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Purpose: To understand why nursing home work can be hazardous to your health.
You have just been to a training program on back injury prevention. You go back to your facility and a co-worker asks you what you learned. You tell her that nursing home work causes more injuries than construction or mining. She doesn't believe you. She says that younger workers aren't "tough" enough and that many workers are too careless these days.
Please answer the following questions. Refer to at least two factsheets in this chapter in your response.
Good news, bad news and back news
Caring for yourself helps you care better for your residents. You don't have to care until it hurts. Getting hurt is not part of the job. Our jobs can be safer. Unsafe jobs should be fixed before you find yourself out on your back.
The Bad News
Nursing home work can be dangerous work. What you do for a living may lead to more back injuries than working in construction, in a warehouse, or even a coal mine.1
In 1993, nearly 17 out of every 100 nursing home workers lost work time due to an illness or injury on the job. That's a total of 216,400 injuries and illness with untold pain and suffering.2 Only meat processing plants and car manufacturing plants had more injuries.
The number of back injuries mentioned here only count the reported injuries. The true number could be much higher. One study of nursing personnel showed that only one third of those workers who had back pain on the job filed and incident report.3 Most used their own sick time. Many workers are afraid they will lose their jobs if they report an incident. They simply can't afford to be sick.
The Back News
One out of every four injuries in general industry are due to back sprain and strain. Yet back and shoulder injuries are responsible for 54 percent - over half - of all injuries and illnesses among nursing assistants.4 While the number of back injuries is going down in manufacturing, the number has gone up among nursing assistants over the last 10 years.
Big, getting bigger, and growing fast
Nursing homes are the fastest-growing part of the health-care industry. People are living longer. The Census Bureau says that 40 years from now there will be 70 million over age 65. Nine million of them will be over age 85. That's three times as many people over age 85 as we have today.5 More old people means more nursing homes. That's plenty of new jobs for nursing assistants.
Sicker residents are entering nursing homes. Many hospitals are shortening the length of a hospital stay because of changes in medical procedures, lack of money, or lack of beds. Medicare also limits the number of hospital days that it will pay for.
Many elderly hospital patients are too sick to go home. But they can't afford to stay in a hospital with the expensive daily price tag. Nursing homes are the solution.
Some nursing home industry studies guess that 10 to 20 percent of acute-care hospital patients can be moved out of hospitals and into nursing homes which provide some of the care found in hospitals, but at a lower cost.6 This is called sub-acute care.
These sub-acute patients are becoming nursing home residents. This changes the kind and amount of work that will be done by nursing assistants in nursing homes.
Nursing home owners are excited. This new group of elderly residents is worth up to $10 billion in new money for the nursing home industry.7 But what does this mean for nursing assistants?
According to the Bureau of Labor Statistics, nearly 80 percent of all back and shoulder injuries are due to handling and transferring residents. In other words, nearly 80 percent of all back injuries are related to overexertion from lifting, pulling, pushing, holding, carrying, and turning motions.8
Altogether, more than 66,500 injuries that resulted in days away from work were reported among nursing assistants in 1992.9 In some cases, many days, weeks, or months were spent away from work. This lost time hurts:
Remember: Most injuries aren't reported. What we see is the tip of the iceberg. And what we're seeing is high enough.
Dropping like Flies
Nursing assistants do nearly all of the lifting, transferring, and heavy work in a nursing home. High staff turnover is a big problem in nursing homes. Many nursing assistants quit before their first year is up. A big turnover in nursing home staff means lots of problems for everyone.
When the staff turnover is high, patient care is affected. There are fewer experienced and well-trained staff. If not enough nursing assistants or equipment are available on a shift, workers tend to do the heavy lifting alone.
Why do nursing assistants quit?
In one year in Wisconsin, one out of three full-time nursing assistants had been at their present job less than a year.10 Wisconsin is just like other states. High turnover tells us what is really going on.
The stakes are high
Prevention of back injuries is smart business. Management can save lots of money.
1. Increased workers compensation costs
Solutions that work: Companies can save money
Nursing home operators who have started back injury programs have found these programs can prevent injuries and save money.
Can nursing home work be hazardous to your health?
1. The nursing home business is the fastest-growing part of the health-care industry. People are living longer. They are also being transferred out of hospitals more quickly. This means more sick and dependent residents will be entering nursing homes.
2. Nursing home work can lead to more back injuries than construction or mining. The number of sprain and strain injuries is skyrocketing. Most of these injuries are due to overexertion from lifting and transferring residents.
3. We only see the tip of the iceberg. The numbers of injuries are really
higher than the numbers show since many workers don't report injuries.
Instead they use their sick time, suffer quietly, or quit their jobs.
4. The turnover among nursing assistants is extremely high. Workers quit because of stressful working conditions. High turnover means short staffing, lifting alone and poor resident care.
5. Back injuries are costing nursing home owners a lot of money. Some injury prevention programs can save a lot of money. Preventing injuries is smart business. Everyone would benefit.