 2004 AJN Table of Contents
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Issues Update
American Journal of Nursing -
January, 2004 - Volume 104, Issue 01
Handle with Care
The ANA launches a multifaceted campaign to prevent
workplace injuries.
What can I do to help prevent back injuries among
nurses in my workplace?
When Maggie Flanagan, RN, talks about the injury that kept her from
her job for eight months, she is quick to point
out that the damage to her back, shoulder, and neck that seemed to happen
within seconds actually had been building, shift by shift, for years.
Flanagan suffered a major musculoskeletal injury five
years ago while helping a charge nurse lift a 75-pound neonatal intensive
care unit (NICU) monitor from a shelf located at shoulder level to a
rolling table and back up. Although lifting in that way was not part of her
typical workday routine, there were scores of other repeated and awkward
movements—such as long reaches to quickly silence alarms—that
were. And they had taken their toll.
“I would leave after many shifts with a sore
back and shoulders,” said Flanagan, a Washington State Nurses
Association member who was working at a hospital in Alaska at the
time of her injury. “I didn’t realize I was setting myself up
for a major acute injury and a potential lifetime of chronic
pain.”
So when the ANA launched its new, multifaceted
campaign to promote safe patient handling and prevent musculoskeletal
disorders among nurses, Flanagan agreed to participate by sharing her story
with other RNs and the media.
The ANA kicked off its “Handle with Care”
campaign this past September by distributing strategic informational
materials to its 54 constituent member associations, 14 specialty
nursing groups, and roughly 130 other health care groups and nurse members.
A media blitz followed with nearly 200 press kits sent to the general and
nursing media. Also available on the ANA’s Web site (www.nursingworld.org/handlewithcare), the materials include a tip sheet that details how nurses can
institute a safe-patient-handling-and-movement program in their facility,
as well as the ANA’s June 2003 position statement, The Elimination of Manual Patient Handling to Prevent Work-Related
Musculoskeletal Disorders, which
serves as the backbone of the campaign.
ANA president Barbara Blakeney, MS, APRN,BC, ANP,
issued a call to action asking nurses, nursing educators, the health care
industry, legislators, and the public to unite with ANA nurse leaders to
promote educational programs and the use of assistive equipment and
patient-handling devices to prevent back and other musculoskeletal
injuries.
The campaign also seeks to reshape the traditional
education that nursing students and ongoing RNs receive by dispelling the
widely promoted myth that injuries could be prevented if workers would just
use proper body mechanics. Furthermore, the ANA wants to collaborate with
other health care groups to win federal and state ergonomics policies.
What’s at stake
Research shows that nursing personnel are at greater
risk for sustaining musculoskeletal disorders than most other U.S. workers.
The U.S. Bureau of Labor Statistics reported that nurse’s aides,
orderlies, and attendants ranked first and RNs sixth on a list of workers
at risk for strains and sprains in 2000. By comparison, truck drivers came
in second, and construction workers ranked eighth.
Other studies revealed that more than 52% of nurses
complain of chronic back pain, and 12% of nurses leave the profession every
year because of back injuries.
“These alarming statistics tell us two
things,” Blakeney said. “Poor ergonomics hurt nurses, who are
choosing to leave the profession rather than suffer unnecessarily, and poor
ergonomics hurt patients, whose safe nursing care is already
threatened by the nation’s escalating nursing shortage.”
Blakeney emphasized that this is why the ANA has
launched the Handle with Care campaign—to reverse these alarming
trends and to send a message to policymakers that this issue needs to be
addressed immediately.
Policymakers have known for three decades that nurses
are routinely injured at work, said Audrey Nelson, PhD, RN, FAAN, director
of the Veterans Health Administration Patient Safety Center of Inquiry in
Tampa, Florida, and a major collaborator on the Handle with Care campaign.
Yet while regulators have corrected problems associated with other
occupations, they have been slow to respond to workplace injuries within
the predominantly female field of nursing.
“There also are a lot of myths that have impeded
the progress of safer patient handling, such as the belief that using
‘perfect’ body mechanics when lifting patients will prevent
injury,” said Nelson, a Florida Nurses Association member and expert
on occupational injury prevention. “As nurses, we tend to be
self-sacrificing. But patients will suffer more if the number of nurses
dwindles further because they are injured while providing care.” (See
“Myths and Facts About Back Injuries in Nursing,” February
2003, for more on back injury myths unveiled by Nelson.)
Nelson contends that nurses can be safe in their
practice—given the right training and technology, such as
lateral-assist devices and transfer chairs. She is currently analyzing data
from more than 700 nurses to determine the effectiveness of certain
injury-prevention strategies, such as assistive devices, back injury
resource nurses, and standardized processes for making decisions on patient
handling. Research from an earlier study she conducted already shows that
injuries among nurses decreased when these procedures and others developed
through her work were used (see “Safe Patient Handling and
Movement,” March 2003).
What continues to shock Nelson about her findings, as
well as her interactions with nurses nationwide, is that so few RNs have
ever heard of or seen the wide array of available patient-handling
equipment.
But it’s hoped this will change through the
efforts of the campaign, according to Nelson and A. B. (Butch) de Castro,
PhD, MSN-MPH, RN, the ANA’s occupational health and safety specialist
and author of this month’s Health
& Safety column, which also discusses
musculoskeletal injuries among nurses, page 104.
“By attending one of the educational sessions
offered through this campaign, nurses will have a true opportunity to not
only check out the equipment that’s available, but also to learn how
they can work toward choosing and promoting the use of equipment
needed to make their workplaces safe,” de Castro
said. “This campaign also is designed to help nurses assess their
physical work environment and implement changes that will eliminate many of
the awkward, repetitive movements they perform every day that can lead to
musculoskeletal disorders.”
De Castro added that the campaign also benefits
patients. “We firmly believe that safe handling devices and
techniques protect patients from injuries, caused by falls or friction, and
help them maintain their dignity and sense of autonomy.”
The campaign rolls on
The ANA so far has been using every opportunity to get
the word out about its Handle with Care campaign within the nursing
community and beyond. For example, the ANA recently sent some 300 press
kits to both general and nursing media.
Other campaign components include:
Although nurses have many pressing workplace concerns,
such as understaffing and mandatory overtime, the ANA and nurses involved
in the campaign believe the time is ripe to address safety for nurses and
patients, especially since nurse injuries can exacerbate understaffing.
“What we see in health care today is that the
honorable men and women who go to work every day to care for the health
of others are doing so at the expense of their own health,” said
Flanagan, who continues to work as a NICU staff nurse. Through this
campaign and other local efforts, she hopes that nurses will begin to
take their aches and pains more seriously and actively work to design and
advocate safer work environments.
For more information and
updates on the Handle with Care campaign, go to the ANA Web site at www.nursingworld.org/handlewithcare
or contact A. B. (Butch) de Castro at (202) 651-7138 or
bdecastro@ana.org.
Susan Trossman is the senior reporter for the American Nurse, published by the ANA.
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