Monday, July 4, 2016

Celebrating and suffering

It is now five years since I began teaching Alexander Technique in Melbourne. I love teaching both individually and in workshops. It keeps me inspired every day. The downside is that I tend to see postural problems all around me.

A recent hospital stay exposed me to the dreadful situation of many health workers - and patients too. There is too much unnecessary suffering for those people in the future, if not already.

Health system warning
All of us need to be mindful at work.  Here I focus on the health system, but I suspect the problems occur where you work too. Please take it seriously and call on help if similar problems are widespread where you work.

I was in hospital for three days because of chest pain. No problem thankfully. The search for a cause took many tests, none of which were conclusive. Pancreatitis was suspected so I stopped drinking alcohol. Months later without pain, I'm sure it was gastric due to over-eating. So on doctor's OK, I was really pleased to resume my daily nip of whisky.

Riding hard in the ambulance
The paramedic riding in the back with me said 10% of his colleagues are off work with injury. They have to lift people from awkward confined places, like the shower, where maintaining good posture is difficult.  The ambulance driver is new to the job, and is concerned that paramedic work will exacerbate longstanding lower back issues.  She was very interested in my explanation of how Alexander Technique might help.

Beware the ultrasound
I was asked to have an ultrasound. The operator sat facing a screen that displays the image coming from the device that was moved around my body with the right hand. It is awkward work.

She has hand pain and said 50% of the 12-14 operators at the hospital have problems. She was initially sceptical that Alexander Technique could help any more than other approaches that they have tried.  But this seemed to change as I explained that AT investigates how we do things,  changing unhelpful habits and using less effort. What a pity we could talk for only a few minutes.

How do nurses bend?
Nurses are often bending over patients, perhaps administering medicine, fixing a bandage or helping them change position.

In the process, I noticed that most nurses keep their legs almost straight but bend in the middle of their back. They unconsciously misuse themselves, perhaps due to a mental map of their bodies that goes back to childhood and which hasn't been challenged by their anatomical training.

Learning how to release the knees in a lunge or monkey could help enormously.  A fellow patient instinctively did this as he folded by the joints to bring his eyes below the window blind, allowing him to see the view to the mountains.

I had several opportunities to talk to one nurse over the three days of my stay. By the end, she was convinced Alexander Technique was worth a try, and found great benefit. She came for six lessons. She now stands without thrusting her hips forward, and sleeps much better at night. She no longer needs orthotics in her shoes when working. How's that!

Pushing a heavy trolley
One observant staff member described the posture of the staff who push trolleys day in and day out.  The workers hold themselves rigid, leaning forward with rounded shoulders - even when not engaged in this activity.

Hospital budgets seemingly don't allow for job rotation and sharing.

Hospitals do clerical work too
Hospitals are now equipped with some standing desks at work stations as well as portable units on wheels that are used in the wards to check and update patient records.

As I saw it,  they are typically used poorly from a postural viewpoint. Key boards are too high so arms are reaching up,  screens are too low inviting a slumping forward. The standing desk can also invite locked knees and hips way too far forward.

But it wasn't just this problem.  Looking through to the back offices,  clerical staff were slumping,  pulling heads back and more. Not a pretty sight to someone trained to observe how people are using themselves.

Tentative answers for our workplaces
Will real action that works be taken to fix the problems in hospitals and in other workplaces?

I want to see organisations

  1. Bring in more job rotation and sharing to reduce time spent fixed in one position.
  2. Bring in skilled people trained in identifying problems in how people are doing their work, not just changing equipment and work practices but changing deeply ingrained habits that lead to postural problems and pain.
  3. Allow for learning over time both in groups and one on one.
  4. Rigorously evaluate each approach for results in addressing poor postural habits, reducing injury, and improving pain management.

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