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1 October 2013

ERGONOMICS - Common Problems in Office Ergonomics

Common Problems in Office Ergonomics

Monitor won't fit

Monitors are getting bigger. They are often too deep to fit on old workstations, if the work surface is backed up against a panel or wall. There are a few possibilities for dealing with this.

Get a wider work surface; for large monitors, the worksurface should be at least 30" deep. (The related preventive approach: if new monitors are being purchased, make sure worksurfaces are wide enough, or if new workstations are being ordered be sure that they can accommodate future purchases of larger monitors.)
Put the monitor in the corner, with a keyboard and chair oriented in the same direction. Some furniture companies now will cut out a piece of counter from the corner and attach it to a sliding mechanism, to create a drop-down keyboard tray.
A monitor arm may be able to help, placing the monitor above the keyboard.
If the problem is that there is not also enough room for the keyboard and monitor on the worksurface, an adjustable keyboard tray will remove the keyboard from the work surface.
If the work worksurface is not backed up against a wall or panel, simply slide the monitor back, so the rear of the casing hangs over the back edge of the surface.

Ideally, a computer user should place the chair, keyboard, and monitor in a straight line. Usually as a result of space limitations, operators place the monitor to one side so that the neck is twisted. Or they may position the keyboard tray at an angle to the chair. Keyboard trays are available with various degrees of swivel and different pivot points, that allow the keyboard to be rotated into a position in line with the operator and monitor. If the worker needs the space in the center of the desk to do non-computer work, a separate computer area is the best solution (such as an L desk, or a rolling computer platform. If that is not possible, due to space constraints, a retractable keyboard tray and a monitor on a monitor lift would allow the computer to be pushed out of the way when non-computer work is being done.

Bad Postures

The ideal basic posture is feet flat on the floor, knees at about 90 degrees (without pressure against the back of the leg), lower back supported and leaning slightly back, shoulders erect, head centered about the shoulders, arms close to the side, elbows at more than 90 degrees, and wrists straight. However, it is helpful to change positions over the course of the day, to change pressure points and promote blood flow; you should experiment with variations from this "ideal" posture. Furniture should be adjustable to allow ideal postures, and workers should know how to make these adjustments. A common problem is that the height of the lumbar support of the chair has never been adjusted and is too high or too low to give lower back support (where the curve of your back is). Keyboards should be at the right height (see above), allowing the operator to bring the stomach right up against the keyboard (sometimes long armrests prevent getting this close - smaller elbow rests are better). The mouse should be at roughly the same height and distance from the body as the keyboard.

Workpractices

Good workstation setup alone can't assure that you won't get symptoms of CTD. Good work practices also need to be observed. This includes problems such as crossing your legs under you on a chair, perching on the edge of your seat so there is no back support, constant tensing of muscles, and prolonged bad postures of any variety. It also includes not changing positions over the course of a day, and typing techniques (see "Poor Typing Technique" and "Bad Postures" elsewhere on the factsheet).

Environmental Factors

Other environmental factors can also combine with risk factors for CTD's. This can include excessive cold or heat (both are physical stressors and cold can affect circulation), or exposure to indoor air quality issues such as toxic substances or inadequate fresh air.

Wrong heights for table and chair

Table surfaces and chairs need to be at the right height for the user to place his/her feet flat on the ground, keep the elbow angle greater than 90 degree, and easily maintain straight wrists. To check your work surface heights in relation to the user, there is a free program available through the internet from the Department of Energy called ErgoEaser (http://www.hss.energy.gov/ergoeaser/download.html).

Monitor wrong height or distance

In general the top of your monitor should be at about eyebrow height. (This is not true for operators who use bifocals! In this case, the monitor height must be lower. Experiment with a height that allows you to easily see the screen through the lower lenses while keeping the head upright.) You can experiment with phone books or inexpensive plastic risers under it until you get a height that feels comfortable. There are also monitor lifts that attach to the edge of the table that allow you to adjust the height over the course of the day (good for shared workstations), or cheap plastic risers that you can also use for storage. In general the monitor should be about 18-24" from your eyes, but this varies substantially with individual preference and strength of glasses. A rule of thumb: bring the monitor close enough so you can easily read print while leaning back against the chair's lumbar support. This positioning reduces the tendency to lean forward as you get fatigued.

Glare

If you can see the image of a window or light in your screen, glare is probably making it harder for you to see the screen. This glare should be reduced or eliminated where possible. While some of the newer glare screens do help somewhat, they are expensive and not as effective as eliminating the source. This can mean window shades, or placing the monitor at a 90 degree angle to the window or other light source. For overhead lights, you can take out some of the bulbs to reduce overall lighting (some say the proper background lighting for computers is "a pleasant level of gloom"), or putting egg-crate baffles on lights to reduce side glare. Task lighting can be used for lighting copy or desk work. Many operators tend to tilt the monitor up. Move the screen to a vertical position; this will often eliminate glare from ceiling lights.

Computer cord not long enough

Sometimes the wires connecting monitors, keyboards, etc. are not long enough to position monitor, CPU and keyboard at the ideal location. Often, longer cords or extensions can be used (although there are sometimes problems with the signal degrading from a long cord). Alternately, sometimes the computer can be placed on top of the table, or a cable hole can be drilled through the desk surface or partition wall.

Bifocals

Using the lower part of bifocals during computer use often forces you to tilt your head back, resulting in neck and shoulder pain. One solution is to get new glasses (progressive lenses with the center set to the 18-24" focal distance for computer use, or a single lens that is just used while on the computer). Sometimes, lowering the monitor allows the operator to hold his/her head upright while viewing the monitor through the lower lenses.

Mouse won't fit near the keyboard

Many older keyboard trays don't have enough room side to side to fit a mouse right next to the keyboard. This is often a problem on desks that have been converted to computer use without enough room for a wide tray. As a result, operators must place the mouse far away on the desk surface, requiring a forward stretch. If there is enough room, you can get a larger tray or a tray with an attached mouse tray. If there is not enough room, consider a keyboard tray with a mouse tray that slides back under the keyboard tray when it is pushed back under the desk. There are also some trays with a "floating" mouse platform; the mouse sits on a bridge that usually sits over the number pad, but can be moved when needed. An inexpensive version can be made with a few pieces of clear plastic or bent sheet metal. Another possibility is a keyboard tray or keyboard that has an integrated mouse alternative, such as a finger-sensitive pad. Voice recognition or keyboard shortcuts can also be used to bring mouse use to a minimum.

Mouse falls off if keyboard tray is in negative tilt

Some mouse trays that attach to adjustable keyboard trays allow the mouse to slide off, especially when using negative tilt. Look for trays that have a backstop. You can glue a piece of foam to the back of the mouse tray, making your own backstop. Sometimes the mouse cord can be looped through or tied (with a wire twist) to a structure to keep it from falling. Alternate input devices such as trackballs, pens or glidepoints can also be used.

Keeping finger tensed on mouse

Some office workers have the habit of keeping the index finger is always "at the ready" to click the mouse. This static posture can stretch the tendons and cause finger and hand pain. Likewise, precision mouse movement often requires contraction of several opposing sets of muscles to maintain accuracy. Sometimes a contoured mouse can help relax the finger, but a solution will generally require consciously relaxing the finger, removing it from the mouse, and regularly taking rest breaks.

Left handed people

Yes, about 10% of the population is lefthanded, and this affects many aspects of workstation set-up. Mouse use is a particularly troubling area. A right-handed contoured mouse (often termed "ergonomic" because it tends to fit the hand better) is worse than a non-contoured mouse for a left-handed person. There are now some companies that make left-handed contoured mice. Some of the keyboard trays now allow the mouse platform to be moved easily from one side to the other. But in tight places the tray will have to be attached to the table somewhat to the right to allow for the mouse on the left. Some keyboards now have detachable number pads, which are very useful for lefties who do a lot of number entry. These are also available as a separate item. The telephone may need to be placed on the right side of the work station to allow writing with the left hand.

Wrists aren't straight

When the wrists aren't straight, tendons have to travel further around the angle and are pressed against wrist structures. Thisreduces the strength of the hands and fingers, tends to inflame the tendons, and can increase pressure in the carpal tunnel. This is true of both up-and-down and side-to-side wrist deviations. For up and down deviations, the keyboard needs to be at the proper height and tilt so that wrists are straight.The height of the tray should put the keyboard as close to the lap as possible, allowing an elbow angle greater than 90 degrees. A negative tilt of the keyboard (the back is lower than the front) assists in keeping the wrists straight. Ideally, the keyboard tray should be adjusted to the proper height after the chair is set to the right height (so that feet can be flat on the floor). If the keyboard cannot be adjusted, then the chair may have to be set up higher, with a footrest.

For side-to-side bending (which typically is more of a problem for people with wide shoulders or with very narrow keyboards, such as laptops), one of the split or bent keyboards may help. Other things to look for include armrests that are too far apart (which bring the elbows out), or resting your wrists on the desk or a wrist pad rather than having the whole forearm move to reach keys on the edge of the keyboard. Adjustable elbow supports and changes in typing technique can solve these problems.

Banging the knees on the keyboard tray

Some keyboard trays have attachments or adjustments that extend below the level of the tray, so that you bang your knee or rip your nylons when you move in or out. There is little that can be done to help this except avoiding that feature when purchasing trays.

Sharp surfaces

Sharp, unprotected edges on desks can compress the underside of the wrist causing problems with tendons, blood vessels or the median nerve. Ideally, adjust heights or use keyboard trays that are at proper heights and have soft padding where wrists rest. You should not continually rest wrists while typing, but rather let your arms float above the keyboard. This reduces wrist bending and excessive finger stretching. Only use wrist rests for pauses between typing activities. The adjustable elbow rests described above allow this "floating" forearm posture, by removing most of the arm weight from the shoulder.

"Anchoring" wrists on table or wrist rest and thus stretching fingers too far

If the hands are "anchored" to a wrist pad or arm rest, then you are likely to stretch your fingers more to reach keys, and thus twist your wrists more. A better idea is to keep your hands floating above the keyboard while typing, and to just rest your wrists every once in a while at pauses in typing.

Laptops

It is impossible to get a proper position while using a laptop: either the monitor will be too low, or the keyboard too high. Additionally, often the keyboard is small and the monitor can be difficult to read. Some improvements can be made by using either an external monitor and lowering the laptop, or by using an external keyboard and raising the laptop. Many laptops can be used with "docking stations"; these allow the use of the laptop's hard drive with a full size monitor and keyboard.

Cramped Space

Many offices are being compressed into smaller spaces, which tends to create problems with setting up computers properly. In addition to the obvious solution of more space, efficient use of the space can help. Monitor lifts give additional desk space under the monitor and can thus allow non-twisted posture. Reducing clutter under desks on a continuing basis can also help (since accumulated clutter forces the operator to sit farther away from the desk). Putting the computer CPU vertically on the floor or in a CPU caddy under the desk can free up desk space. Sometimes printers can be moved away from the immediate area (which also creates a reason to get up and move around on a regular basis to pick up print jobs). Experimenting with different set-ups using phone books and other home-made solutions can reduce crowding.

No back support

There is no acceptable substitute for a good chair that is properly adjusted. Pillows that attach to chair backs with straps or Velcro that can provide temporary lower back support. Experiment with the back of the chair set to different heights. You may find yourself leaning away from the back support due to other workstation deficiencies, for example:

the chair is so high that your feet are dangling off the floor,
the monitor is too far away or small,
glare makes the screen difficult to see-the tilt or height of the lumbar support is not set correctly.

Ask a co-worker to observe your posture over the course of the day to see how you are sitting.

No elbow support

There are differing opinions on the use of armrests: they are useful in giving support to the shoulders, but they can discourage you from moving your whole forearm while typing, causing you to twist your wrists more. A hard armrest can also put pressure on the elbow and compress the ulnar nerve. Long armrests can prevent you from pulling in close to the keyboard, which can result in long reaches. Non-adjustable armrests can result in your shoulders drooping too low or being pushed up. Or they may place your arms out too much to the side, thus increasing twisting of the wrist. Newer, padded elbow rests that are adjustable both horizontally and vertically give the best shoulder support. Sometimes these can be purchased separately to replace the older style armrests (or no armrests) on otherwise good chairs. It is also possible, in single-user chairs with fixed armrests that are too low and far apart, to wrap them with foam, thus bringing the armrest surface closer to the body and higher.

Improperly sized chair

A properly sized chair that is adjusted correctly is one of the most essential pieces of equipment. It should allow the feet to be flat on the floor, provide good lower back support, be adjustable so that positions can be changed over the course of the day (or for multiple users or multiple uses). It should not push against the back of the knee (proper pan depth and curved front), be adequately padded, and have adjustable elbow supports.

Big & small people

Most furniture is designed to accommodate about 95% of the population. This means that 5 people in 100 are too large or too small for typical furniture. This is particularly true of chairs and table heights. Some chair manufacturers make "papa bear" and "baby bear" chairs that that are designed to fit larger and smaller workers. Most table heights in modular panel systems are adjustable on a semi-permanent basis. Tall people can also be accommodated through putting blocks under tables to raise them up an inch or two. The ErgoEaser computer program (see above) can help in deciding on heights and angles of office furniture.

Elbows on hard arm rests or desk surface

Having the elbows on hard surfaces can put pressure on the ulnar nerve (well known as your "funny bone") which passes around your elbow. Proper height keyboard trays and mouse can reduce this, as can padding on arm or elbow rests (even some additional foam rubber padding put on with duct tape, while not pretty, can be effective).

Cradling the phone while using the computer

Cradling the phone between ear and shoulder to free up the hands for other activities is very likely to lead to neck and shoulder pain. The foam pads that attach to handsets help a little bit, but by far the best solution is a headset. In addition to eliminating the neck problems, these also help increase productivity since they make it easy to use the computer, pull files, or move around while on the phone.

Pulling files

Pulling files can be very stressful to the wrists and hands, since it requires a forceful pinch grip. This is especially true for tightly packed files. It should not be considered "light duty" for people who are restricted from other work due to Carpal Tunnel or other musculoskeletal disorders. There is additional stress if you have to reach for files in upper drawers where the wrist must be strongly bent while using a pinch grip. Solutions include cleaning out or storing less-used files to make them easier to pull out, and also putting the most used files in middle drawers.

Multiple users

Where more than one person is using a workstation, easy adjustability is crucial. This includes chair adjustments (seat height, back height and tilt, armrest height and width, pan depth, etc.), keyboard tray height, and monitor height. This is particularly important for people of very different sizes. Chairs in particular tend to present problems - sometimes two chairs can be set up (for two users), and swapped out (the second chair could be used for visiting guests).

Job stress

The highest levels of job stress are found in workers who have high work demands but low control over their jobs, especially if there is also low social support. Job stress is known to contribute to CTD's, as well as other problems, such as cardiovascular disease. There are some individual approaches to help reduce symptoms (exercise, meditation, mini-breaks) and also group solutions to try to prevent the problems through re-design of jobs and social relationships.

Not enough micro breaks

Constant work on a computer can lead to many problems. Micro breaks are brief task breaks where you get your hands off the keyboard and eyes off the monitor. This can include getting up to retrieve copies from the printer, stopping to make phone calls, stretching breaks, or other activities. They should be a minimum of 5 minutes an hour, but more frequent, shorter breaks are better. These are task breaks in which you perform other work activities, not "coffee breaks" (which should also be taken, but less frequently). Micro breaks tend to also improve productivity and concentration, as well as reduce stress on the hands and eyes. There is a variety of software and shareware that you can get to remind you to take these breaks, including some that give stretching exercises to do at the break.

Poor Typing Technique

Several typing techniques can lead to hand, arm, shoulder, and neck problems, particularly if in combination with improper computer set-up. This can include:

Keeping the little finger or thumb raised while typing (such as trying to not hit a key or spacebar by mistake when using cursor devices that are in the middle of the keyboard)
"Clacking" (hitting the keys hard)
Resting the wrists on the desk or wrist rest while typing
Inadequate breaks

Re-training can help with these problems. Lower strike force, letting the arms float above the keyboard while typing, relaxing fingers that are not being used, and reducing awkward stretches to far keys can all be helpful changes.

WORKPLACE HEALTH - Ergonomics and the workplace

There's been a lot of talk in recent years about “ergonomics”. Ergonomics is the study of the relationship between people and their work environments, which is very important to both health and safety. Good ergonomics adapt the job to fit the person rather than forcing the person to fit the job. In an ergonomic workplace, tasks and tools are designed to fit individual capabilities and limitations so people can do their jobs without being injured.

Ergonomics has emerged as a hot issue because it shows the link between certain types of injuries and the ways in which people perform their jobs. We now realize that the human body can only stay in awkward or unnatural positions for so long without paying a price.

The study of ergonomics, both in general and in terms of specific tasks and motions, has helped to identify what types of positions and movements can cause physical pain and injury, as well as ways to prevent these problems.

This article will explore ergonomics and how to avoid the poor ergonomics that put our bodies at risk. Take this discussion very seriously. After all, ergonomics affects each of us personally. We're the ones who get aches and pains when tasks or tools have poor ergonomic design. In addition, you are the only one who knows when you are experiencing pain and strain, and you're the one who's best able to determine what tasks, tools, and positions cause those symptoms. By being alert to problems, you can help identify injury causes and solutions. That means you play an essential role in helping your company create a workplace in which you can work productively and comfortably.

General hazards

Poor ergonomics leads to a number of serious physical problems. Often, we brush off the symptoms that could help us identify problems at an early stage. But that's the worst possible thing to do. With the types of physical problems discussed here, it's important to deal with them as soon as possible. If you wait until the pain is too much to bear, you may already have permanent damage.

Probably the most talked-about physical problem resulting from poor ergonomics is musculoskeletal disorders (MSDs). MSDs are the fastest-growing occupational concerns. MSDs develop over long periods of time. They're painful, sometimes even crippling, conditions that affect nerves, tendons, tendon sheaths and muscles, especially in the arms, hands and wrists. MSDs are sometimes called “repetitive motion syndrome” because repetitive motion is one common cause of this problem. Other causes include forceful exertion, vibration, and awkward positions or movements. The longer you expose your body to any of these situations, the more likely you are to develop a painful problem.

One of the most common MSDs is carpal tunnel syndrome. The carpal tunnel is a passageway in the wrist. When the nerve that runs through that tunnel gets pinched, it can cause tingling, numbness, and pain in the hand, wrist and even the arm. It can also reduce the strength and mobility of your hand and could, in the worst cases, lead to permanent nerve damage and even partial paralysis.

Other MSDs primarily affect the tendons, especially at or near the joints. One common problem is tendonitis, an inflammation that results from using the wrist or shoulder too much or in ways that they're not meant to move. If the condition is bad enough, the tendon fibers may even fray or tear. The longer MSDs are ignored, the worse they get. In addition, if you let them go long enough, they may not be able to be "cured." Failing to take early action may force you to live with the pain and with limited use of your hand or arm permanently. So pay attention to how your arm, neck, shoulder, hand, wrist and fingers feel.

Let a supervisor know immediately if you experience:

Pain or achiness
Numbness or tingling
Stiffness
Burning
Swelling
Weakness

Another type of ergonomic problem relates to vibration. Repeated, prolonged exposure to vibration may cause Raynaud's syndrome, or white finger. That means the skin and muscles aren't getting enough oxygen from the blood. It may take months or even years for a worker’s fingers and hands to feel the effects of working with vibrating tools. But once the symptoms get really bad, it can be too late. In the worst cases, the tissue in the fingers can die or you might lose the use of your hand.

So if you work with pneumatic tools, grinders, chain saws or other tools that vibrate, you have to be very alert. If you work with these tools when it's cold or if you smoke, you're particularly at risk.

Here are the symptoms to watch out for:

Tingling
Numbness
Pain
Fingers turning white and losing feeling
Loss of finger dexterity

Vibration-related injuries can be permanently crippling if you don't catch them early. To minimize vibration and its negative physical effects:

Operate tools at the lowest speed possible without lengthening the time it takes to do the job.
Keep tools well-maintained.
Hold tools as loosely as safety permits.
Wear gloves designed to protect against vibration.
Use offset or spring-loaded handles or shock-absorbing exhaust mechanisms to reduce vibration.
Use mechanical aids rather than your hands to grasp and hold pieces.
Avoid bending your wrists or placing your hands and arms in awkward positions.
Keep your body, especially your hands, warm.
Try to alternate tasks so you don't spend all day operating a vibrating tool.

Identifying hazards

As mentioned above, the study of ergonomics has identified a number of tasks and positions that are most likely to lead to cumulative trauma disorders and other physical problems. Among the risk factors for cumulative trauma disorders of the arm and hand are:

Repetitive activities – making the same motion over and over. The longer you repeat the same movement, the greater the risk.
Forceful exertions, particularly with the hands. The combination of repetitive motion and force, such as pushing on a tool over and over, is a particular risk.
Staying in the same position, whether sitting or standing, for an extended time.
Awkward body postures, such as reaching above your shoulders or behind your back or twisting your wrists to perform tasks.
Continued physical contact between hands or arms and a work surface or surface edge.
Excessive power tool vibration.
Hand tools that either don't fit the job or don't fit the hand.

Poor ergonomics can also injure the back. Among the factors that raise the risks of back injury are:

Bending continually from the waist.
Lifting from below the knees or above the shoulders.
Twisting at the waist, especially while lifting.
Lifting or moving objects that are too heavy or awkward.
Sitting for long periods of time, especially if you have poor posture.

We'll get a little more specific in a minute about the kinds of movements, positions or tools that you should watch out for. But in general, poor ergonomics means forcing your body into unnatural movements and positions. When you do that, your body uses pain, achiness, numbness, etc., to tell you there's a problem. It's crucial that you be alert to those symptoms, because, if you just keep doing what you're doing, your body will finally send signals which are so strong that you can't ignore them and you may have to live with the results for the rest of your life.

Protection against hazards

In its ergonomic guidelines for meat packers, the Occupational Safety and Health Administration explains that there are four parts to a good ergonomics program:

1) Worksite analysis

2) Hazard prevention and control

3) Medical management

4) Training and education

By including training and education, OSHA is emphasizing that good ergonomics is everyone's responsibility. It's up to the employer to provide you with information and guidance on how to avoid risks, but only you can use that information to do your job in the proper way.

Engineering and work practice controls

When it comes to preventing and controlling hazards, OSHA recommends that employers look first at engineering controls that can help improve the way the job fits the person, rather than forcing the person to fit the job.

One type of engineering control might be to modify the design of a workstation – for instance, moving the work surface to a height that's more comfortable for the individual worker. It's also possible to redesign the work method. You could, for example, put handles on boxes to make them easier to lift. Engineering controls can also mean redesigning tools. One recommendation is to provide tools with a selection of handle sizes so that each individual (of any size, right- or left-handed) can find one that's comfortable to hold and use.

When engineering controls aren't enough, you can try to ease the strain with work practice or administrative controls. That might mean scheduling more rest pauses for someone who works with a vibrating tool, rotating tasks so the worker is not constantly in the same position using the same muscles, or using mechanical equipment for a task rather than doing it by hand.

Safety procedures

Let's talk now about things you can do to improve the ergonomics of your workplace and reduce the chance of injury. The positions you work in and the movements you make are key parts of ergonomics. And, these are things over which you have control.

First, look at how your workstation is organized. Do you have to reach more than 20 inches to get to tools or materials you need? If so, try to rearrange your workstation to bring those things closer.

Bending and twisting are also problems. For most people, a comfortable work surface is at about waist height. A work surface that's more than 6 inches below your waist is probably not in accordance with good ergonomics.

If you can't make these changes yourself, talk to someone. You will need to figure out a way to make your workstation more comfortable. Here are some other things you can do to reduce the risk of injuries caused by poor ergonomics:

Keep your elbows down on the work surface instead of leaning on the elbows.
Work with your palms down.
Work with your wrists straight, not bent.
Shift positions every so often; don't sit or stand for too long at a stretch.
Perform tasks with two hands rather than one when possible.
Grip objects with your whole hand and your fingers – a power grip – in order to distribute the force over a larger area of your hand.
Try to avoid applying pressure to a tool with the center of your palm; that spot is much weaker than the parts of the hand padded with more muscle.

Tool use and selection

Tools are another important part of ergonomics. First and foremost, select a tool that fits the job. If a tool is too small or not really designed for your purpose, you're going to be forcing the tool – and yourself – into bad positions. It's also a good idea to use a power tool rather than a hand tool when possible. Another suggestion is to use the lightest available tool for the job.

Other ergonomically desirable things to look for in tools include:

Padded handles
Textured grips, rather than grips with pre-cut finger-hold grooves
Triggers that are operated by more than one finger.
Tools that can be supported by two hands or an overhead suspension system.

Saving your back

When it comes to avoiding back problems, the most important thing is to lift properly – let your knees rather than your back do the work. The details of back safety, including proper lifting, are important enough for their own safety meeting. But in general, remember to:

Avoid lifting; whenever possible, use material handling systems.
Don't try to lift objects that are too heavy for you or whose size and shape are too awkward to allow a good grip.
Don't twist while lifting or carrying a load; that's one of the fastest routes to back injury.

Conclusion

This article has outlined some of the most common ergonomic problems, their causes and some actions you can take to reduce the risk of injury. But, as you know, ergonomics seeks ways to make the job fit the person, rather than the other way around. That means it is, by definition, a very individualized approach to designing tools, tasks and work areas.

Each individual body is different in terms of size, shape and capability. Each of us uses different tools and movements and sits, stands and moves in different positions in the course of a day. So any effort to make your workplace really ergonomic – to adapt jobs to people and not force people to fit their jobs – must involve every single person in the workplace.

If you ignore symptoms for too long, you may eventually be unable to perform your current job. You may have to permanently transfer jobs, undergo physical therapy, or even have surgery. In the very worst cases, you may develop such a major and painful disability that you're unable to work.

So pay attention to how your body feels when you're working. Try to identify what causes pain, numbness or other symptoms. Work with your supervisors to make sure you have a workplace that's free of ergonomic hazards.

MEDICAL NURSE - 4 Simple Ways for Nurses to Improve Patient Satisfaction Scores

1. Who Are You Caring For?

Providing nursing care to patients is an intimate process. A process that many times includes removing all modesty and privacy of the patient to perform our very jobs. The irony is that this is the very thing that nurses try to protect and approach in a cautious manner due to the sensitivity of the situation. However, as a patient and a nurse I can assure you that no one has ever felt more vulnerable and at the complete mercy of others when placed completely naked (other than that paper-thin gown) and forced to wait on that cold, hard table awaiting for an ominous figure in the white coat. So, remember who you are providing care for other than that semi-naked person underneath the hospital-issued blue & white speckled gown.

Nurses are at a disadvantage when it comes to "knowing" our patients. We've already spent 10-15 packed minutes of your entire history, diagnoses, medications, previous hospitalizations and surgeries, family members, significant others, occupation, insurance status, social status, laboratory and diagnostic results with the previous nurse that cared for you. We're focused on our tasks at hand that include patient safety, pain medication, antibiotic administration, fluid and electrolyte balance, and the list goes on: Unfortunately, it doesn't allow the time for us to sit down and listen to find out about our patients on a personal level.

So, one small act a nurse can do is simply being interested in your patient; other than treating them as the sick person in a hospital gown. So, take just a minute out of your usual routine and ask your patient about their life. What do they do, or what did they retire from? Do they have children? What are they most proud of? It's likely you'll find something in common with your patients after a couple of simple questions and it will be amazing the sincerity that you'll receive in return.

Source: Leslie Young via Centers for Disease Control & Prevention

2. Give 110%

It's reasonable to say that the typical nurse provides 105% of their effort on any given day. But rare opportunities arise when there is a lull in the day when the nurse has the option to decide between sitting down, taking a deep breath or providing a helping hand. I'm not telling nurses to avoid breaks or to not enjoy those rare moments, but if you see a visitor who looks like they're worn out and lost in the confusing matrix of the hospital, just offer yourself. A simple offer of a wheelchair ride to their car or assistance with directions will be greatly appreciated. One will be surprised how quickly word spreads about these compassionate staff members that take the extra minutes out of their day to help not only patients, but their loved ones as well. Patient satisfaction isn't always about satisfying the actual customer; it's providing genuine compassionate care to every person you meet.

Source: Nasheka Powell via Centers for Disease Control & Prevention

3. Be on their Level

A simple rule that many fail to notice because they're simply too busy trying to keep up with day-to-day necessities of a healthcare job, is recognizing that the patient is an actual human being. Being able to look past the illness in a hospital gown and connecting with the human being underneath is the first step in providing excellent patient care. Remember when talking with patients to meet them at their eye level, listen before speaking, and try to take a "short walk in their shoes." Is this patient a 65 year-old lifelong farmer with a 3rd grade education that requires medical jargon to be broken down in simple, easy-to-understand terms? And does this same patient have macular degeneration that disables his vision; but he signs your consent papers anyways just because of your request? Basic knowledge of a patient's background will provide one with the ability to be an excellent patient advocate and prevents miscommunication that commonly occurs between medical providers and their patients.

Source: Richard Duncan via Centers for Disease Control & Prevention

4. Expect the Expected

Hospitals as well as the patient-admission process can be a mystery to outsiders and non-healthcare workers. Remember to always inform the patient and designated family members about what to expect: Especially concerning common delays that occur in the hospital environment, frequency of laboratory draws, vital signs, explaining the invasive nature of procedures, and to reassure them that they are receiving the best of care. Additionally, inform family members of common complications to expect for their ill family member. For example, if Grandma is admitted with a urinary tract infection, be sure to warn family members about confusion, agitation, forgetfulness and extra precautions needed to ensure her safety. Family members are never happy when they arrive at 7 in the morning the following day to find Grandma asking them why strangers were sleeping in her bed last night. Delirium is a very real complication for these elderly patients and nurses are so busy staying focused on labs, antibiotics, and safety measures, that we often forget to educate their family members. Therefore, every encounter with a patient or family member should involve some type of education: Educate them about their diagnosis, common side effects, medications, reviewed test results (especially if family members weren't present during physician/provider rounding), or a review of the patient's progress. When patients and families are involved in their care, expectations have already been exceeded.

COURTESY - The lost art of "Hello, how are you today"

The lost art of "Hello, how are you today"

by uptownbrown

Are good manners a lost art?

Have we really come to the point in our society that we no longer feel the need to greet or be greeted to get what we need? There once was a time when you entered a store and were made to feel as if the store operator had been waiting for you to come in, not just anyone, but you! "Hello, how are you today" was a common, almost mandatory greeting. In today’s world it seems we struggle to get any type of greeting. Have we really slipped all the way down to "what do ya want"? Is this all we have time for anymore? Are manners really a lost art? Is it just because our parents are not behind us with a hand raised ready to slap us in the back of the head if we are not polite? Why have we strayed so far form the simplicities of having to be polite, or even simply wanting to be!

I was brought up on a small farm in northern Vermont in a time when manners were enforced. When I say enforced, I mean that hand raised poised to set me straight, if I was not courteous. Not just to those in my immediate family, no not just them! It was expected that you treated everyone in a manner such that you were seen as a polite young man, oh and if you didn’t, there would certainly be consequences! It was just common place, please, thank you, yes sir, and no mam, these words could almost always start you out on the right foot. Now we say yes mam to the lady on the other side of the counter and we often are looked at like we just cursed at them! When I was brought up mam was not a sign of how old you were but a polite term said to all women. I don’t know how many times I have been reminded after the choice of mam that “mam? Really do I look that old ”? If you would like to see a look of disbelief throw a thank you mam! At the twenty something girl on the other side of the counter. It has become, can’t believe I am saying this, but an unfriendly term towards a young lady! What the hell has happened to all of us! Why must we streamline, speed pass, and dumb down everything for the sake of time and efficiency? To the point where it’s ok to not be polite and god forbid have a bit of small talk? Who is to blame for this? Parenting? Society? Schooling? Pick your poison they all play a role.

Parenting, now maybe that’s the lost art. Just seems as though things were done differently back when I was a young man. My parents brought me up right, or at least I think that now. As we all know when we were kids there was nothing worse than listening to your parents and pretending that they were right about everything. Looking back now, holy crap they were!! I was taught at a very early age that there was a certain way that things would be done and a particular way to treat others. I mean really what parent doesn't start word training with please, thank you, yes sir, and no mam. Maybe not in these exact dialects but in some form. Manners were one of the first things that a new parent would teach, and you didn't even need the “guide to being a super parent” book to help with this one. It was something that came as second nature, something that was like knowing that letting little Jimmy jump off the roof or play with matches wasn't the right thing to do. Some things are just common sense right? If so, what the hell has happen to this generation? Not only are kids jumping off roofs and playing with matches, but it is next to impossible to get a pleasantry out of today’s work force? What the hell! When did this happen? Where did I go wrong? My parents brought me up better than this! That’s what you’re all saying right now. So maybe parenting is not the only fault? For arguments sake let’s just say it’s not the parenting, then what? What could it be?

It has to be how we are taught in school right? It’s the teachers! They are the culprits here, I knew they couldn't be trusted. I tried to tell my parents that when I was back in high School but they didn’t listen. “Mom I told you that Mr. Teacher was a real ass” I said, “why” mom asked. “He’s asking way too much of me!” I exclaimed. “How’s that” asked mom “He wants me to do my homework and hand it in on time! He wants me to engage with the class and explain how I feel! He wants me to treat others who have a differing opinion with respect! And to top it all off he wants me to answer him with yes sir, no sir!! I ain't gonna do it cause I don’t owe Mr. Teacher nothing” I said. “This is because you already know everything about everything right?” she politely asks. “Yea and its bad enough that I got to act like that around here mam”. Now this is when the raised hand ready to correct comes in, you may want to look away. My parents never did use that hand as more than a jester, but that was enough to create a moment of fear and reflection. Soon you would be sent down the right path with your tail between your legs. The moral here is that our teachers, as hard as it was to believe then, were simply trying to perfect upon our parents earlier lessons. Look back at it today and you can see that schooling was always a bit smoother on the kids who were respectful, right? Ok so this answers some of our questions, and raises a few more. What is the problem, if not parenting or schooling then what could it be?

Our parents brought us up knowing the commons laws of treating others with respect. Our teachers further imprinted this into our way of life. So where has it gone wrong, has society come to the point that “what do you want” is more customary than “hello how are you today”. Why? Why? Why? Is time so precious that we no longer have a moment to be polite? Do we really have so little time for the person on the other side of the counter, that we need not be polite? I say it shouldn’t matter if you’re in a hurry or not. Manners should be necessity not time related event! Yea I get it, we are all busy! Bla Bla Bla, ya know what I'm busy to, work, parenting, shopping, ball practice, and I could go on and on but ya know what I always have time for “hello how are you today”! There is really no good excuse or answer for why we have lost the fine art of “hello how are you today”, but it makes it no less important to return to a era when we had time to be polite. If I could show you the shocked and awed faces of my customers when I ask such a question, you would see just how far we have fallen. Such surprise that someone has time for them? It shouldn’t matter whether it is the suit & tie type or the dude in sweatpants, we should always take a moment too be polite to gain a sense of comfort with them. And hopefully next time when they are faced with the choice, maybe just maybe, they will remember the “hello, how are you today” guy opposed to the “what do ya want“ guy from down the street.