REPORT: May 2005

Safe Patient Handling

NYSNA seeks state support for “safe lift” programs

by Diane Pineiro-Zucker

Joanne Brennan loved her job. She was an ER nurse at St. Catherine of Siena Medical Center from 1979 until 1996. That year, when she and another nurse lifted a resistant patient, Brennan immediately suffered lower back pain, a shooting pain down her leg, and urinary incontinence.

Since then, life for Brennan, now 47, has been a living hell. She has had back surgery and a discectomy infusion, as well as ongoing physical therapy, and takes pain medication daily. She also has quarterly epidurals and trigger point injections every six weeks. Her doctors have advised her to consider a second surgery because the interventions are not working.

“This one injury has devastated my life,” Brennan says. “Not only did I lose the job I loved most in the world, I’m in pain every single day of my life. It’s a horrible way to live.”

Nurses need lawmakers’ support

Brennan’s message for lawmakers considering safe patient handling legislation is simple: “We’re an older group of nurses – our average age is 47 or 48 years old –you must make it easier for nurses to do their jobs. Whether it’s ancillary personnel or equipment, we need to be guaranteed the assistance we deserve.”

The aging of the nursing workforce and the need to retain and recruit nurses is one reason NYSNA has championed safe patient handling legislation. Nurses are among those at highest risk of developing musculoskeletal disorders (MSDs), according to the U.S. Department of Labor. Patient handling tasks, which are often manual and repetitive, are the primary cause of MSDs. These tasks involve activities such as lifting, transferring, and repositioning patients – just the sort of activity that cost Brennan her career in the ER.

Research has determined that the impact of MSDs on the American nursing workforce is significant. More than half of RNs report chronic pain, 12%, leave the nursing profession because of back pain, and 38% suffer occupation-related back pain severe enough to require a leave of absence. Six percent of RNs change jobs due to neck injuries or problems, 8% due to shoulder problems, and 11% due to back problems.

Injuries ‘all too common’

“Hospitals are dangerous workplaces for registered nurses, and musculoskeletal disorders – sprains, strains, tears, carpal tunnel damage, even severe back injuries – are all too common on-the-job injuries,” wrote NYSNA members Ann Converso and Colleen Murphy in the December 2003 issue of RN magazine.

According to Converso and Murphy, thousands of RNs “work in hospitals where workplace safety issues are overlooked, where nurse-patient ratios are unsafe, where RN concerns and recommendations are ignored, and where RNs who sustain injury are blamed for failing to follow procedures. And they work in hospitals that too often attribute injuries to aging rather than years of cumulative, repetitive musculoskeletal stress.”

Improper patient handling can also have a negative impact on the quality of care, ranging from increased patient discomfort, fear, pain, shoulder injuries from manual lifting, hip fractures from being dropped, bruising of arms, and loss of dignity during the lift procedure.

Glens Falls Hospital implemented a “minimal lift” ergonomics program in January 2002. They have since reported that patient handling injury rates were cut in half and worker’s compensation costs decreased by 45%. Similar programs elsewhere report reduced worker injuries and a subsequent reduction in costs – worker’s compensation claims and replacement of displaced workers. It is also believed that such programs contribute to employee retention and recruitment.

Safe patient handling pays

“Safe patient lifting requires enough staff, the right mix of staff, and the patient lifting equipment for the unit and movement required,” state Converso and Murphy. “All staff must be trained on safe lifting procedures and use of lifting equipment. Most important of all, RNs in each unit who are familiar with patients and procedures must have a strong voice in determining the staffing, equipment, and training needed in their unit.”

As the nation’s population ages and obesity rates soar, a safe patient handling program becomes even more significant. Figures from a 1999 New York State Department of Health study indicate that over half of adult New Yorkers (54.1%) were overweight; about one in six was obese.

Because it pays to implement these programs, for both nurses and patients, NYSNA has proposed safe patient handling legislation (A7641/S4929). NYSNA supports the allocation of Health Care Reform Act (HCRA) funds to establish voluntary safe “best practice” patient handling programs throughout the state by providing seed money for the purchase of appropriate equipment at participating facilities.

The legislation would authorize a two-year demonstration project for safe patient handling programs implemented voluntarily by healthcare facilities in New York state. The results would build upon existing evidence-based data, with the ultimate goal of designing a “best practice” for safe patient handling throughout the state.

Assemblyman Richard Gottfried (D,WF-New York), chair of the Assembly Health Committee, and Senator George Maziarz (R,C-Monroe, Niagara, Orleans), chair of the Senate Labor Committee, have sponsored the legislation.

Call your legislators to ask them to co-sponsor and enact this vital legislation.