Nursing Practice and Challenges: Manual Handling, Fall Risk, and Workplace Stress

Running head: NURSING PRACTICE AND CHALLENGES
Nursing practice and challenges
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NURSING PRACTICE AND CHALLENGES
Introduction:
While treating critically ill or mobility restricted patients, the most important challenge
that the nurses caring for this patient population face is related with manual handling and fall
prevention for the mobility restricted patient. Along with that, the workplace stress of handling
such patient demographics also has a considerable impact on the burnout experienced by the
nurses and performance statistics of the nurses (Kay, Evans & Glass, 2015). Considering the
policy oriented environment, there have been many policies identified to address the issue of
manual handling of acute patients and preventing falls and fall related injuries. For instance, the
Falls policy, 2004 by Health.wa.gov.au and the safe patient handling policy by the ANMF or
Australian Nursing and Midwifery federation have identified plenty of the issues or challenges
that are prevalent in the acute or aged care scenario (Anmf.org.au., 2018; Health.wa.gov.au,
2018). This paper will attempt to examine the challenges associated manual handling of the acute
or mobility restricted patients and the risk of fall and fall associated injuries along with its
associated with workplace related stress on the nurses.
Brief description:
Manual handling is a very common care need for patients with mobility restrictions or
any kind of disability. On a more elaborative note, manual handling can be defined as a task
which requires the person to lift, lower, push, pull, carry or otherwise move, hold or restrain any
patient using repetitive or sustained force. In this case, the task of manual handling of a patient is
associated with a variety of different risks, not just to the patients but also to the nurses and care
staff. The heavy lifting and manoeuvring that the nurses have to carry out is often associated
with extreme hazard risks (Abedini, Choobineh & Hasanzadeh, 2015). There is mounting
evidence that the manual handling that the nurse have to carry out in order to be able to complete

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NURSING PRACTICE AND CHALLENGES
the care needs of the acute or chronically ill patients has resulted in lower back and
musculoskeletal injuries. Along with that, the manual handling is also associated with a far
higher risk of falls. On a more elaborative note, the heavy lifting of a critically ill and/or mobility
restricted aged patient is complex and requires a systematic approach and the assistance of tools.
The lack of any of the mentioned facts can lead to fall and injuries for both the patient and
nursing staff as well. The manual lifting of positioning of the patients is needed to be avoided as
per the Safe patient handling policy by ANMF and the risks of fall and the effect of the same on
the empowerment or the dignity of the patient. Yet, the need for manual handling is still
prevalent in the patient care scenario, and in most cases the nurses lack the exact training or the
resources to follow the exact manual handling guideline or protocol to ensure minimal hazard
risk on both patients and the nursing staff. Hence, the risk of fall and injury continues to escalate
along both physical and emotional stress on the nursing professional involved with the care
(Mital, 2017).
Critical analysis of manual handling, fall and impact on workplace stress:
The challenges associated with manual handling and the associated fall risk among other
injurious risks have been a considerable concern of the health care industry for a considerable
amount of time. Hence, many research studies have invested efforts and resources in discovering
the extent of the various challenges associated with manual handling and how it links with fall
risk and what impact it is capable of inflicting on the workplace stress scenario of the nurses and
their performance or productivity. As mentioned by Allahyari et al. (2014), musculoskeletal
injuries are the most abundantly reported risk associated with manual handling actions, although
it has to be highlighted in this context that the exact aetiology of these musculoskeletal injuries
are multifactorial, there is considerable evidence that indicates the presence of a causal

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NURSING PRACTICE AND CHALLENGES
relationship between the musculoskeletal disorders in the health acre facility and the care staff
that have to carry out manual handling of patients. The most prevalent type of musculoskeletal
disorder that is found in the patients is the low back pain, which has been attributed to be linked
with repetitive movements, forceful exertions, non-neutral body positions and exposure to
vibrations (Anap, Iyer & Rao, 2017).
As argued by Villarroya et al. (2016), on the other hand, the musculoskeletal disorders
that developing the nursing or care staff results primarily from the cumulative damage rather
than a single incident or accident. Hence, it can be deduced that for the manual handling, the day
by day damage caused ion the musculoskeletal system of the nurses of the manual hand ling of
the patents without proper training or infrastructure for a prolonged period of time causes the
development of several disorders. As discussed by Piccenna (2017), there is a significant lack of
rehabilitation or screening facility available for the nurses that are associated with care practices
requiring regular manual handling, which adds to the burden of the diseases by not being
recognized early one. On a similar note, the prevalence and persistence of the musculoskeletal
diseases in the health care industry has created serious concerns all across the globe. Challenges
in the musculoskeletal disorder detection and diagnosis and the limitation in the claiming of
injuries and the cultural influences that discourage injury reporting contribute to the present
scenario.
Exploring the issue further, it has to be mentioned that the risk of manual handling and
associated falls is the most contributed by the lack of training and education among the nursing
professionals. On a more elaborative note, the safe patient handling practice education of the
nurses are more focused educating good body mechanics to the nurses rather than focusing on
the empirical evidence and judgment regarding the co0mpetency of the injured nurses and their