Nurse's Health: Nurses and Musculoskeletal Injury

Oh my aching (insert body part)!! Nursing can be exciting—running to codes, complex care of complex patients, a fast-paced environment. Unfortunately, the things that excite have the potential to harm. Brown, Trinkoff, Rempher, McPhaul, et. al (2005) reported that “work-related injuries are common among health-care workers…musculoskeletal injuries, such as back injuries, have been reported to affect as many as 30% to 60% of registered nurses” (AAOHN, p. 213). Musculoskeletal injuries, or MSIs, result from either overuse or overexertion and affect bones, joints, ligaments, tendons, muscles, and soft tissues (WORKSAFE ALBERTA, p. 1). Not only do MSIs affect individuals, but institutions may see increased sick time, increased disability claims, heavier workloads, and further contribution to the nursing shortage.








The physical demands of nursing include caring for patients with decreased mobility. Nurses are then required to assist with repositioning and transferring. If not done correctly, injury and strain can occur. Nurses can injure their backs, necks, and shoulders when repositioning patients without raising the height of the bed. According to Potter and Perry (2004) “nurses should move the bed and patients to their centre of gravity in order to reduce strain and injury” (p. 818). Another risk factor is prolonged standing. Standing for long hours without breaks can cause injury to the back, hips, and knees (Miejsen & Knibbe, 2007). Transferring patients also causes damage, as many nurses attempt to lift their using their back, neck, and shoulder muscles, rather than utilizing the patient’s own strength. How often have you heard “use your legs, not your back”?

Time pressures, the nursing shortage, increased patient loads…these conditions are a breeding-ground for nurses to sustain injury in the workplace. In a study by Shamian, O’Brien-Pallas, Thomson, Bruce, and Sale (2002) “…hospitals often identified workload as being a contributing factor in high injury rates” (p.12). When the workload increases, nurses will look for “shortcuts” to help them get their jobs done. Some examples are: transferring patients alone who normally require two nurses for transfer; and, not taking the time to raise the bed to complete a treatment. The equation is simple. The nursing shortage creates an increased workload which creates time pressures. The nursing profession is unpredictable. Nurses must strive for or maintain good health. Without it, the susceptibility for injury is evident.

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Educating nurses on proper ergonomics in the workplace will help reduce the number of MSIs. In order to reduce the risk of injury and potentially prevent it, one solution is to adjust the work environment to the worker rather than the worker to the environment (Owen, 2000). Adjusting the work environment includes employing devices like roller boards, friction pads, and slider boards. These devices help transfer patients easily, causing less The solutions to the high MSI rates among nurses are not endless, but certainly many. strain on the back and shoulders. Of course, these devices must be available and in good working order, and nurses must be trained in their proper use. Other solutions are as simple as wearing proper footwear, using the legs rather than the back to lift, and raising the bed to the nurse’s waist level, avoiding bending at the waist.

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It is clear the nature of the environment is responsible for the high incidence of musculoskeletal injuries among nurses. That environment is not likely to change. Nurses and their employers must work together to implement Workplace Injury Prevention Programs, ensure availability of assisting devices, and educate about proper body mechanics. It is a win-win situation; decreased MSI rates = decreased work time lost = decreased disability claims = increased time management = decreased nurse attrition.

Websites related to nurses' health:

Back Care for Nurses

Nurse's Health

Stress and effects on nurses' health

Nursing Health Problems

Step by step proper body mechanics

Body Mechanics

Injuries in health care - safety with patient transfers

What you need to know

References:


Hedge, A. (2006). Back Care for Nurses. Retrieved from http://www.spineuniverse.com/displayarticle.php/article1509.html
Brown, J., Trinkoss, A., Rempher, K., & McPhaul, K., et. al (2005). Nurses’ Inclination to Report Work-Related Injuries: Organizational, Work-Group, and Individual Factors Associated with Reporting.AAOHN, 53 (5) 213. Retrieved from http://proquest.umi.com.uproxy.library.dc-uoit.ca/pqdweb?did=839287881&sid=1&Fmt=4&clientid=72790&RQT=309&VName=P

Hedge, A. (2006). Back Care for Nurses. Retrieved from http://www.spineuniverse.com/displayarticle.php/article1509.html
Miejsen, P., & Knibbe, H. (2007). Prolonged Standing in the OR: A Dutch Research Study. AORN Journal, 86(3) 399-414. Retrieved from http://ww.aorn.org/
Owen, B. (2000). Preventing Injuries Using an Ergonomic Approach. AORN Journal, 72(6) 1031-1036. Retrieved from http://proquest.umi.com/pqdweb?did=66892273&Fmt=4&clientId=72790&RQ=309&VName=PQD
Potter, P., & Perry, A. (2004). Clinical Nursing Skills and Techniques, pp. 799-824. Missouri: Mosby
RaortizDPT (2008, November 29). Body Mechanics by Layla Rabbani [Video file]. Video posted to http://www.youtube.com/watch?v=1uOq7cfhf7c
Shamian, J., O’Brien-Pallas, L., Thomson, D., Bruce, S., & Sale, J. (2002). Musculoskeletal Injuries, Stress and Absenteeism: Job Strain is a Contributing Factor that Affects the Health and Productivity of Ontario Nurses, Resulting in Additional Strain. The Canadian Nurse, 98(9) 12-17. Retrieved from http://proquest.umi.com.uproxy.library.dcuoit.ca/pqdweb?did=506700531&sid=1&Fm3&clientId=72790&RQT=309&VName=PQD
WORKSAFE ALBERTA (2000). Musculoskeletal Injuries-Part 1. Workplace Health and Safety Bulletin. Retrieved from http://employment.alberta.ca/whs/network/hstopics/ergonomics/msi.asp