PURPOSE: To understand why nursing home work can be hazardous to
your health.
TASK:
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.
- What do you say to her? List three or four responses.
- Why has the back injury rate gotten worse over the past 10 years? List three or four responses.
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.
GROWING PAINS
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?
- Sicker residents
- More dependant residents
- More lifting and transferring
- More risk of getting a sprain or strain injury
Losing Time
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:
- the income of the injured worker
- the families who depend on the hurt worker
- residents who suffer from lack of care
- the employer who must pay for replacement help
In addition, the cost of workers' compensation
premiums rises.
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?
- Low pay
- Stressful working conditions
- On-the-job injuries.
BARELY SURVIVING
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.
- Individual back injury claims have cost as much as $90,000. Run-of-the-mill claims can
cost $15,000 to $118,000.11 Your
employer pays in a couple of ways:
1. Increased workers compensation costs
2. Cost of hiring and training replacement workers.
- Nursing home work is hazardous and expensive. Just ask any
insurance company. In Pennsylvania, nursing homes
paid almost five times more in workers' compensation premiums
than hospitals.12
- The nursing home industry paid $1 billion
in workers' compensation insurance costs
in 1994.13 The average size nursing home lays out $50,000 to $100,000 per year for
insurance.14 We sure could fix a lot of workplace safety problems with that kind
of cash.
And we provide a big chunk of that money-Taxpayers pay into the Medicare
system. Medicare pays for most (75 percent) of the inpatient days for
residents in nursing homes.15
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.
- A nursing home in Wisconsin was studied to see which job tasks were most stressful to nursing assistants. These stressful tasks changed when nursing
assistants were given new equipment and were trained to use it properly. During the 12 months of the study, injuries dropped 43 percent. There was also a big drop in lost or restricted
workdays.16
- The Kennebec Long Term Care facility in Maine lost 573 work days in 1991. By 1994, the number of lost days had dropped to 25. How? A back injury prevention program was put into place. Workers were told never to lift alone. Twelve new lifts were bought after nursing assistants chose the kind they wanted. Kennebec's management said they would make money from the program even if only two injuries were
prevented.17
- Meridian Healthcare Company saved $800,000 in workers' compensation premium costs in 1993 after starting a back injury prevention
program.18
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.
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