Kim wrote a recent post about why nurses leave the bedside. She referenced an article that talked about more of the same.
Sinus arrhythmia then wrote a response post about nurses and salary. Both the posts and the article are a very intriguing read.
But of all the reasons a nurse would leave the bedside, one of the biggest reasons must be injuries, and this was not mentioned anywhere at all. There are a few articles about injuries and nurses; feel free to get your facts and figures there.
I personally know of nurses who have had such severe shoulder and back injuries from caring for patients that they required months and months off of work and surgical intervention. I know of one nurse who was kicked in the head by a patient. She was not harmed in any serious way, thank goodness, but the potential was there.
There is also the concept of repetitive stress injury. This is where you perform the same action (pulling patients up in bed, assisting them to the bathroom, etc) again and again over years. Then one day, you’re pulling a patient up in bed, and wham! You pull a muscle in your back or sprain a ligament in your shoulder, even if you’d had no problem with those areas before. Even with practicing good body mechanics, you can still incur these types of injuries over time.
Consider a scenario: You are working in a critical care unit that is crazy busy. You have a 350 pound patient that stooled in the bed and needs to be cleaned up. This patient has horrible skin problems and laying in stool will really exacerbate those problems. Literally every other nurse is busy with issues just as important. The only person you can find to help you is 5 feet tall and might weigh 110 pounds after a large meal.
What do you do? It’s a horrible dilemma. You could try to turn the patient by yourselves, but you wouldn’t be acting in a safe manner at all. In order to practice good body mechanics, the person who would be turning the patient towards them should have the side rail down. 350 pounds is a lot of weight… get a tiny bit of momentum there and the patient could literally fall off the bed if the nurse/aide wasn’t able to keep them on it! Not to mention the fact that you’d be seriously risking your back by doing that.
Some nurses would actually attempt cleaning the patient with only one other person to help them. Some would let the patient lay in stool until enough personnel were available to help turn the patient safely. Both situations have major drawbacks.
What’s a nurse to do??
There are some solutions – lift teams, no-lift policies, and lifting equipment that can make moving patients easier. We have several pieces of equipment that help us move patients…. from bed to gurney, from bed to chair, from laying down to dangling. But I don’t know of any equipment that would help in the above scenario other than having at least 3 other human beings in the room with you to help move that patient. Yes, there are some beds that inflate/deflate in weird ways to make it easier to move the patient over, but sometimes you have to move them way over. And that takes manpower.
On a crazy busy unit, it can take a long time to find 3 other nurses/aides who are all free and can help you with something that could easily take 15-20 minutes.
So I know that nurses are leaving the bedside due to salary, lack of opportunities to advance, and even hostile work environments. But one should never forget what a physically demanding job it is to be a nurse. Some nurses leave the bedside and never come back because they have been injured just doing their jobs.