MIND AND MOVEMENT working smarter not harder

Nursing Homes, April, 2001 by Robert Pater

Safety should not be a process or program -- it should be a mindset

Nursing homes lead all other industries in on-the-job back injuries. However, unlike workers in other industries that deal with lifting static, stationary objects, nursing home employees deal daily with the resistive, shifting weight of residents.

Some of these people work with varying degrees of pain that they might not even consider job-related. Many will attribute their aches, pains and weaknesses to age or other activities and feel that their jobs simply amplify these physical conditions. For example, an aide might resign her position because she feels the job is just too hard on her body, without realizing that the way she performs her duties might be the cause of her physical discomfort.

By teaching correct movement techniques and training employees to focus their attention on analyzing the task at hand, the problems of injury, strain and stress can be resolved and lead to improved staff satisfaction and retention.

Strategic Safety Associates' MoveSMART[R] training system has three interrelated objectives. First, by using technology adapted from select martial arts, kinesiology, ergonomics, industrial psychology and practical, on-the-job experience, the program educates staff on injury prevention. Second, by encouraging better, judgment, motivation and personal responsibility, MoveSMART promotes safe behavior that crosses over into all aspects of life. Finally, as a result of the program's theory and practical techniques, a new safety culture is achieved through better employee-management involvement and communication.

MoveSMART is based on internal martial arts-its principles, philosophies and disciplines. The MoveSMART system teaches how to make better judgments, increases attention and motivates staff to continue this focus not only at work, but in their personal lives.

One of the basic tenets of safety is attention. It is a crucial element in productivity and decision making. Employees need to notice the details of their surroundings and learn to make good, safe judgments in response to them. It is important to realize that different attention patterns exist and that one must learn how to shift from one pattern to another. These attention patterns are termed as follows:

* Narrow external: This attention style permits one to concentrate on a task without being distracted by internal thoughts or external noises. The negative aspect would be the inability to detect body tension or changing risk factors in the environment.

* Wide external: The person knows everything that's going on around him, but, on the downside, he could become externally overloaded, which might lead to confusion in determining the best response to an immediate situation or crisis.

* Wide internal: They can feel forces transferring in their bodies, and are more aware of tension building up and adjust to it before it leads to an irrevo cable injury. They see from the general to the specific and can select principles they can apply to a variety of tasks. Negatively, there is the risk of distraction (i.e., not listening effectively) or internal overload. They have so many things on their minds that they can become confused or forgetful.

* Narrow internal: This is the pattern of effective concentration. People who concentrate in this way keep thoughts from interfering with what they are seeing or listening to, and vice versa. But on the downside, those with this primary attention pattern might become mentally fixated (e.g., having a song running through their heads) and have difficulty clearing their minds or with not recognizing significant changes happening in front of them.

It is important to decide what your primary attention pattern is so attentional "versatility" can be developed. This means that the worker must learn to shift attention patterns to better control the immediate situation, realizing that each pattern has its strengths and limitations and is effective in different situations.

Once the worker decides which pattern he naturally possesses, then he can begin to understand where mistakes in judgment are made and where a shift in attention focus would benefit a situation.

With an awareness of how important attention is to safety and job performance, it is time to discuss a lifting technique and explain its benefits in moving, lifting or transferring a resident to or from his bed. For best results, the aide must use "intelligent" force, not brute force.

When brute force is used, the aide goes directly to the task and lifts the resident, using all the strength she can muster without regard to her physical preparedness. When using intelligent force, the aide will assess the task, the size and condition of the resident, and any other variables that might be present and then perform it.

As always, the goal of the aide is to make a safe, smooth transfer for the resident, while preventing injury to herself. Unlike bending down to pick up a box, her movement involves a person with a shifting center of gravity whose movements can range from listlessness to combativeness. That is why it is so important to incorporate the correct physical movements with the appropriate mental assessment to achieve a refined attention to detail.