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Moments of speaking and silencing: Nurses share their experiences of manual handling in healthcare

Published:December 12, 2013DOI:https://doi.org/10.1016/j.colegn.2013.11.005

      Summary

      Nursing care involves complex patient handling tasks, resulting in high musculoskeletal injury rates. Epidemiological studies from the 1980s estimated a lifetime prevalence of lower back injuries for nurses between 35 and 80%. National and international studies continue to mirror these findings. Despite the development of programs intended to reduce manual handling injuries, sustainable solutions remain elusive.
      This paper reports on a study of nurses speaking about their perspectives on current manual handling practices. Qualitative research conducted in 2012 investigated nurses’ perceptions and experiences relating to manual handling in the healthcare context and their participation in injury prevention programs. There were two research methods: semi-structured interviews and researcher reflective journaling. The research was framed in critical emancipatory methodology. Thirteen nurses from two Australian states participated in the study.
      Thematic analysis revealed an overarching theme of ‘power relations’ with a subcategory of ‘(mis)power’ that comprised two subthemes, these being ‘how to practice’ and ‘voicing practice issues’.
      Specifically, this paper explores nurses verbalising their views in the workplace and responses which left them feeling silenced, punished and disillusioned. The findings suggest that the socio-political context within which nurses practice impacts upon their ability to voice concerns or ideas related to manual handling. Inclusion of nurses in the manual handling dialogue may generate an expanded understanding of, and the potential to transform, manual handling practices in healthcare environments.

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      References

        • Angus J.E.
        • Clark A.M.
        Using critical realism in nursing and health research: Promise and challenges.
        Nursing Inquiry. 2012; 19: 1-3
        • ASCC
        Research on the prevention of work-related musculoskeletal disorders.
        Australian Safety and Compensation Council, Canberra2006
        • ASCC
        National code of practice for prevention of musculoskeletal disorders caused from performing manual tasks.
        Australian Safety and Compensation Council, Canberra2007
        • ASCC
        National Hazard Exposure Worker Surveillance (NHEWS) survey.
        Australian Safety and Compensation Council, Canberra2009
        • Braun V.
        • Clarke V.
        Using thematic analysis in psychology.
        Qualitative Research in Psychology. 2006; 3: 77-101
        • Buckle P.
        Epidemiological aspects of back pain within the nursing profession.
        International Journal of Nursing Studies. 1987; 24: 319-324
        • Burdorf A.
        • Koppelaar E.
        • Evanoff B.
        Assessment of the impact of lifting device use on low back pain and musculoskeletal injury claims among nurses.
        Occupational and Environmental Medicine. 2013; 70: 491-497
        • Charney W.
        • Hudson A.
        • Gallagher S.
        • Lloyd J.
        • Baptiste A.
        • Nelson A.
        • et al.
        Back injury prevention in health care.
        Handbook of modern hospital safety. 2nd ed. CRC Press, Boca Raton2010: 1-125
        • Clark A.M.
        • Lissel S.
        • Davis C.
        Complex critical realism: Tenets and application in nursing research.
        Advances in Nursing Science. 2008; 31: E67-E79
        • Clemes S.
        • Haslam C.
        • Haslam R.
        What constitutes effective manual handling training? A systematic review.
        Occupational Medicine (London). 2010; 60: 101-107
        • Collins J.
        • Menzel N.
        Scope of the problem.
        in: Nelson A. Safe patient handling and movement. Springer, New York, NY2006: 3-26
        • Cromie J.
        • Robertson V.
        • Best M.
        Work-related musculoskeletal disorders in physical therapists: Prevalence, severity, risks, and responses.
        Physical Therapy. 2000; 80: 336-351
        • D’Arcy L.
        • Sasai Y.
        • Stearns S.
        Do assistive devices, training, and workload affect injury incidence? Prevention efforts by nursing homes and back injuries among nursing assistants.
        Journal of Advanced Nursing. 2012; 68: 836-845
        • Elliott M.
        • Crookes P.
        • Worrall-Carter L.
        • Page K.
        Readmission to intensive care: A qualitative analysis of nurses’ perceptions and experiences.
        Heart & Lung. 2011; 40: 299-309
        • Fay B.
        Critical social science: Liberation and its limits.
        Cornell University Press, New York1987
        • Garg A.
        • Kapellusch J.
        Long-term efficacy of an ergonomics program that includes patient-handling devices on reducing musculoskeletal injuries to nursing personnel.
        Human Factors: The Journal of the Human Factors and Ergonomics Society. 2012; 54: 608-625
        • Georges J.
        Evidence of the unspeakable: Biopower, compassion, and nursing.
        Advances in Nursing Science. 2011; 34: 130-135
        • Hignett S.
        Intervention strategies to reduce musculoskeletal injuries associated with handling patients: A systematic review.
        Occupational and Environmental Medicine. 2003; 60: e6
        • Hignett S.
        • Crumpton E.
        • Ruszala S.
        • Alexander P.
        • Fray M.
        • Fletcher B.
        Evidence-based patient handling: Tasks, equipment and interventions.
        Routledge, London2003
        • Hignett S.
        • Fray M.
        • Rossi M.A.
        • Tamminen-Peter L.
        • Hermann S.
        • Lomi C.
        • et al.
        Implementation of the Manual Handling Directive in the healthcare industry in the European Union for patient handling tasks.
        International Journal of Industrial Ergonomics. 2007; 37: 415-423
        • Holloway I.
        • Biley F.
        Being a qualitative researcher.
        Qualitative Health Research. 2011; 21: 968-975
        • Holman G.
        Decision factors in patient handling.
        in: Paper presented at the fourth annual regional National Occupational Research Agenda (NORA) young/new investigators’ symposium. 2006 (Retrieved from http://www.mech.utah.edu/ergo/pages/NORA/2006/51-66%20Holman,%20Talley.pdf)
        • HSE
        Manual handling of loads – Guideline to the manual handling operations regulations.
        Health & Safety Executive, London1992
        • HSE
        Manual handling training: Investigation of current practices and development guidelines.
        Health & Safety Executive, London2007
        • Iakovou G.
        Implementation of an evidence-based safe patient handling and movement mobility curriculum in an associate degree nursing program.
        Teaching and Learning in Nursing. 2008; 3: 48-52
        • Jack S.
        Guidelines to support nurse-researchers reflect on role conflict in qualitative interviewing.
        Open Nursing Journal. 2008; 2: 58-62
        • Kay K.
        • Glass N.
        • Evans A.
        Reconceptualising manual handling: Foundations for practice change.
        Journal of Nursing Education and Practice. 2012; 2: 203-212
        • Kitto S.
        • Chesters J.
        • Grbich C.
        Quality in qualitative research.
        Medical Journal of Australia. 2008; 188: 243-246
        • Koppelaar E.
        • Knibbe J.
        • Miedema H.
        • Burdorf A.
        Determinants of implementation of primary preventive interventions on patient handling in healthcare: A systematic review.
        Occupational and Environmental Medicine. 2009; 66: 353-360
        • Koppelaar E.
        • Knibbe J.
        • Miedema H.
        • Burdorf A.
        The influence of individual and organisational factors on nurses’ behaviour to use lifting devices in healthcare.
        Applied Ergonomics. 2013; 44: 532-537
        • Mantzoukas S.
        The inclusion of bias in reflective and reflexive research.
        Journal of Research in Nursing. 2005; 10: 279-295
        • Menzel N.
        Underreporting of musculoskeletal disorders among health care workers: Research needs.
        AAOHN Journal. 2008; 56: 487-494
        • Mitchell T.
        • O'Sullivan P.
        • Burnett A.
        • Straker L.
        • Rudd C.
        Low back pain characteristics from undergraduate student to working nurse in Australia: A cross-sectional survey.
        International Journal of Nursing Studies. 2008; 45: 1636-1644
      1. National Statement on Ethical Conduct in Human Research.
        The National Health and Medical Research Council, Canberra2007
        • Parlour R.
        • McCormack B.
        Blending critical realist and emancipatory practice development methodologies: Making critical realism work in nursing research.
        Nursing Inquiry. 2012; 19: 308-321
        • Porter S.
        • O’Halloran P.
        The use and limitation of realistic evaluation as a tool for evidence-based practice: A critical realist perspective.
        Nursing Inquiry. 2012; 19: 18-28
        • Punnett L.
        • Wegman D.
        Work-related musculoskeletal disorders: The epidemiologic evidence and the debate.
        Journal of Electromyography and Kinesiology. 2004; 14: 13-23
        • Retsas A.
        • Pinikahana J.
        Manual handling activities and injuries among nurses: An Australian hospital study.
        Journal of Advanced Nursing. 2000; 31: 875-883
        • Roberts S.J.
        • DeMarco R.
        • Griffin M.
        The effect of oppressed group behaviours on the culture of the nursing workplace: A review of the evidence and interventions for change.
        Journal of Nursing Management. 2009; 17: 288-293
        • Roffey D.M.
        • Wai E.K.
        • Bishop P.
        • Kwon B.K.
        • Dagenais S.
        Causal assessment of workplace manual handling or assisting patients and low back pain: Results of a systematic review.
        Spine Journal. 2010; 10: 639-651
        • Rose J.
        • Glass N.
        The importance of emancipatory research to contemporary nursing practice.
        Contemporary Nurse. 2008; 29: 8-22
        • Rose J.
        • Glass N.
        An investigation of emotional work, emotional wellbeing and professional practice: An emancipatory inquiry.
        Journal of Clinical Nursing. 2010; 19: 1405-1414
        • Safe Work Australia
        Work-related injuries in Australia, 2005–06: Factors affecting applications for workers’ compensation.
        Commonwealth of Australia, Canberra2009
        • Smith D.
        • Leggat P.
        Musculoskeletal disorders among rural Australian nursing students.
        Australian Journal of Rural Health. 2004; 12: 241-245
        • Taylor B.
        Qualitative methodologies and postmodern influences.
        in: Taylor B. Kermode S. Roberts K. Research in nursing and health care: Evidence for practice. 3rd ed. Thomson, Melbourne2006: 362-392
        • Taylor B.
        • Roberts K.
        Research in nursing and health.
        in: Taylor B. Kermode S. Roberts K. Research in nursing and healthcare: Evidence for practice. 3rd ed. Thomson, Melbourne2006: 1-32
        • van der Molen H.
        • Sluiter J.
        • Hulshof C.
        • Vink P.
        • Frings-Dresen M.
        Effectiveness of measures and implementation strategies in reducing physical work demands due to manual handling at work.
        Scandinavian Journal of Work, Environment and Health. 2005; 31: 75-87
        • Wilson V.
        • McCormack B.
        Critical realism as emancipatory action: The case for realistic evaluation in practice development.
        Nursing Philosophy. 2006; 7: 45-57
        • WorkSafe Victoria
        Code of Practice for Manual Handling.
        Victorian Workcover Authority, Melbourne2000
        • Yassi A.
        • Lockhart K.
        Work-relatedness of low back pain in nursing personnel: A systematic review.
        International Journal of Occupational and Environmental Health. 2013; 19: 223-244