Why does ergonomics matter?

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Ergonomics is a frequently overlooked facet of workplace safety. But, providing top-notch patient care shouldn’t come at the expense of ensuring an injury-free environment for veterinary staff. At the Fetch dvm360® veterinary conference in San Diego, Benita Altier LVT, VTS (dentistry) spoke about the importance of participatory ergonomics in veterinary dentistry, but her guidance can easily be applied to various aspects of the profession.

Contorting to examine the ears of an anxious patient, hunching over in a desk chair to complete charts, bending to lift an overweight dog—these are all potentially harmful habits veterinary professionals routinely experience. “The physical nature of the work can make it difficult to have a long career in veterinary medicine,” Altier said. “But there are little things that can be changed every day to increase the longevity of our profession.”

Beyond a basic comprehension of ergonomics, Altier said it is in veterinary professionals’ best interest to understand participatory ergonomics, which requires playing an active role in planning and controlling a significant number of work-related activities. This involves taking an analytical look at how daily tasks can be improved and putting together a plan of action. It’s more than minor aches and pains, Altier pointed out. Work-related musculoskeletal disorders (WRMD) cause a significant amount of lost work time and bodily injuries.

A pain in the neck...and back and shoulders

WRMDs vary in severity and are among the nation’s most common workplace injuries. “Without treatment or proper time to heal, WRMD can lead to permanent damage and even anatomical changes if scar tissue forms,” she warned. In veterinary medicine, most musculoskeletal disorders are the result of small repetitive movements that cause ongoing strain. Think placing sutures or cleaning teeth.

One of the most recognizable WRMD is carpal tunnel syndrome, which occurs when the median nerve in the hand is compressed as it travels through the wrist. This results in pain, numbness, and tingling in the hand and arm. Women are more susceptible to this particular condition as are individuals living with rheumatoid arthritis and hypothyroidism, she explained. “This is definitely something people suffer from when they perform repetitive motions.”

Persistent discomfort in the neck and shoulders is another common ailment. This is due in part to constantly maneuvering the body to examine a patient and moving towards the animal rather than adjusting the animal to meet your height. “Poor posture can cause you to flex the neck forward more than 15 degrees for long periods of time,” she explained. “We also start hunching our shoulders towards our ears without even realizing it.” When pain is present, it becomes second nature to then try and compensate by moving into positions that provide temporary relief. Many times, this exacerbates the problem by causing strain to other parts of the body. It’s a vicious cycle.

How can participatory ergonomics help?

“Participatory ergonomics helps reduce risk factors associated with WMSD, decrease injuries and lost time at work, prevent a decline in the ability to perform your job, and increase productivity and efficiency,” Altier said. To start, she recommended looking at these 3 aspects of a typical work environment to see where changes can be made:

• Posture: Too often, the veterinarian or veterinary technician manipulates their posture to meet the patient. This results in an abnormal curvature of the spine and overextension of the neck. Take note of your position when you are examining patients performing a procedure. Are your shoulders hunched, head tilted, or elbows above the wrists?
• Equipment: The location, height, and weight associated with equipment all play a pivotal role in proper ergonomics, Altier explained. Swivels, integrated lighting, a comfortable grip, handle diameter, and straight air and water lines all make a notable difference in how much veterinary staff needs to strain or overcompensate to complete a procedure.
• Scheduling: Appointments that require a high level of precision or will take a long time should not be scheduled consecutively for the same veterinarian. Breaks are imperative, she said.

Changes to consider

Some areas of participatory ergonomics will be completely personal, such as adjusting a chair to meet your needs, while others may require the input and cooperation of various team members. Altier encouraged attendees to initiate group discussions and make small adjustments over a period of time so that the changes are both manageable and rewarding.

Here are some of her suggestions:

1. For optimal posture and comfort, both the exam table and the patient should be adjusted to the ideal position for the operator. This ensures a normal curve of the spine without undue pressure or stress.
2. Proper seating should support a neutral posture that avoids nerve compression in the legs, thus adjustable chairs should be made readily available.
3. Allot for mini-breaks during a procedure to stretch strained muscle areas.
4. Avoid hunching shoulders up toward the ears and tilting your head to one side.
5. Forearms should be parallel to the floor when in a working position and the elbows should not be elevated significantly above the hands.
6. Opt for larger diameter, round handles with a textured grip to help facilitate an easy grasp.
7. Choose hand-specific gloves to help reduce stresses on hand muscles and joints from ill-fitting ambidextrous exam gloves.
8. If you are healing from an injury, allow yourself time before committing to tasks that require you to repeatedly reinjure the area.

Most importantly, she said, come up with a plan. Go to your boss with information about how the hospital’s chairs cause staff to strain and overextend to perform procedures, and how that is negatively affecting their health. Preemptively select and price the chairs you want to use and explain how this will prevent staff from developing WRMD. There is a trickle-down effect to everything, she said. With less pain, you will have an improved quality of work which can enhance time management and allow you to provide help to additional patients.

“Our jobs have become more complex and time-consuming, but we really have to take care of our own health and wellbeing to be able to manage those additional responsibilities,” Altier said.

Amanda Carrozza is a freelance writer and editor in New Jersey.