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Nurses, watch your backs! But actually, though…

iStock | OJO_Images

iStock | OJO_Images

Nurses, all that heavy lifting you’re doing isn’t just metaphorical; you must take caution against back injuries. Think about it: You won’t be in any condition to care for others, at least for long, if you aren’t caring for yourself. 

Yes, we know you’ve heard it before, but we’re going to tell you again. Only this time, we’re going to let Kati Kleber do it, since she’s witnessed firsthand the devastating consequences, both professionally and personally, when a nurse’s back says “no more”: 

 

After you land your first nursey job, you’ll sit through a long orientation. You’ll have just come back from lunch in a food coma, and will barely be paying attention to what they’re saying. And that’s when they talk to you about how important ergonomics are. They don’t want you to hurt your back or neck while working; and you’ll think to yourself: “I’m young (maybe), healthy, smart, etc. I won’t hurt my back! Is this almost over?”  

But wait! Stop!

You foolish, foolish nurse!

Let me paint a nursey picture for you.

(Note to self: I need to see how we can get the word “nursey” added to the dictionary.)

You’re running up and down the halls, frantically passing meds, doing turns, helping coworkers, and you go check on your 376-pound patient who’s here for cellulitis. He doesn’t look so hot. You grab a blood pressure, and it’s 60/40. His face and hands are blue. You pop the O2 prop on his finger and his sat is 72 percent. You barely feel his pulse.

As you reach for the ambu bag and connect it to the O2 and crank it all the way up, you scream for help: “CODE BLUE, ROOM 361!”

They run to call the code overhead, someone else runs to get the code cart and you’re in the room alone.

He’s 376 pounds; his chest and head weigh more than you do. He’s slumped down in the bed. You pull the CPR level to get him flat, and use the sheet to pull him up because you have to do your jaw thrust to get that BVM on and sealed and that oxygen down into his lungs.

And then you feel a pop and surge of pain in your lower back and straight down your legs.

But you don’t care right now because your adrenaline is rushing and he’s literally dying in your hands.

The second you get that mask on, your tech shows up. You tell her to get on his chest and start compressions while you wait for the troops to arrive.

You heard his ribs crack; she’s pushing hard and fast enough, so you tell your tech, “Hey you’re pretty good at CPR!” while you’re bagging him. She says, “Thanks, I’d high-five you if I could!” And you think to yourself, “Okay, she’s awesome.”

The troops arrive. Respiratory takes over for you, and you explain your patient’s story to the MD as they intubate him, get his pressure back up and quickly take him to the ICU because he’s probably septic.

You roll with them to the unit, give that nurse report and start to walk back to your floor.

Just like that. It’s over. It’s only been 14 minutes.

And then you remember. OMG, MY BACK.

Your back. Your back. Your precious, precious back.

The above situation happened to a friend who can never, ever work at the bedside again.  She herniated and ruptured a few discs and has had surgery twice. She was only 29 years old when it happened.

Just like that, her bedside nursing career was done. She had only been at the bedside for six years. And she was darn good at it.

Thankfully, she was in grad school, and after her back surgery, she was able to get a job at the same (awesome) hospital and transitioned into a non-bedside role.

So please, new nurses out there—please, please protect your back. It is so valuable, precious and fragile.

Use proper ergonomics. So when you’re about to turn, lift, pull up, etc., your patient:

  • Make sure the bed is at an appropriate height. “Yes, Mr. Patient, I’ll make you wait 45 seconds to give you your IV pain meds because I’m not bending over your bed for two minutes while I push this Dilaudid ever so slowly.”
  • If you have the time to use a lift, use it—ESPECIALLY for the bigger bariatric patients. Don’t even attempt to lift them. If they are really, really large, double check the weight limit of your lift.
  • When you do lift your patient, stick your butt out and use those legs. Your butt and legs should look like you’re doing a squat. You’ll look ridiculous, but you need to lift with your legs.

 

I’ve also had friends who had an injury/accident happen outside of work that kept them from working at the bedside as well. We have a high-stress job with a weight limit. So if you break your hand, your shoulder, your back, etc., you cannot work at the bedside. You won’t be allowed to go to work. And you’re screwed.

My recommendation is to get disability insurance. This is especially important if you’re like the rest of us and have a mortgage and other bills to worry about, and if you went a few weeks without a paycheck, it would be devastating. It’s usually a pretty cheap policy that many employers offer. Sign up for it when you sign up for your benefits. Yes, even if you’re 23 years old and healthy. Yes, even if you work out all the time. I highly recommend this, guys.

I have another friend who sustained a shoulder injury while skiing, was out for eight months and lost her bedside nursing job. She had to transition to an office setting until she was completely cleared. Then she had to reapply. And she went months without a paycheck, had student and car loans, and was stressed to the max.

Seriously, guys. Protect your back.

No one will protect it for you.

Others will try to rush you to get something done really fast because they have 700 other things to do as well. You need to say, “Hold up, let me change the height of the bed before we turn,” and they’ll look at you like, “OMG, HURRY UP.” And you can just sit there, loving your back with a smile on your face while you’re pushing that button to adjust the height.

You have to take responsibility and time to care for it. You wouldn’t want those terrible years at nursing school to go to waste when you hurt your back after only two years of nursing. So you’re in debt, not working your dream job that just slipped through your fingers because you didn’t take the time to protect your back. And when you got into a situation that couldn’t be helped (coding someone like above), you didn’t have a backup (ha!) plan.

Are there any benefits-savvy people out there? Anyone have any more detailed recommendations on how nurses can financially protect themselves from this?

Any nurses out there who did hurt their backs and have some advice for us?

To read more, visit NurseEyeRoll.com.

Nursey-123x18511Becoming Nursey: From Code Blues to Code Browns, How to Take Care of Your Patients and Yourself talks about how to realistically live as a nurse, both at home and at the bedside…with a little humor and some shenanigans along the way. Get ready: It’s about to get real, real nursey. You can get your own copy at NurseEyeRoll.com, Amazon or Goodreads (ebook).

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Kati Kleber BSN, RN

Kati Kleber BSN, RN CCRN is a a nationally certified critical care nurse located in Charlotte, NC. She is the Nurse Advisor and Editorial Director of the #ProtectNurses initiative, and will be guiding the content we curate, create, and share back with you. Kleber, aka Nurse Eyeroll, is a popular blogger, the voice behind the wildly successful #ProTips series, and a frequent speaker on nursing leadership. You can buy her book "Becoming Nursey" at nurseeyeroll.com, Amazon, Barnes and Noble, and other sites. She also has two more books in the works, which will be published by the American Nurses Association and on shelves Feb. 2016!
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