The act of caring for a sick or injured patient can be physically demanding. Our role as healthcare workers can sometimes put our own physical and mental health at risk. Nurses, nursing aides, physical therapists, and occupational therapists all work in professions that require bending, reaching, lifting, twisting, long periods of standing, and long periods of sitting while we document. Whether it is repositioning a patient in bed, demonstrating how to perform a correct squat, or bending over to untangle a patient’s lines or IV, these repetitive movements do increase the risk of work-related injuries in our given fields. Nurses can even walk up to 4 miles in a 12-hour shift taking care of their patients1. The average American only walks roughly 2 miles a day2.
In physical and occupational therapy, patient handling and manual treatments are associated with work related injuries. Therapists who help perform patient transfers for 6 to 10 patients during daily care had a 2.4 times higher risk of low back injury than therapists who did not. Therapists who perform manual treatments such as soft tissue work and joint mobilizations see an increase in injury rates to their wrists and hands3. Nurses encounter similar trends of work-related injuries. According to the U.S. Bureau of Labor and Statistics, 51% of injuries or illnesses to nurses resulted in sprains, strains, or tears in 20164. The bottom line is that medical and rehabilitation specialists can, and do, experience injuries on the job. These injuries take us out of our clinics and hospitals and away from our patients. Increases in work related injuries have broader impacts on healthcare in general. The more we are injured, the less we are able to help the ones who need us most.
So, what are we to do about this trend? Accept this as a normal hazard of working in healthcare? No. While you cannot limit the risk of injury completely, you can reduce the likelihood of it happening. There are several steps that can be taken to help mitigate work related injuries.
- One way to reduce the risk of injury on the job is to utilize the variety of equipment we may have at our places of work. Several healthcare settings have programs that limit the amount of lifting allowed such as “zero lift” or “minimal lift” protocols. The use of patient mechanical lifts, sit-stand lifts, ceiling lifts, and standing transfer frames greatly reduce the physical demand on the healthcare worker and can decrease the frequency and severity of injury. According to the Occupational Safety and Health Administration (OSHA), introducing safe patient handling programs that incorporate the use of lifts, equipment training, and specialized “lift teams” can diminish the number of injuries and days of work that are lost due to these injuries5. While at times it may seem easier and faster to perform a stand-pivot transfer from your patient’s chair to bed, using the equipment you have available can decrease your risk of injury. If you don’t know how to use the equipment or know where it is, be sure to ask. It may just save your back from future injury!
- While it may not be the first thing we want to do after a long day at work, finding the time to exercise can also decrease the risk of injury at work. Athletes train specifically for the sports they participate in. There are multiple studies that show that athletes who incorporate sport specific and functional activities to their training programs can decrease the risk of injury. Should healthcare workers train in a similar fashion? To some degree, yes. Working on mobility, strength, and endurance can improve your ability to do similar types of movements at work. If you must lift, pull, or push at work, try to lift, pull, and push while exercising. If you need to bend down frequently during patient care, work on your mobility as a part of your self-care. If you are required to be frequently on your feet, work on your endurance with low impact cardio activities. Remember, a body in motion stays in motion! Exercise not only plays a role in maintaining a more physically ready body for the demands of the workday, it has positive benefits on our mental health as well. Exercise has been shown to improve mood, decrease stress which increases our body’s cortisol levels, help manage weight, improve sleep, and improve mental alertness6. All around, exercise has multiple benefits that may help reduce the risk of injury while at work. Be sure to consult your physician before starting a new exercise routine.
- Lack of sleep can also impact our health as healthcare workers. Not having an adequate amount of sleep can increase our bodies risk for a variety of illnesses and injuries including heart disease and obesity. While we sleep, the body can recover and repair its tissues and cells7. Our patient care schedules often make it difficult to have a consistent wake and bedtime, especially in the outpatient settings. However, it is important that we are able to get 7 – 8 hours of sleep to allow our bodies to fully recover from the demands of our professions.
- The most optimal way to reduce the risk of injury at work is being proactive. Utilize the resources that are available in your setting such as patient lift devices. Exercise to improve the ability to perform your tasks safely and successfully. Get enough sleep to allow your body to fully recover. Being proactive should not just apply to our mental and physical health as healthcare workers. Having the appropriate liability or malpractice insurance already in place will reduce the risk of you or your clinic’s exposure if involved in a lawsuit. Ensure you are covered so you can focus on furthering your career as a healthcare worker. Learn more about professional liability insurance for physical therapy groups here.
Written By: Thomas Dyke, PT, DPT, OCS
- “Measuring How Far Nurses Walk.” Herman Miller, https://www.hermanmiller.com/content/dam/hermanmiller/documents/research_topics/Nurse_Walking.pdf.
- Rieck, Thom. “10,000 Steps a Day: Too Low? Too High?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 23 Mar. 2020, https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/10000-steps/art-20317391#:~:text=The%20average%20American%20walks%203%2C000,now%2C%20as%20your%20own%20baseline.
- Campo, Marc et al. “Work-related musculoskeletal disorders in physical therapists: a prospective cohort study with 1-year follow-up.” Physical therapy 88,5 (2008): 608-19. doi:10.2522/ptj.20070127
- “Occupational Injuries and Illnesses among Registered Nurses : Monthly Labor Review.” S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, https://www.bls.gov/opub/mlr/2018/article/occupational-injuries-and-illnesses-among-registered-nurses.htm.
- “Safe Patient Handling Programs: Effectiveness and Cost Savings.” Occupational Safety and Health Administration, https://www.osha.gov/sites/default/files/publications/OSHA3279.pdf.
- Sharma, Ashish et al. “Exercise for mental health.” Primary care companion to the Journal of clinical psychiatry 8,2 (2006): 106. doi:10.4088/pcc.v08n0208a
- “The Benefits of Slumber.” National Institutes of Health, U.S. Department of Health and Human Services, 4 Apr. 2018, https://newsinhealth.nih.gov/2013/04/benefits-slumber.