<< Back to Back Facts

Purpose: To learn how to identify job tasks and body movements you do every day on your job that might be hurting your back.


1. Working alone, fill out the checklists on page 32 and 33.

2. Working in your small group, make a list of at least five of the hardest job tasks or body movements you do as part of your job. Review factsheets #1-6 to see if you left anything out.

3. Make a list of three things your group learned from the factsheets that you didn't think about before.

4. Describe two ways that you will use these checklists in your workplace.


Job task risk factors

Use the following checklist to think about the tasks that you do during an average shift that could lead to a sprain or strain injury.

How many times a day do you do this task during an average shift?
1. Transferring a resident from toilet to chair ___________
2. Transferring a resident from chair to toilet ___________
3. Transferring a resident from chair to bed ___________
4. Transferring a resident from bed to chair ___________
5. Transferring a resident from bathtub to chair ___________
6. Transferring a resident from bathtub chairlift to chair ___________
7. Weighing a resident ___________
8. Lifting a resident up in bed ___________
9. Moving resident from side-to-side in bed ___________
10. Repositioning a resident in a geri chair, wheelchair or regular chair ___________
11. Changing "Attends" on a resident ___________
12. Making the bed with a resident in it  ___________
13. Undressing a resident ___________
14. Feeding a bedridden resident in an awkward sitting position ___________
15. Making a bed when the resident is not in the bed ___________
16. Lifting a resident to or from a Clinitron bed ___________
17. Lifting wet linens or laundry ___________
18. Lifting heavy trash bags ___________
19. Pushing and pulling heavy food carts ___________
Total number of stressful tasks per day: __________

Body movement risk factors

Use this checklist to help you understand what kinds of body movements and positions can lead to back injuries. Read each type of stressful body movement listed below. Think about how many rimes each day you have to do this activity.

Body Movement Seldom  
(One to three times per day)
(Four to ten times per day)
  Very often(eleven times or more per day)
1. Twist your body while lifting, carrying, or positioning a patient. __ __ __
2. Lift more than 50 pounds. __ __ __
3. Reach above your shoulders to get something. __ __ __
4. Pick up something weighing over 20 pounds from the floor. __ __ __
5. Grip tightly with your hands a belt, sheet or article of clothing in order  to pull, lift, or reposition a resident. __ __ __
6. Sit in an awkward position for more than 15 minutes. __ __ __
7. Stand still in an awkward position. __ __ __
8. Lift something that is more than one foot away from your body. __ __ __
9. Lift something that is more than one foot away from your body with a bent back. __ __ __
10. Transfer a combative resident. __ __ __
11. Lift something heavy above the height of your chest. __ __ __
12. Stoop or bend over to perform a job task. __ __ __
13. Lift using just one side of your body. __ __ __
14. Transfer a resident who cannot bear weight without the use of equipment or the help of a co-worker. __ __ __
15. Transfer a resident who cannot bear weight without the use of equipment but with the help of a co-worker. __ __ __

Fact Sheet 1

Bit by bit

Many back injuries happen bit by bit, even if there is no pain.

Stressful job tasks or body movements that can lead to injury are called risk factors.

Knowing how to find the risk factors is the first step toward preventing back injuries in nursing homes.

Here are some things you can do:
  • Watch your co-workers to see if they are doing physically stressful job tasks and movements. Think about how these stressful tasks and movements can be prevented.
  • Listen to co-workers talk about where they hurt and what tasks are hard to do.
  • Talk to your co-workers about how to prevent back injuries. Ask injured workers how they got hurt. Tell the health and safety committee about the hazards you see and how t hey can be prevented.
  • Use the checklists found in this activity to find out where the problems are on your job.
Fact Sheet 2

Twist and shout

Carrying or lifting weight while your back is twisted is very risky business. Your back was built to do its best work when in a straight, upright position. If your feet and shoulders are not pointed in the same direction, then you are twisting your back. Even if you are twisted a little bit, your back is at risk of getting injured.

Twisting puts an extra strain on muscles, ligaments, and discs. When you add the weight of lifting or the force of pushing or pulling, the shouting begins. For example:
  • Transferring a resident from a wheelchair to a toilet in cramped bathrooms.
  • Transferring a resident who suddenly moves, throwing you off balance.
  • Lifting a resident using only one arm and one side of your body (as when you and your co-worker bend toward the resident and lift the resident to a standing position).
Fact Sheet 3

Stressful body movements are common to nursing home work

Stooping Down Low to lift stresses every part of the body: back, neck, shoulder, and legs. For example:
  • Lifting residents who have fallen to the door.
  • Leaning and stooping to turn a stiff or broken bed crank.
Somewhere, Over The Shoulder
Lifting loads above the shoulder puts an extra level of force on your shoulders, arms, neck, and back. For example:
  • Lifting linens down from a high shelf.
  • Reaching above shoulder level for items you need.
So Far Away
It's much harder to lift residents or objects that are far away from your body. Your back has to work much harder when you lift with your arms stretched out. Lifting while stretching puts much more strain on the discs in your lower back. For example:
  • Transferring residents from a geri chair to bed, or from bed to a geri chair.
  • Making a bed with or without a resident in it.
  • Lifting a resident to and from a Clinitron bed.
Fact Sheet 4

The back stops here

Even with the best body posture, you can still get hurt. Close to half of all workers' compensation claims for back injuries are from lifting.22 Frequent lifting causes muscle fatigue, which also increases your chances of getting hurt.

Lifting heavy weights can hurt your back. For example:
  • Working alone to transfer a resident who cannot bear any weight.
  • Transferring a resident from the toilet to a wheelchair.
What a Drag
Pulling and dragging is very stressful on your shoulders and back. For example:
  • Lifting, pushing or pulling a gel mattress.
  • Pushing or pulling a medication cart.
Staying Put
Sitting and standing in awkward positions puts lots of strain on your muscles. This strain can cause fatigue and weakness, especially in your lower back. For example:
  • Feeding a bedridden resident.
  • Bathing a resident while in a bent position.
Fact Sheet 5

In a pinch

When you grip a sheet, belt, or piece of clothing very tightly in order to lift or pull a resident, a strain injury can occur. For example:
  • Repositioning a resident in a bed by pulling on the drawsheet.
  • Transferring a resident who is lying down by using a sheet as a sling.
  • Supporting an unsteady patient by grasping a gait belt without handles.
Studies have shown that comfortable handles reduce the amount of force needed to do the task. Less force means fewer injuries.

The Bulky and The Awkward
Strain and sprains can be caused by lifting objects that are too big, bulky or have uneven weight. For example:
  • Kitchen workers who have to lift large plexiglass table tops in order to clean the tables.
  • Carrying big bulky bags of trash to the dumpster.
  • Moving wheelchairs, chairs, and other equipment out of the way.
Fact Sheet 6

It's the law

OSHA (Occupational Safety and Health Administration) requires all nursing homes to keep a yearly log of every work related injury or illness among workers. If you have an injury that causes you to stay out of work, get medical care, or go on light duty, then you must be listed on this log. This is called the OSHA 200 log.

The information on the log must include:
  • Date, worker's name, job title and department.
  • A description of the injury.
  • Exact body part or parts that got hurt.
  • Number of lost work days.
  • Number of "light" or restricted duty days
You have the right to ask for and get a copy of the OSHA 200 log for your facility. It is best to make your request in writing. Ask to see the whole log and not just a summary. According to the law, your employer is required to annually post the OSHA log summary in a place where workers can see it. This summary must be posted no later than February 1 of each year.

The OSHA 200 log shows what kinds of injuries are most common in your nursing home. You will be able to see how much work time was lost and how many workers went on light duty last year.

Some joint safety and health committees keep a separate record of injuries at a facility m addition to the OSHA 200 log. See Activity 7 for more information about how your committee can find out who got hurt last year. You can also find out what kinds of injuries happen most often to your facility. Knowing this information will help you prevent injuries in the future.


On the lookout: Does your work make you hurt?

1. Risk factors are job tasks and body movements that can lead to injury. Finding the risk factors in your job is the first step toward preventing back injuries.

2. Back sprain and strain injuries happen bit by bit Many injuries do not happen all at once. The following job tasks have the biggest risks:
  • Twisting while lifting or carrying
  • Stooping down low to lift
  • Lifting or reaching above your shoulder
  • Lifting residents or objects far from your body
  • Lifting residents even with perfect posture
  • Frequent lifting without adequate rest between lifts
  • Pulling and dragging
  • Sitting or standing in one position for a long time
  • Lifting bulky or awkward objects
  • Lifting heavy residents or objects
3. Checklists are tools to help you identify the risk factors to your lob. Find out what the risk factors are and educate your co-workers.

4. The OSHA 200 log gives you information about the kinds of injuries that happen at your facility. Under the law, you have a right to see this information. OSHA 200 logs must be posted by February 1 each year.