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A back injury from nursing can end your bedside nursing
career. I learned that the hard way last year and much
more about work injury that I wish I had known when
I started nursing. I have traveled down the lonely and
confusing road of workers compensation ever since.
I've only been a nurse for six years and today I am
retraining for another position in nursing. I have always
felt strong and capable enough to lift patients properly
to avoid injury. I remember always being the one to
tell my co-workers to slow down and use good technique.
I also know there are days that are so unbelievably
busy that I didn't even have time for a break.
One of those days became my "date of injury,"
words I would repeat a thousand times to the practitioners
I would meet after I strained my back.
It was a typically busy day. My feet groaned and whimpered
as the day wore on. I wasn't feeling well (first warning
sign) but couldn't go home because of short staffing.
At the end of my shift, I quickly changed and repositioned
a patient in a hurry (second warning sign) to finish
my day. All I remember is a minor strain in my back
while I lifted. The next morning, I couldn't straighten
to stand up because of the pain.
I reported my injury to my supervisor. After an injury,
even if it feels minor, it is important to report it
as soon as possible. This is for your benefit to begin
the proper care of an injury in order to heal quickly.
Another important reason is that a delay in reporting
brings into question whether you actually were hurt
on the job.
By the time I made it into Occupational Health that
morning, I felt silly for being there. The ibuprofen
was working and I seemed to have a minor strain in my
lower back. They never even took X-rays.
The doctor gave me weightlifting restrictions for work
and orders for physical therapy and ibuprofen. I would
soon discover that a nurse with any restrictions couldn't
work at my hospital. Many minor injuries lead to restrictions
for lifting or bending. If you examine your job description,
the physical duties listed for floor nurses are extensive,
even if you work in pediatrics.
Suddenly, a minor injury keeps you out of work.
The complications start if you are per diem. Because
per diems don't have benefits, you are out immediately
without sick pay. The government does not pay workers
compensation.
After your work injury, your case is handed to a risk
management company employed by your organization. The
office worker on the other side of the phone now has
the power to approve or deny your claim that your injury
was work-related. Legally, they do not have to decide
your case for up to 90 days. After those three months,
you may hire a lawyer and argue your case. Meanwhile,
you are out of work, without pay, and financing your
own recovery.
I was off work, without pay, for six weeks. This little
back strain was persistent and quite painful. Fortunately,
after being "disallowed, but temporarily"
until my claim could be approved, I was able to see
my regular doctor for treatment.
Meanwhile, my human resources department was confused
about what to tell a per diem nurse. First, I was told
to apply for disability through the state because per
diems don't have benefits. I applied, was denied and
was told that workers compensation cases were not paid
by the government. The medical treatment and lost wages
budget are managed by the risk management company deciding
your case and paid for by your employer.
The bottom line is to remember that if you are injured
at work, the human resources department should be the
people helping you. The government is not involved with
the process at this point.
If your HR department is confused like mine was, the
next step is your union. Do not underestimate the power
of your union. This is a good time to belong to one,
because they can make the internal phone calls and push
the paperwork forward for you.
A couple days after I called and cried to my union
representative after two months of frustration, my case
was approved and Ifinally received the coveted benefits
check.
During my initial diagnosis, I heard over and over
that back strain is common and chronic. OK, I said,
so just when is this pain going to end and when am I
going to get back to work? It's chronic; translation-nobody
knows. The frightening prospect of never healing looms
after months out of work without improvement.
I asked my favorite physical therapist a few questions
about her experience with work injury patients.
The most common back injury she sees is sprains and
strains. "Mostly repetitive injury from the use
of improper body mechanics. They don't know that the
injury builds up and all of a sudden the back gives
out," she said.
Another physical therapist once told me that most people
think that only one injury hurt them, but it usually
is a cumulative effect that will occur from poor muscle
tone and repeated abuse.
I now know that my injury shouldn't have been a surprise.
My job is physical and I had dropped out of exercising
for lack of time and effort. I had assumed over the
years that if I wasn't injured from my technique by
then, I was doing it correctly. In fact, I was slowly
injuring myself with my daily duties of lifting, rotating
and walking from room to room. My drop in muscle tone
most likely precipitated the inevitable.
If I had taken the time to strengthen my lower back
and abdominal muscles before my injury, I would be in
good physical shape by now, instead of just attempting
to work toward daily functionality.
Some organizations will allow an RN with physical limitations
to continue working. Because my hospital couldn't accommodate
me, I was introduced to a vocational rehabilitation
counselor.
After your injury has been decided by your doctor as
"permanent and stationary," (P&S in rehab
lingo), your wages will be immediately ended and your
company has 30 days to offer you another position within
the company, given certain conditions mandated by law
such as pay scale.
Unfortunately, nurses with injuries are so common that
generally there aren't any positions that satisfy your
wage and skill standard, according to my vocational
rehab counselor.
If there is no position for you, vocational rehab is
the next step. Basically, you may choose any training
that you wish to have paid for by workers compensation
within a mandated price range while being starved out
on a monthly stipend.
The saying "left out in the cold" seems appropriate
here. Just how many desk jobs are out there for non-BSN
nurses who make even close to the same wage as hospital
nursing?
Like me, I think a lot of RNs don't have an equivalent
position to fall back on. I am afraid the nursing shortage
will further stress even more nurses into injury than
before. The best solution for injury is to avoid it
at all costs.
Incorporate abdominal, pelvic and back strengthening
exercises into your daily routine. Buy disability insurance,
finish your BSN and recruit new nurses.
Your precious back depends on it.
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