Moving and handling

Manual handling is defined as ‘the lifting, lowering, pushing, pulling, carrying, transporting or supporting by hand or bodily force any object including a person’ (Health and Safety Executive, 1992).

The emphasis for movement and handling must be to undertake an efficient movement, using a suitable and appropriate method whilst maintaining client safety and comfort. An efficient movement is one that achieves the objective by employing minimal effort to do so with the minimum of strain.

The term ‘lifting’ has previously been widely used to refer to movement and handling activities. However, this term has been seen to indicate the need to take the client’s full weight as part of movement and handling. In recent years it has become readily apparent that to undertake such a manoeuvre is potentially dangerous for both the nurse and the client. For these reasons, ‘lifting’ is now considered an inappropriate term and its use to describe movement and handling activities is discouraged. Indeed the manual lifting of clients is now deemed unsafe in most institutions and is not generally recommended under any circumstances.

Care of self:
Back injury is the largest single cause of long-term sickness, with reported back pain being most common in those with skilled manual, partly skilled and unskilled jobs. The true cost of back injury to industry is difficult to define.

There is now a great deal of legislation relating to manual handling, which sets out responsibilities and gives guidance for both employers and employees. The dangers of manual handling to the nurse are now well understood: ‘One in four qualified nurses has taken time off with a back injury sustained at work and for some it has meant the end of their nursing career’ (Disabled Living Foundation, 1994). All nurses and carers must be aware of and consider these risks and adopt safe principles of
manual handling. The need for safety in practice has now been recognized as a fundamental necessity.

The UKCC (1996) stated: ‘although the most important consideration must be the patient’s safety and well being, this must not be at the expense of the nurse’s health and safety’.

The importance of looking after one’s back is vitally important, not only at work but also at all other times during the day. An injury sustained outside of work will still have the same effect on a career involving movement and handling activities as one sustained during these duties. Caring for oneself and one’s back should therefore be a 24-hour responsibility and the reader is reminded that the adoption of safe movement and handling techniques outside of work is just as important as undertaking these at work. By avoiding top-heavy postures and following simple principles of safe movement and handling, it is possible to maintain a fit and healthy back and consequently look forward to a long and rewarding career.

Top-heavy posture:
relates to positions where the individual is leaning slightly forwards or bending forward with the spine arched and not in its natural line. This position is often adopted unconsciously, with the individual being unaware of the fact that they are bending and arching the spine. Although immediate problems may not be felt, both short- and long-term effects and injury can occur with the recurrent use of a top-heavy posture.