Capitol Hill press conference, June 22, 1999
Statement of Beth Piknick, RN for theAmerican Nurses Association,

Why ANA Supports an Ergonomic Standard

Good afternoon. I am Beth Piknick, a registered nurse and a member of the Massachusetts Nurses Association. I am here today to voice the American Nurses Association’s strong support for an OHSA ergonomic standard. I also am here today because my 21-year career as an intensive care unit nurse was cut short due to a preventable back injury.

In all industries combined, 8.5 out of 100 workers reported non-fatal occupational injuries and illnesses. However, nearly 12 out of 100 nurses in hospitals reported work-related injuries, and 17.3 out of 100 nurses working in nursing homes reported injuries -- double the rate for all industries combined. The vast majority of these nurse injuries are back injuries.

Back injuries are mainly caused by lifting unreasonable loads. Ninety-eight percent of the time, nurses lift patients manually. For nurses, the most stressful tasks involve the transferring of patients -- from a bed to a chair and, more so, returning to bed.

The National Institute of Occupational Safety and Health says that a 51-pound stable object with handles is the maximum amount anyone should routinely lift. Our patients are unpredictable human beings, not "stable objects with handles." Lifting the patient under the armpits places excessive force on the lifter’s spine -- from 1.5 to 2 times the maximum acceptable load for human lifting.

Elements of an Acceptable Ergonomic Program

Most health care institutions provide neither the appropriate staffing nor equipment to protect nurses from back injury. The employer must set up a way for employees to report injury and potential hazards for effective management and control. Preferred methods for controlling hazards -- such as patient lifting teams, lifting devices, and slide boards -- must be implemented, as recommended by the Institute of Medicine in 1996. The IOM also documented a proven relationship between nurse understaffing and back injury. Medical management of the ergonomic program, and of injured workers, is needed. Personal protective equipment and work restrictions for injured workers must be provided by the employer at no cost to the injured employee. An example of one kind of personal protective equipment is a "walking belt" attached to the waist of the patient the nurse is assisting. But personal protective equipment is no substitute for permanent control measures when other controls are feasible. Employees must have the ability to be actively involved in developing, implementing, and evaluating job hazard analysis and injury prevention and training programs.

Cost Savings from Ergonomic Programs

Comprehensive ergonomics programs have successfully reduced workplace injuries in settings ranging from a shoe manufacturing firm, a textile manufacturer, a newspaper, a poultry processor, and a cabinet manufacturer. These efforts in a wide range of workplaces have significantly reduced workers’ compensation costs and lost workdays due to injury.

America’s nurses -- who care for the most ill and vulnerable among us -- deserve the protection of an ergonomic standard. Studies have shown the effectiveness of ergonomics programs in the health care setting. Such programs have allowed nurses to reduce back injury risks as well as lost work days, and have saved the health care industry money. Even patients have expressed that they feel more comfortable and secure thanks to the implementation of ergonomics programs. Too many nurses are becoming patients themselves due to preventable back injury.

The Personal and Professional Impact of Back Injury

I am one of the statistics. On February 17, 1992, I suffered a back injury while assisting a patient. That injury required major surgery -- spinal fusion -- and two years of major rehabilitation before and after surgery.

The injury was devastating to me personally and professionally. I led a very active life, enjoying competitive racquetball, water-skiing, and white water rafting. But, most important, I enjoyed my work as an ICU nurse, my career since 1971. The loss of my ability to take care of patients led to a clinical depression lasting four and a half years. I now administer T.B. tests to employees at my hospital. My ability to take care of patients -- the reason I became a nurse -- is gone. My injury -- and all the losses it has entailed – were preventable.

Call to Action

The science of back injury prevention is documented and well-understood. In health care, we have the knowledge to intervene to reduce injury, illness, disability, and expense. I come before you today not only as a nurse who was disabled due to a preventable back injury, but as a representative of nursing -- America’s largest health care profession. The American Nurses Association says it is long past time to protect health care professionals and workers.

In 1996, Congress included language in the OSHA appropriations measure which prevented OSHA not only from publishing an ergonomics standard, but from doing any research on the subject that might demonstrate the need for a standard – in essence, tying OSHA’s hands and blinding them to the science.

Since then, thousands more American workers have needlessly sustained preventable work-related injuries. The American Nurses Association represents the nation’s 2.6 million registered nurses. The ANA strongly opposes H.R. 987, as well as S.1070, bills that once again would stop OSHA from protecting workers against ergonomic injuries and illnesses.

It is critical that OSHA release a quality ergonomic standard that works.

The American Nurses Association is the only full-service professional organization representing the nation’s 2.6 million registered nurses through its 53 constituent associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public. ANA Media Relations: (202) 651-7048; RN=RealNews@ana.org; www.nursingworld.org/rnrealnews.