worked bedside 27 years and ended up with severe spinal stenosis, unknown to me.    I was so blissfully unaware I would help turn and move the patients for other nurses who were in terrible back pain.  One nurse would come to work and take a chair down the unit from patient to patient rather than walk, until she was finally better.  She was pool and didn't have disability or PTO.  It was sad to see.

Meanwhile, my left leg would go numb, and I would notice it when I layed down to sleep, but I have had two surgeries on that leg years before so blamed it on that.  Not being an ortho nurse I didn't know that was a silent sign of nerve impingement of stenosis.  I also would get a knee pain here and there and a foot/ankle pain intermittent mostly left and at night my toes would ache and cramp all signs of stenosis.  The only back pain I had was when standing but I was able to sit on the night shift.  I knew I couldn't stand for 5 minutes without pain or kneel either or bend, but bending always hurts your back.  Even had OAB, overactive bladder symptoms since I was 40 but they say it's common and women get it and 1/2 of women are incontinent, like that is a normal thing!  While I didn't have incontinence thankfully, I did learn about caude equina medical emergency where new onset of bladder/bowel incontinence, groin saddle anesthesia ie numbness is a sign of it and if you don't get to the ER and get surgery in hours your problem may become permanent.  Which makes me wonder is this why 1/2 of women are incontinent or at least part of the problem!  I do feel women's medical issues are many times dismissed and not taken as seriously as a man's in general.  Even more so if you are overweight or obese, they will blame everything on that!

I worked with so many walking wounded nurses and CNA's over my career in constant pain, getting epidurals and aware of a couple serious ones.  One nurse had such bad back pain she peed her pants during the shift a sign of caude equina, refused to go to the ER, had to be wheeled out to her car.  Later she went to her chiropractor.  She never consulted her medical Dr let alone an ortho so I can assume she has serious back problems too.  The other my coworker's daughter also a CNA awoke her during the night as she crawled to her room and she had the medical emergency of caude equina.  She had to be rushed to ER and surgery.  Thankfully she is doing OK but had to find a new job, of course!

In my case, I didn't go to the Dr much to begin with, didn't realize these symptoms were connected and a sign of serious back problems until after I took early retirement.  My OAB went away soon after but I thought it was because I was taking topamax, well I stopped that and still no OAB.  So it went away because I was no longer hurting my back at work.  

I recently had a serious flare up after doing yard work and gardening dragging big bags of soil and pots and my OAB started up, my bowels changed to more constipation out of the blue and my left foot was on fire with pins and needles.  I knew I had hurt my back at that point.  My L3-L5 mod to severe stenosis and severe disc narrowing L5-S1.  I didn't rush to the ER since I could still void.  Did lots of internet research and started taking anti-inflammatories like NSAIDS, tumeric, krill oil.  I also started steroids prednisone and neurontin.  After the prednisone I woke the next day and my foot and leg were no longer on fire.  The other symptoms slowly resolved.  I now have an ortho consult coming up for further workup.  I've already had PT last year so know and do core abdominal exercises, pelvic tilt etc.

I'm writing this as a warning to both the OP to think twice about nursing and also to the rest of nurses out there if they have any of these symptoms they should talk to their Dr as they may have silent form of back injury.  Truthfully the typical workload causes multiple silent injuries to the back over time, until it makes itself evident one day.  Workers comp is only for a sudden acute injury so it discounts the vast majority of injuries nurses and healthcare workers sustain!

 

[brandy1017, ASN, RN]

Another weird, rare side effect of stenosis or spondylosis can be foot and leg swelling which I have in the left leg, but again I brushed it off as lymphedema from my past surgeries.  My calf was always slightly larger, but then I developed pitting edema in my foot, ankle and calf every day.  It goes away after I sleep.  It is a slow insidious process so I couldn't say when the pain, numbness and swelling started, just that it had been ongoing for years before I retired.

I briefly considered SSDI but I knew from my patients it was next to impossible to get, they deny you the first time unless you are terminal.  It has a 36% first time approval and the wait times for an answer have reached over a year.  Then you have to reapply in a short order and keep going till hopefully you will finally be approved.  It literally can take years and you must be going to the Dr frequently and documenting your medical problems and how they physically impact your ability to work. 

I've read that since Trump was President the SS Director made it even harder to qualify for disability for back problems you need to require a walker.  How many people want to use a walker when they are young.  Although it certainly would help, and if you feel better leaning onto a shopping cart you probably have it.  It is known as Shopping Cart Syndrome as leaning forward takes the pressure off your spine and sitting usually relieves the pain at least in the beginning. 

The only real cure is surgery a laminectomy or spinal fusion.  There have been some newer, less invasive techniques that are Medicare approved, but I'm not sure if other insurance pays for them, the Vertiflex and MILD.  Both are devices that hold your vertebrae in a way to make more room for your spinal cord and nerves, but the MILD is more invasive where they actually remove excess bone and ligament as well.  So that is promising!  Thousands have been helped by these procedures re pain and ability to walk longer, and if you later need surgery; you can remove the devices and do the surgery.

Surgery is reserved for worst cases generally.  At first they have you do PT, physical therapy focusing on abdominal muscles, core, and pelvis strengthening and stretching.  Sometimes they suggest TENS treatment and portable ones are available even at Amazon.

I just wanted to offer some more info and mostly hope for any nurse or healthcare worker who thinks they have a back problem.  Talk to your Dr and an orthopedic specialist.  It gives me hope!

 

[barcode120x, RN, NP]

What are your reasons for going into nursing at 51? Passion? Pay? What are your physical limitations that you have right now if any? I think these two questions are the most important to think about. As a PM&R NP that works in the SNF setting, I come across a good portion of acute and long term residents with prior histories of spinal fusions and it's usually more than one surgery. Most common complaint now that they are much older is chronic pain. I could not imagine living with chronic pain, let alone be working as a nurse with chronic pain. Or, worsen your back because of the strain of working as a nurse. Keep in mind that Trauma to bone, whether it was done accidentally or through surgery, increase the risk of degeneration or can worsen the degeneration of your spine. And as I'm sure you know already and have read in the comments here, bedside nursing is very demanding on the body while non-bedside position can still take a toll on the body from long hours of standing, sitting, typing. To be blunt, you are older and as much as well all want everyone to pursue their passion for nursing, you need to be realistic about your body's condition, finances, and your goals at your age.