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Purpose: To understand how a written plan can help injured workers get better and get back to work.

Task:

Pat is a nursing assistant. She hurt her back last week when she transferred a resident from the geri chair to the bed. She filed an incident report and rested for a few days. When she returned to her night shift job, she was put on "light duty." Pat's doctor told her not to do any heavy lifting.

There were 46 residents on her floor and just two other nursing assistants. Pat didn't want to burden her coworkers. When Mr. Brown asked for help to get to the bathroom, she said okay because Mr. Brown can walk with assurance. Mr. Brown slipped. Pat caught him. Pat is now flat on her back.

1. Why did Pat help Mr. Brown when she knew she was on light duty?

2. What could Pat's employer do to make sure that this doesn't happen again? Look at factsheets #3, 4, and 5 to help you answer this question.

3. You are on the labor management safety and health committee. The committee is reviewing a program that will help injured workers get better and get back to work. Make a list of six things that should be in this plan. Look at factsheets #6, 7, and 8 and the checklist on p. 73 to help you answer this question.

Fact Sheet 1

You bring home more than a paycheck

Back injuries often happen bit by bit, ether than all at once. If you have any signs of a strain or sprain injury,
  • Report it!
  • Get medical help!
  • Fix the unsafe job!
We all know how it goes.

You don't report the first signs of injury. You don't want to dump extra work on your co-workers and friends. Maybe you're afraid of losing your job. Then you get put onto light duty. But there is always so much heavy work to do. You feel pressured to do your regular job. You're back to lifting and transferring residents. You get hurt again, this time worse. You're out again, and money is tight. Now you're really afraid you'll lose your job.

Let's break this cycle!

Fact Sheet 2

Ouch!

Don't turn your back on these body sensations that may be a sign of a back sprain or strain injury. If you feel any of these symptoms, pay close attention:
  • Aching
  • Sharp pain
  • Dull pain
  • Pain that comes and goes
  • Hot, inflamed feeling
  • Tingling
  • Unusual tightness
  • Unusual muscle weakness or fatigue
Listen to your body. Your body tells the truth.

Fact Sheet 3

Document everything

If you have any signs of an injury, file a report with your employer. Make sure your injury is documented. Keep a copy for yourself. Make sure your health and safety committee knows about your injury.

Record and report every incident that results in back pain. This is very important information for two reasons:
  • For investigating hazards in your workplace.
  • In case you need to file for workers' compensation or disability.
Your injury is not just your problem. You are not alone. Other workers are probably hurting too.

Keeping track gives us important information that we need to make changes on the job.

Speaking out helps all of us make nursing homes safer to work in.

Fix the unsafe job. Good medical care won't make you better unless changes are made in your workplace. Your doctor can't fix your job. You, your co-workers, your union, and your management, together, can fix your job.

Don't Wait: Get Help

If you have signs of any injury, get medical help immediately!

Three good reasons why you should get help right away:
  • To get proof that your job may have contributed to your injury.
  • To get better and learn how to stay better.
  • To find out what conditions may have led to your injury.
Report the symptoms to your employer as soon as you feel them. Early reporting may:
  • Prevent you from getting seriously hurt.
  • Prevent you from ruining your back and ruining your life.
  • Prevent you from needing workers' compensation.
  • Prevent other workers from getting hurt.
Fact Sheet 4

Trip to the doctor

The doctor can help you find out which part of your body was strained, sprained, damaged or injured.

Educate Your Doctor

The medical treatment you will get depends on what's wrong and what's causing the pain.

Tell your doctor all about your job. Explain the tasks that you must do on your job. Make sure the doctor knows:
  • How long you have been working as a nursing assistant.
  • The kind of lifting, bending and twisting you do every day.
  • How much weight you are lifting every day.
  • Which job tasks cause pain and discomfort.
  • What kinds of body movement cause pain.
Some states require that you see the company doctor first. If so, go see your own doctor as well.

Fact Sheet 5

Light and Lively?

When a doctor at your facility puts you on "light duty," you may have the following restrictions:
  • No heavy lifting (above 25 pounds)
  • No lifting while twisting
  • No lifting while bending forward
  • No lifting while reaching
  • No sitting for long periods of time.
Light duty means that you are not expected to do your regular tasks. Light duty tasks can include: doing closet checks, passing ice, manicuring nails, doing simple office casks, and sometimes feeding residents.

The average nursing home resident weighs 136 pounds. Light duty restrictions often mean extras staff will be needed to do the heavy work.

Returning to work soon is a good thing. A long recovery process can be lonely, isolating, and put extra burdens on your family members. Returning to work benefice everyone. But it has to be safe.

Make sure your light-duty restrictions aren't violated. Your recovery matters too much. Preventing a permanent disability is the most important thing you can do. Be clear about the tasks you are not able to do. If you are already injured, you can't take those kinds of chances. If no one is there to replace you, contact your supervisor or your union right away.

Disabled people have the right to work. The Americans with Disabilities Act (ADA) says that your employer has to provide disabled workers with a "reasonable accommodation." This means your employer has a responsibility to make changes in your job to help you perform it adequately. This could mean providing lifting equipment or more staff to assist with a resident transfer. You will need to find out if your injury counts as a "disability." If you are disabled but can still do certain job tasks, you may be able to get an accommodation from your employer. To find out more information about the ADA, contact the Equal Employment Opportunity Commission (EEOC) or your union representative.
Fact Sheet 6

Make a new plan, Stan

Every nursing home operator should have a plan for handling injuries after they happen. This is called a medical management plan. A medical management plan helps you get better as fast as possible. It also helps you return to work safely while continuing to earn your full paycheck. Everyone benefits: you, residents, and your employer. Everyone saves money. It makes sense!

The Pieces Of The Plan

Medical management is a program for getting care, medical treatment, and follow-up to any worker who is injured. It's a way to help you get better, stay better and get back to work sooner. Medical management starts with the "responsible person."

A responsible person is someone from management who is in charge of staying on top of the whole program. Management should pick someone who knows how to prevent back injuries in nursing homes.

Your employer should:
  • Encourage every worker to report the first signs of back pain.
  • Make sure injured workers are seen by an experienced health-care provider.
  • File an injury report right away and keep track of all injuries at your facility.
  • Make sure workers' compensation forms are filled out right.
  • Stay in touch with every injured worker while they're getting better, at home or on the job.
  • Make sure light-duty restrictions aren't violated.
  • Make sure unsafe job tasks are fixed.
Trained health-care providers should be available to work with you. They should understand how to prevent injuries caused by your job.

Everyone Benefits

Everyone benefits firm a medical management plan. Your employer's workers' compensation insurance costs are lower. Management benefits from less staff turnover. Residents get better quality care. Everything runs better with more experienced staff on board.
Fact Sheet 7

Don't wait for workers' comp: It could be too late

Workers' compensation may provide benefits to you if you become permanently or temporarily disabled from your job. Workers' compensation is "no-fault" insurance. This means that you can't sue your employer if you receive money and benefits from workers' compensation.

Workers' compensation laws are different in each state. Some states have strict guidelines. There is a lot of paperwork, but the effort is worth it. You need to educate yourself about your rights and the benefits that might be available to you. Ask your employer or your union for help filling out the forms.

Workers' compensation benefits may include:
  • Part of your salary
  • All medical expenses paid
  • Money back for the cost of traveling to the doctor or hospital
  • Sick leave time back (if that time was used because of a job-related injury).
It's against the law to be fired or discriminated against because you got hurt on the job and filed for workers' compensation. Under the law, you cannot be harassed for using your rights. Don't grin and bear it. Don't avoid getting treatment. The longer you wait, the worse off you could be.

Start The Ball Rolling

Before you file a workers' compensation claim:
  • See your doctor. In some states, you have to see your employer's doctor first. Go see your own doctor, too. Make sure your doctor understands what kind of work you do.
  • Let your employer know in writing that you have a work-related
    injury.
Fact Sheet 8

Getting better all the time: Healing your back injury

Your doctor will need to take a medical history and give you a physical exam. Be sure to explain your back symptoms, including when they began and which activities make the pain better or worse. Again, tell your doctor about the job tasks and body movements that are part of your job.

What your doctor prescribes depends on what's wrong. Here is the most updated opinion on sprains and strains from the medical world:
  • Don't do any job task or body movement that causes discomfort or pain. If you continue doing them, your body won't be able to heal and your symptoms might get worse.
  • Some injuries require cold packs, others need heat. Sometimes both heat and cold are recommended.
  • Sometimes doctors prescribe medications that reduce the amount of pain and inflammation (the hot, swollen feeling). These drugs don't cure the problem. They just reduce the pain and discomfort.
  • Bed rest is rarely prescribed. For most injuries it is better to move around in ways that don't make the pain worse. Walking and riding a stationary bike are good exercises. Ask your doctor about exercises that will improve strength and muscle tone in your back.
  • Some people benefit from chiropractic and other care. Ask your doctor.
  • Surgery is tricky business. If your doctor recommends surgery right away, get a second opinion. Surgery is a last resort. It often fails to provide lasting relief and can cause other serious problems.
  • Some workers can return to work quickly with light-duty restrictions. A good medical management policy will make sure light-duty restrictions are safe and not violated.

CHECKLIST

Medical management plan

Does your medical management plan include the following? Yes No
 
1. The name of the management person responsible for the policy. __ __
 
2. A system for recording all injuries that occur in your family. __ __
 
3. Training that encourages you to report the first signs of back pain, sprain or strain. __ __
 
4. The name of the person to whom you report an injury or any symptoms of back pain. __ __
  
5. A system to provide every worker with a written copy of the medical management plan. __ __
  
6. A written light-duty policy in your facility. __ __
 
7. A responsible person appointed by management who checks in with you to make sure your light-duty restrictions are not violated. __ __
 
8. A responsible person appointed by management who follows up with you to make sure you are getting better. __ __


Summary

If you are hurt on the job

1. Keep track of everything. Report all incidents of pain, numbness, tingling, and aching to your employer. These records are very important.

2. See a doctor right away at the first signs of back injury, strains, or sprains. The longer you wait, the more damage can occur. Tell your doctor about your job. Explain the tasks and activities you must do on a regular basis.

3. Light-duty means no heavy lifting, or lifting while twisting, bending, or reaching. Be clear about the tasks you are unable to do. Make sure your doctor provides dear instructions about the tasks that you are unable to do.

4. If you are hurt on the job, you have a right to workers' compensation. It is against the law to discriminate against you because you got hurt on the job. Find out the laws and deadlines in your state and make sure you file on time.

5. With a medical management plan, workers get help as soon as the first signs of back injury begin. Workers stay healthier and productive. Residents get better care. Management saves money. Everyone benefits.

6. Find out how to care for your injury. In most cases, some movement is better than bed rest. Surgery is a last resort. Your best bet is a medical management program that helps you return to work safely.