Which Nursing Tasks Impose Great Stress on The Back

The purpose of this study was to reduce back stress for nursing personnel by changing the physical demands of the job. The goals were :

• To determine the most stressful clients handling tasks
  
• To conduct an ergonomic evaluation of these task
  
• To find less stressful methods for carrying out these tasks, and
• To apply the less stressful methods in the clinical setting.

The ergonomic process involved identifying the jobs and specific task within those jobs that impose great stress on the back; studying and pilot testing ways to change the task demand; and implementing these changes in the work setting.
The study took place in two setting: a nursing/long-term care facility in which 38 nursing assistants ( two were males) ranging in age from 19 to 61 tears participated, and a laboratory in a university school of nursing in which six senior nursing students participated. participants listed the client handling tasks they perceived as most stressful in their duties. An ergonomic evaluation was then completed on the ten tasks perceived as most stressful.
The tasks ranked as most stressful were transferring the client on and off the toilet and in and out bed, and the transfers involved in bathing and weighing clients. The participants reported that they felt the greatest amount of exertion in the lower back. Problems encountered in the transfers were the presence of railings around toilets, unequal height of toilet and wheelchair seats, and stress levels related to the use of hoists. Problem with the use hoists resulted from body postures the nurses needed to assume in order to position the slings and the effort needed to push the hoist with the client in it.
Of the manual lifting techniques used, the method of lifting client under the axilla was perceived to be the most stressful; the walking belt was rated the least stressful. the most commonly used assistive device was the walking belt.
Implication : To minimize back pain, nurse need to explore ways to change environmental impediments, such as altering railings around the toilet and raising toilet seat levels. furthermore, nurses need to learn to use transfer device effectively.

Does Slow Stroke Back Massage Relax Hospice Clients?

This study was conducted to investigate the effect of a non pharmacologic intervention, slow stroke back massage (SSBM) on systolic and diastolic blood pressure, heart rate, and skin temperature. These effects were evaluated as indicators of relaxation in 30 hospice client, all of whom where in the terminal stage of illness.

SSBM is a slow rhytmic stroking with the hands. The hands move over a 2-inch-wide area on either side of spinous proccesses and from the crown of the head to the sacral area. The entire massage lasts 3 minutes. findings revealed that after SSBM, the client's heart rates and systolic and diastolic blood pressure decreased, skin temperatures increased. The effects of the treatment persisted for 5 minutes following SSBM.

Implications : Slow stroke back massage has been used effectively to promote relaxation with hospice clients. It is easy to administer, takes only a bief time, requires minimal supplies of massage oil or lotion, and can be taught to family caregivers.