National Nurses United

NEWS BRIEFS RNs give public comment on lift team regulations CALIFORNIA n sept. 19, more than 80 California Nurses Association RNs from across the state packed a hearing room in Oakland where the state Division of Occupational Safety and Health (Cal/OSHA) board heard public comments from nearly a dozen nurses about the abysmal and dangerous situations they have been put in while moving and lifting patients at work. The Cal/OSHA board proposed regulations that spell out exactly how hospitals must comply with A.B. 1136, the safe patient lifting and handling law that CNA passed in 2011. While CNA nurses were pleased overall with Cal/OSHA's proposed draft regulations, particularly the requirements that equipment and lift staff had to be available at all times on all units and for stringent training on how to use the equipment, they pointed out to the board that the proposal could still be strengthened in two ways. First, the regulations should ensure that RNs' direct patient care assignments are not compromised when they are pulled away to lift other patients. Currently, RNs report that their employers have drastically cut or completely eliminated all ancillary and support staff to help move and turn patients. As a result, nurses are often the O 6 N AT I O N A L N U R S E only ones available to help colleagues lift patients and must leave their own patients unattended, however briefly. "Sometimes we can have three to four nurses on a patient, cleaning them up. This can take up to 20 minutes, and nobody else is watching the other patients," said Tina Guglielmotti, an ICU RN at Los Alamitos Medical Center in Long Beach, Calif., to the board. "We're all in a room lifting somebody else! We need language that explicitly protects our patient assignments." Second, the nurses would like to see language in the regulations clarifying that the RN's nursing judgment supersedes other healthcare workers' mobility assessments in moving and positioning patients. Nurses gave examples of instances where physical therapists or other healthcare workers may not be aware of medical reasons for why a patient must or must not be moved in a certain way. The California Hospital Association, which represents the state's hospital industry, is lobbying to weaken the regulations as much as it can. Though nurses cheered the passage of A.B. 1136, it was clear from the nurses' testimony that California hospitals still have a long way to go toward ensuring that nurses and patients are not injured during lifts, transfers, and other patient handling situations. Behind construction workers, registered nurses and other healthcare workers W W W. N AT I O N A L N U R S E S U N I T E D . O R G lead all occupations in the number of musculoskeletal injuries they incur on the job. Almost all nurses can tell stories of how they, or colleagues they know, have hurt themselves by lifting and moving patients at work. Repeatedly, nurses described to the Cal/OSHA board how their hospitals were woefully inadequate in complying with safe lifting requirements. Many did not own lift equipment. If they did, the equipment was often not available, broken, hidden away in storage, insufficient to handle the weight of many patients, or did not fit in patient rooms or bathrooms. Hospitals often did not provide hands-on training of how to use the lift equipment, but simply asked nurses to watch a video or click through an online training module and declare that "everyone is now trained and part of the lift team." LaTaushia Hall, an ICU RN at St. Bernardine Medical Center in San Bernardino, Calif., recalled how the three pieces of lift equipment on her unit were useless in helping transfer a patient weighing more than 800 pounds who ultimately required eight EMTs and two nurses to move. "We have no input into what kind of equipment we buy," said Hall. "We feel like we are all just on our own." Hopefully, with real, enforced regulations in place, the younger generation of nurses will not have to suffer as much damage to their bodies and careers, said RNs. "I really greatly love what I do," said Guglielmotti, who sustained a back injury at work. "But when I got into nursing, I had no idea the toll it would take on my body." —Staff report O C TO B E R 2 01 3

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