Back-injured nurse tells her painful story

Job loss compounded physical pain

Being a nurse is all that Rebecca Rhoads, RN, BSN, CLNC, ever wanted to be. She loved working at the bedside. And that is where she'd be today — if she hadn't suffered a debilitating back injury.

"I look at young nurses, and I say 'Protect yourself. Be proactive to protect yourself. Use the lifts. Know that injuries happen and happen very frequently in nursing,'" says Rhoads. At 54, she lives on a 200-acre farm in Cedar, MI, takes pain medication every day, and has taken up painting as an avocation. She shared her story with Hospital Employee Health to provide the perspective of a back-injured nurse.

Her hospital, Munson Medical Center in Traverse City, MI, declined to comment on the specifics of her case because of privacy concerns. But Munson administrators discussed the hospital's program to prevent back injuries and help injured nurses return to work. "We do value our people very much," says Jan Lyon, OTR, manager of the hospital's return-to-work program.

While hospitals around the country are in varying stages of implementing safe patient handling practices, each serious injury leaves an impact on a nurse's life. Some are able to return to work if the hospital has lift equipment and a minimal-lift policy. Others suffer from chronic pain and restrictions that force them to leave the field.

Injured nurses have found a forum in WING USA (Work Injured Nurses Group), where they post their stories online. They describe lifting, repositioning or transporting patients weighing as much as 500 pounds without mechanical devices. They tell of collapsed discs, multiple surgeries, paralysis and constant pain.

Anne Hudson, RN, a back-injured nurse from Coos Bay, OR, who lost her job because of her lift restrictions, founded WING USA to raise awareness and advocate for safe patient handling. Hudson suffered cumulative trauma disc injury to her back from years of lifting patients. "I've talked with nurses that still are unaware of the equipment that's available, nurses who still have not heard of the phrase 'safe patient handling,'" she says.

One pull on the draw sheet

Rhoads' back problems actually began when she was still a student nurse. She developed a herniated disc after moving a patient and needed back surgery to decompress the disc. The surgery was successful, and she was cleared to work with no restrictions. But she knew she would always need to be protective of her back. She thought good body mechanics would protect her.

Rhoads remembers using a scale with a sling as a makeshift lift. When she and her fellow nurses would place bedridden patients in the sling to weigh, they would quickly make the bed and reposition the patient.

But one day, she was working in radiology when she reached across the exam table to transfer an elderly woman using a draw sheet. "She kind of pulled her body up toward her right side. I was on the left side. It set me a little off balance," says Rhoads. "Immediately, I could feel it down my leg and back."

Feeling their pain: Back-injured RNs tell their stories

On an online "Read Other Stories" page at www.wingusa.org, back-injured nurses tell their stories of enduring pain, surgeries, and job loss. Here are some excerpts:

"I would have never dreamed that one day I would go to work and face the possibility of never walking or feeling the ground below my feet again. To this day, I cannot feel my hands or the lower one-half of my body and I catheterize myself six to eight times a day. My career is over since I cannot lift more than 10 pounds."

"At the time of my injury, I had been a critical care nurse for 17 years. About every three years there would be the 'minor' back strain event, with the necessary paperwork filed, and a day off to recuperate. But on that fateful night came the straw that broke the camel's back. That night, I transported an elderly patient for a chest x-ray who was about 4'10", around 250 lbs., and, unknown to me, had a collapsible hip (replacement in the past). When the radiology tech and I helped the patient to stand for the x-ray, the leg collapsed and the patient dropped like a rock. She grabbed my shoulder on the way down and the rest is history."

"My brain is fine; it's my back that's not. And, at 52, I feel like I'm just too young to give up on life because I can't walk or stand."

"No wonder there's a nursing shortage. If we're not injured, we don't want to [become injured] and so leave the field."

"I broke seven discs in my back and five in my neck. Four surgeries and four years later I am permanently disabled... It is a shame that when you are really given a calling to this field of nursing, and you give so much, you never realize that you can lose so much, too. I used proper body mechanics, but a body is only capable of doing so much before it gives up. Today, I spend my time watching nursing programs instead of being able to do what I loved the best."

She felt a surge of pain in her back and down her right leg to her ankle, and her foot went numb. Each time she put on a lead apron, she felt pain. "I still didn't want to report the injury, until two days later my co-worker said, 'You have to report this injury.'"

Repeated heavy lifting had placed stress on Rhoads' spine, and but she wasn't aware of the cumulative trauma until that acute injury.

"There was nothing remarkable about the patient transfer that ultimately led to the end of my career, but only that the disc was ready to give way," she says. "I spent the next six months telling myself it was going to go away and I didn't need any help. Finally, my personal physician told me I needed to see the occupational health physician because I was still having problems."

That began a years-long saga of pain and medical interventions. She says the hospital's occupational health physician sent her to physical therapy and back school, then back to work with restrictions. She couldn't wear the heavy lead aprons of radiology. When she went off restrictions, and put the lead aprons back on, the pain began to increase again.

She used ice and over-the-counter anti-inflammatories and tried to keep working. Although Jan Lyons at Munson stresses that "immediately we start to look at what work possibilities are out there for [injured nurses]," Rhoads says she knew of injured nurses who "disappeared" and never returned to the hospital. Rhoads feared that her injury would cause her to be forced out of her job. "I was scared to death," she says. "I wanted to protect my job. I didn't want to lose my job."

Finally, Rhoads needed back surgery. She found herself in a battle with the hospital over workers' compensation coverage and whether the back injury was work-related. The surgery wasn't successful and she needed another surgery. She went through physical therapy and was cleared to return with restrictions.

Just when Rhoads was preparing to return to work, she says she learned that her job had been posted. She applied for at least six other jobs, trying to find an appropriate spot, but she was unsuccessful. "I did everything I possibly could," she said.

Rhoads won her workers' compensation case in 2003, and the hospital dropped its appeal and signed a voluntary agreement in 2007. She also sued for wrongful termination and disability discrimination. The hospital settled this fall, and did not acknowledge any wrongdoing. As a condition, Rhoads is not allowed to reapply for any jobs there in the future.

Rhoads joined WING USA and tells her story in the hope of making the workplace safer for nurses so they can stay by the patient's bedside, where they belong.