Nurse Theresa Brown Has Got Your Back

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Nurse Theresa BrownTheresa Brown is a clinical nurse who tells it like it is. She’s the author of “Critical Care: A New Nurse Faces Death, Life, and Everything in Between” and a columnist for The New York Times. Brown gives voice to issues that resonate with nurses. And one of these subjects is the prevalence of on-the-job injuries.

Nurses have more than 35,000 back and related injuries each year. Moving and lifting patients is the No. 1 reason nurses get injured, according to a recent NPR story. And even if they don’t miss work, 80 percent of nurses report working with pain.

Brown says a nurse friend of hers recently had back surgery, and her first preceptor had to quit work because of a back injury. “People say this like you would talk about a football player — like it’s an accepted part of the job. But to me it’s just unacceptable,” she says.

What’s more common is someone gets injured but continues to work. Brown says she and her co-workers accommodated a peer who had a foot injury. But she laments that her co-worker would have healed quicker if she could have stayed home and rested.

A joke from the television show “Nurse Jackie” is “What do you call a nurse with a bad back?” “Unemployed.” Brown says this line illustrates just how much nurses worry about getting injured on the job.

People say this like you would talk about a football player — like it’s an accepted part of the job. But to me it’s just unacceptable.

Brown says she hadn’t realized how physically able you need to be in order to be a nurse. And the job doesn’t do much to guarantee safety. “I’ve seen doctors in crutches or in wheelchairs, but that can’t happen if you’re a bedside nurse,” she says.

So what changes does Brown recommend to improve the situation?

More staff available

“The main thing is having enough people on the floor,” she says.  “As patients get heavier, I don’t think they realize what that means for us.”  Some hospitals even have dedicated teams to handle patient lifting and moving.

If dedicated lift teams aren’t workable, then Brown suggests a shift in mindset. She says assisting a patient needs to be perceived as everyone’s work, including doctors. Many hospitals already have the policy of “all hands on deck” to respond to a call light. “You’ve got these bodies on the floor and there are people who could help, so why not ask them to help?” she says.

Increased safety awareness

Hospital administrators should make injury prevention a higher priority. Just as factories have signs with safety awareness, hospitals could do the same. Something like, “Our last back injury was X number of days ago.” This increased visibility gives everyone a goal to work toward.

You’ve got these bodies on the floor and there are people who could help, so why not ask them to help?

Greater accountability of hospitals

Instead of asking nurses to report their injuries, hospitals should have to answer to an external agency. “If you make a rule and put penalties on them, hospitals will comply,” says Brown. She cites Medicare’s no-payment rule for patients readmitted within 30 days as an example. The key is to have the reporting managed by an outside agency and to have financial consequences.

Brown recently transitioned to doing home hospice work, which is less back straining.  “People at the end of their lives weigh less,” she says, “and there are family members available to help.”

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