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Nurses are considered to be the most crucial component in
the delivery of primary care within any public or private healthcare setting.
Throughout this environment, regardless of the availability of several types of
lifting equipment, the nurse’s role will generally include manually lifting or
assisting in movement of patients as a major portion of regular healthcare
activities, such as bed to chair transfer or mobilizing.
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However, the nurse’s constant participation in these type of
tasks frequently leads to a considerable increase of back complications, back
injury, or back pain in comparison with other occupational groups. In fact,
nurses and other healthcare workers are considered to show the highest prevalence
of lower back pain and back problems needing medical or hospital intervention
among the high risk groups for occupational low back pain. Registered nurses
rank seventh while nursing aides and orderlies are the highest ranked among all
occupations for back injuries associated with work absences.
A study conducted in an acute care facility in Hong Kong to
determine the occurrence of back pain in nurses reported that 80.9% of the
participating individuals suffered from some form of back pain throughout their
careers with one third of them experiencing back pain at least once a month.
The study also concluded that the contributing factors for back injuries among
those nurses were caused from lifting and transferring patients, where stooping
was recognized at the most common factor contributing to back complications.
Most diagnosed cases of back pain were reported on orthopedic wards, closely
followed by elderly or geriatric nursing. According to the study, back pain as
a result of standing for extended periods of time was not considered
significant.
Another study conducted to determine the impact of back pain
in nurses concluded that depression is associated with chronic low back pain
and other symptoms which could exhibit as low morale and lower job performance
among nurses. Additionally, the study also showed that two thirds of the nurse
sample population suffered from back pain more than twice a year.
The physical size, build, and gender of the nurse were
considered to be contributing factors to the occurrence of back complications in
the study, especially where lifting assistance, either mechanical or by support
staff, was not needed. Other determined factors that could possibly lead to an
increased risk of developing back complications in nurses included, exposure to
great amounts of physical loading on the back from lifting tasks, poor posture
or abnormal twisting of the torso during mobilization tasks, improper lifting
techniques, insufficient back pain prevention training or education, and
physiological characteristics or psychosocial factors in nurses. The results of
one cross sectional study while evaluating back complications in nurses
demonstrated statistically that back pain was twice as high in female nurses (68%),
than in male nurses.
Nursing qualifications are ultimately essential in
healthcare settings where nursing assistants have shown a heightened risk of
developing back pain as compared to registered nurses. Evidence indicates that
experience or length of service in nursing may also be a contributing factor,
with studies concluding that younger nurses are at greatest risk of developing
low back pain. Although lumbar back pain in nurses is frequently diagnosed, it
is not yet clear over what period a nurse may experience lower back
complications. A study conducted in Western Australia sought to identify the
relationship between age and occupational exposure on the prevalence of low
back pain in both nursing students and graduates.
Ultimately, the study demonstrated that the increase in the
occupational exposure from student to working nurse was the primary cause of
the heightened chance for nurses developing low back complications.
By Dr. Alex Jimenez
