Despite High Rates Of Nursing Injuries, Government Regulators Take Little Action While industry and government officials agree something needs to be done to prevent the tens of thousands of debilitating injuries among nursing staff, nobody can agree how to enforce it.

Despite High Rates Of Nursing Injuries, Government Regulators Take Little Action

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We've been reporting recently about a little-known epidemic affecting hospitals across the country. Tens of thousands of nursing employees suffer debilitating back and arm injuries every year. This happens mainly from lifting and moving patients. Hospitals could prevent many if not most of these injuries, but most hospitals don't. Today NPR's Daniel Zwerdling examines why government regulators aren't doing much about it either.

DANIEL ZWERDLING, BYLINE: Most hospital executives still don't get it - that's what David Michaels says. He's America's key official in charge of protecting workers' health. He runs OSHA, the Occupational Safety and Health Administration.

DAVID MICHAELS: A lot of hospitals still believe this old myth that hospitals are safe places to work.

ZWERDLING: Michaels says nursing employees suffer more debilitating back and arm injuries than almost any other occupation.

MICHAELS: It means that workers who are relatively young have to stop working early in many cases, but they go home and they have real disabilities. They have trouble lifting up their kids, they have trouble doing a lot of the daily tasks of life because of back injuries, arm injuries, shoulder injuries. It's a very big deal.

ZWERDLING: So you might wonder, what is OSHA doing about it? Not much. Michaels is trying to persuade executives that they should prevent their nursing staff from getting hurt.

MICHAELS: I sent out a letter to 5,000 hospital administrators describing exactly why it's in their best interest to do what we think is the right thing to do - we should start protecting workers.

ZWERDLING: Are most hospitals taking aggressive action, or are most not?

MICHAELS: Most hospitals are not yet taking aggressive action.

ZWERDLING: Meanwhile, nursing workers are saying, somebody help us please.

UNIDENTIFIED PROTESTERS: Yeah, yeah. Because we're on strike. Yeah, yeah.

TORI NEET: My name is Tori Neet. I have been injured for two years. I was helping transfer a patient. I injured the elbow and shoulder.

ZWERDLING: Tori Neet is a nursing assistant in Springfield, Ore. On a recent afternoon, she and dozens of other staff were waving signs in front of their hospital right near the emergency room. They were briefly on strike over pay, but workers like Kristi Kuipers said injuries are a big issue.

KRISTI KUIPERS: Probably at least half of our staff in the last couple of years has been injured. There have been some that have been off work for almost a year.

ZWERDLING: Studies show that hospitals could prevent most of those injuries if they bought special equipment to move patients, but most haven't invested the money.

KUIPERS: I think it should be mandatory. Until there's a law made to make them realize that people are getting hurt, hospitals won't do it on their own.

ZWERDLING: And it turns out, there was a law - once. It was early 2001, just before President Clinton left office. OSHA issued a sweeping new rule. It required companies across the country, from auto factories to hospitals, to prevent ergonomic injuries. Here's NBC.


UNIDENTIFIED MAN: To Washington now, in a battle over workplace safety.

ZWERDLING: Ergonomic injuries are the ones you get from doing tasks that repeatedly stress the body, like lifting auto parts or lifting patients. OSHA's rule warned specifically about all the nursing employees who get hurt in hospitals.


UNIDENTIFIED MAN #2: If more than one worker is injured within 18 months doing the same job, the employer must redesign the workplace.

ZWERDLING: The nation's business leaders said, no way. Before the rule went into effect they called a press conference.


UNIDENTIFIED MAN #3: Testing one, two, three. Testing one, two, three.

ZWERDLING: It was organized by the National Association of Manufacturers. One executive after another predicted doom.


UNIDENTIFIED MAN #4: And our concern is that this rule is all cost and no benefit.

UNIDENTIFIED MAN #5: And that's the devastating effect that this is going to have on the American worker.

UNIDENTIFIED MAN #6: It will force some employers to move overseas.

ZWERDLING: Then right after OSHA's rule went into effect, Republicans took over the White House and Congress. They said, we're against burdensome regulations, too.


UNIDENTIFIED MAN #7: And ABC's Linda Douglass tells us tonight that before the day is over, businesses will likely have their way and the regulations will be repealed.

ZWERDLING: Congress killed OSHA's rule. So, public health and nursing advocates decided, OK, if OSHA can't put out a national rule, let's set our sights lower - let's convince states to pass laws just to tell hospitals, you have to buy equipment to move patients so nurses don't wreck their backs.

KEITH FREDERICK: Well, of course we are all very interested in preventing any sort of injury to our nursing staff, but...

ZWERDLING: But, here's what happened. Keith Frederick is Republican chairman of the Health Care Policy Committee in Missouri's House of Representatives. Two years ago, the state nurses association and a labor union pushed for a pretty strong bill. It would give state officials the power to inspect hospitals and then fine them if they didn't protect nursing workers from getting hurt lifting patients. Missouri's hospital industry opposed it and so did Frederick in the state legislature.

FREDERICK: You say, well, would it hurt to pass this one little government requirement? And a friend of mine who's in the military used this analogy - that one little pebble in your rucksack doesn't really make much difference, but you keep adding them and you keep adding them, it gets half-full and now it's pretty much a load to carry. And I feel like our hospitals - and I feel like this about our small businesses - are laboring under increasing loads of government regulation.

ZWERDLING: Frederick let the bill in the Missouri State House die. You'll find similar stories in states like Florida and Oregon and Massachusetts.

Keith Frederick, I did a bit of research on your background on a nonpartisan website called and I see that the hospital industry in Missouri contributed more money to your campaigns then just about any individual or other industry. Has that in any way affected your position on these bills?

FREDERICK: No, it hasn't. And in fact, before I even started to run - before I was elected - one of the things I thought was wrong with our medical system in Missouri was that our hospitals were being overregulated.

ZWERDLING: Despite the hospital industry's opposition, 10 states have passed laws that require hospitals to prevent injuries from lifting patients. But most of those measures don't have many teeth. For instance, Washington State has had a law for almost 10 years now. Ninica Howard works for the agency that oversees it and she says state officials don't know if hospitals are actually protecting nursing staff or not.

NINICA HOWARD: True. I mean, the only way that we can know for sure is if we do inspections.

ZWERDLING: And do you have the resources - the money and the staff to do those inspections?

HOWARD: No, we don't. We don't have the money and we don't have the resources.

ZWERDLING: And that brings us back to the federal agency in charge of protecting workers - OSHA. Congress created OSHA in 1970, quote, "to assure safe and healthful working conditions for working men and women," un-quote. The man who runs OSHA today, David Michaels, says he'd love to issue regulations to protect nursing staff across the country from getting hurt lifting patients, but here it is 14 years since Congress smacked OSHA down, and he says...

MICHAELS: The process for OSHA to issue new regulations is broken. We can take on very few issues. The requirements that OSHA has to go through to issue a new standard are very, very onerous. It takes us years if not decades to put out a rule.

ZWERDLING: So Michaels is sending the agency's inspectors mainly to factories and construction sites, where workers suffer amputations or get killed. As for hospitals, OSHA has created a website and other materials that show administrators how to prevent nursing staff from getting injured - if hospital administrators bother to read them. Michaels says there is one institution that could require hospitals across the country to protect their nursing staff - Congress.

MICHAELS: There is no question, a national law requiring protections in hospitals would protect workers and would result in the reduction in musculoskeletal injuries in hospitals.

ZWERDLING: But, that's pretty much where we started this story. Daniel Zwerdling, NPR News.

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