Does your job give you a pain in the neck? How about one in the back? If so, you're not alone. Nurses, aides and orderlies in hospitals and nursing homes are injured on the job more often than any other type of worker, including those in seemingly dangerous occupations such as trucking and construction.

One out of 10 serious work-related back injuries involves nursing personnel, and about 12 percent of nurses leave the profession because of back injuries. Workers compensation costs for back injuries among health care workers are an estimated $1.7 billion annually.

These statistics would not surprise Robin Bunch, RN, who seriously injured her back during an emergency situation, pushing a bed locked in the low position; or Kathy Jones, RN, who suffered two fractured discs struggling with a confused patient; or Nancy Schwab-Ketner, RN, who herniated a disc while helping to pull up a 300-pound patient in bed. These nurses had to leave hands-on patient care behind them.

"Nurses are most likely to suffer a back injury where there are unpredictable responses from patients during ambulation or transfer, situations in which patients require constant lifting and turning, and in situations that require awkward positions while moving patients," said Kathleen McAndrew, MSN, NP, member of the Board of Directors of the American Association of Occupational Health Nurses.

"These areas include intensive care units, operating rooms, post-anesthesia recovery, orthopedic and rehabilitation units and convalescent homes," she said.

Easy does it
Some back injuries are preventable. "A nurse can avoid injury by taking precautions," said Mary Rodts, MS, RN, an expert on the spine and editor of the National Association of Orthopaedic Nurses' journal, Orthopaedic Nursing.

"Prior to moving patients, assess the situation for possible hazards. What activity needs to be done-transfer or ambulation? Determine the ability of the patient to help, and consider the patient's size. Use good body mechanics, use assistive aids such as draw sheets, and always seek help from other team members, for your safety and the safety of the patient."

A number of devices are designed to help move patients, including hydraulic lifts, sliding boards, patient belts, and chairs and gurneys that adjust to different positions. One mechanism is designed with tracks mounted on the ceiling of a patient's room. The patient wears a harness and can be lifted anywhere in the room.

Some hospitals use lift teams-a group of trained individuals that moves throughout the facility and performs most of the lifting.

Working together
"Nurses can develop interdisciplinary committees with representatives from high-risk positions to review accident and injury reports. Committee members can make recommendations about safety equipment and facility design, which can impact employee health and safety," McAndrew said.

"Hospitals can do a lot to help prevent back injuries," said Deborah Lechner, MS, PT, president of the American Physical Therapy Association's special interest group on occupational health.

"Staff must understand principles of safe lifting, and there must be enough people to do it correctly. Most importantly, hospitals need to develop a culture that considers it important to protect the backs of staff," she said.

Know your rights
When back injuries do occur, be sure to seek early treatment. "There's a trend away from using narcotics and bed rest to treat back injuries," Lechner said.

"The preferred method is to use anti-inflammatory medications while maintaining normal activity as much as possible. Early intervention with physical therapy has been shown to decrease the likelihood of permanent dysfunction and to increase the number of people who can return to work," Lechner said.

Some nurses may be reluctant to report a back injury. The helper may find it difficult to ask for help; nurses may continue to work even with significant pain.

Also, damage to the back can be cumulative-a relatively minor event at work or home may be the final trigger for a serious injury.

Injured nurses Bunch and Jones have this final advice: Know your benefits and rights, document everything and consult an attorney if a work-related injury occurs.