Taking a toll: Back pain sidelines nurses daily

Debilitating injuries could be prevented

[Editor’s note: Every day, 150 health care workers suffer musculoskeletal disorders (MSDs) that cause them to lose time from work. Countless more end their shifts with aching backs, shoulders, or necks. In hospitals, overexertion in lifting is the most common cause of lost-workday injuries. Here is the story of a nurse who suffered a debilitating injury — and the steps she says could be taken to prevent others from a similar fate.]

Anne Hudson of Coos Bay, OR, was walking across her kitchen when she suddenly felt a surge of incapacitating pain. She could barely move. Ten years of lifting patients without mechanical aids had led to cumulative trauma injury to two lumbar disks. As she stood immobilized in her kitchen, Hudson didn’t know about the condition of her back. She kept thinking the pain would go away and she would be able to return to work on her weekend shift that Saturday. Her most immediate concern was finding temporary relief from pain. "I couldn’t sit; I couldn’t lie down; I couldn’t get in a car to go to the doctor," says Hudson, who is now 54. "I didn’t recognize my pain as severe muscle spasms in response to spinal injury. All I knew was that I had pain like I had never experienced before. A deep severe ache and intense burning settled into my lower back, and I had pain and burning into my lower legs and sometimes into my feet."

The pain lessened at times, enabling Hudson to at least lie down and rest. But she was in no condition to return to the hospital that Saturday, where she worked as a floor nurse in the medical/surgical, telemetry, and intermediate care units. Hudson began back therapy with the same mantra in her head: "This will pass, and I will be better." She couldn’t imagine life without nursing, without caring for patients.

But her career as a floor nurse already was over. While Hudson visited physical therapists, orthopedic doctors, and neurologists, and tried anti-inflammatories, heat and cold treatments, and pain medications, she faced a struggle over workers’ compensation. At first, she was allowed to work in limited-duty jobs that used her nursing skills. That avenue shut down when workers’ compensation denied her claim. Hudson convinced one of her physicians to give her a work release, as long as she wore a back brace. That lasted three weeks — until she helped care for and reposition a 400-pound patient. She realized she could no longer handle the lifting and transfer tasks.

A workers’ compensation judge and the workers’ compensation board ruled that Hudson’s injury was work-related. The hospital continued to appeal. Meanwhile, Hudson was allowed only two 90-day periods of light duty. There were no permanent accommodations for a floor nurse who could lift no more than 20 pounds.

Today, Hudson works for the county health department, a job she enjoys but one that pays significantly less. Workers’ compensation payments, which brought her income up to two-thirds of her wage at injury, stopped at claim closure. Still, Hudson is very grateful to be working as a public health nurse. "Many back-injured nurses never work as nurses again. Either they are too severely injured to work or they are unable to find an employer willing to accept an injured nurse."

A chiropractor helped ease her pain, and a neurosurgeon fused two of the disks, giving her relief from some of the most intense pain. But not a day goes by without a deep aching in her back. Hudson can no longer work in the garden. Doing laundry or grocery shopping brings pangs of pain. She rarely enjoys a night of sound sleep. But for Hudson, there is another pain that is not physical. She has become an unwitting expert on the ergonomic hazards of manual patient handling and MSDs among nurses, and she now knows that a zero-lift policy and proper lifting equipment could have saved her career and her back. She also stresses it is unethical for hospitals to deny permanent light duty to injured nurses after not providing safe patient lift equipment and policies to protect them from lifting injuries. 

Hudson formed WING USA (Work-Injured Nurses’ Group USA), an advocacy organization patterned after similar organizations in the United Kingdom and Australia. Hudson also has co-edited a book with health and safety expert William Charney, which includes the personal stories of injured nurses as well as technical information on ergonomics and safe patient handling. Hudson is working on state initiatives for Zero Manual Lift for Healthcare legislation and promotes industry-specific ergonomic solutions that could spare other nurses from a similar fate. "Their careers, their finances, their lives are being impacted by a preventable injury," she says. "It’s devastating."

[Editor’s note: The book — Back Injury Among Healthcare Workers: Causes, Solutions, and Impacts — edited by William Charney and Anne Hudson, is available from CRC Press Catalog No. L1631. Price: $79.95. Phone: (800) 272-7737. Web: www.crcpress.com.]