Nursing, especially in the hospital setting, is physically demanding -- and nurses’ backs bear the brunt of their jobs.
Just how prevalent are back problems in nursing? According to an American Nurses Association fact sheet:
- RNs ranked fifth among occupations most at risk for strains and sprains -- higher than stock handlers and construction workers.
- Studies of back-related workers’ compensation claims reveal that nurses have the highest claim rates of any occupation or industry.
- Nearly half of nurses have considered leaving the nursing due to job's physical demands. For nurses with job-related pain or injuries, that number jumps to nearly 60 percent.
Improper lifting or transfer techniques are prime culprits behind nurses’ back woes, says Scott Howell, PA-C, of the Florida Back Institute. Boosting patients from lying to sitting and the quick movements needed to keep a patient from falling can also cause injury, according to Jill Taylor Pedro, RN, MSN, a clinical nurse specialist at Massachusetts General Hospital (MGH).
There’s no way to completely avoid these motions, but there are things you can do to lessen the threat of career-ending back pain.
Use Good Body Mechanics
“For lifting, nurses should bend at their knees, using their legs and not their backs,” says Howell, who specializes in orthopedic spine issues. “While transferring patients, nurses should use transfer boards and assistance from a second individual.”
Rick Kassler, MSPT, OCS, supervisor at the Orthopaedic and Sports Therapy Center at the New York University Hospital for Joint Diseases, adds nurses should keep the objects or patients they’re lifting as close to their midsections (centers of gravity) as possible.
Maintain the back in a neutral position that preserves its natural curves, Kassler says. “The key to maintaining a neutral spine when bending forward or lifting is to bend or ‘hinge’ from the hips, not from the back,” he says.
Stay in Shape
Nurses who maintain muscle strength, flexibility and normal weight are less likely to get hurt, says Richard H. Haglen, MSPT, CSCS, a Boca Raton, Florida, physical therapist.
“Nurses should consult with a physical therapist to learn proper body mechanics and good lifting technique as well as to learn trunk stability exercises that could help prevent injuries,” he says.
Wear Good Shoes
Prolonged standing and walking on hard floors puts stress on the back. Comfortable shoes that are good shock absorbers can help, Kassler says.
Advocate for Proper Technology, Training
Seek employers that offer the technology and training necessary to decrease the risk of an on-the-job injury, says Daniel Kerls, MBA, OTR/L, senior project specialist at MGH.
MGH is among the hospitals adding mounted motorized ceiling lifts, portable lifts, transfer technology and more to ease the physical demands of nursing.
“If you’re choosing between a hospital that does not have the technology…as opposed to one that does, you might want to go with the one that does have the technology, because it means longevity in the profession,” Kerls says.
MGH also has an injury-prevention program and an ergonomics specialist who evaluates nurses’ work environment, says Dawn Tenney, RN, MSN, associate chief nurse at MGH.
If in Pain, Look for Alternatives
In most cases, nurses can switch specialties or settings to get relief from back pain.
That’s what Carol McAfee, RN, did when chronic back problems prompted her to change from trauma nursing to the cath lab.
“The majority of the patients in trauma are unconscious -- many are ventilated and unable to assist in turning in the bed and going from bed to stretcher,” McAfee says. “You have to literally lift their entire body weight. At first, my back would feel tired, strained. Then it got to be a chronic issue. I knew it was going to get worse, and I didn’t want to be disabled from it.”
Working in the cath lab at Delray Medical Center is more back-friendly, she says.
“In the cath lab, when we move patients from the stretcher to the procedure table, they are lying on a sheet, which is on top of a piece of plastic, so you just slide them over,” she says. “In the cath lab, you’re more likely than in trauma to get help when turning or positioning patients.”
The less-stressful environment of the cath lab also helps McAfee avoid back injury.
“In trauma, there’s a lot going on,” she says. “You’re called into action fast, and that can cause a lot of tension in your body. Under such stress, one doesn’t think about proper lifting techniques.”