Lynch Ryan’s very first client was a Massachusetts community hospital where the experience modification factor was 2.77, primarily due to nursing and nursing assistant back injuries.

The year was 1984, 86 years after Mrs. Robb’s observation, quoted above, and the hospital had two problems: What to do about the employees who were suffering the back injuries and how to prevent them from happening in the future.

Pulling a good-sized rabbit out of a small hat, we were spectacularly successful at solving the first problem, but pathetic failures when it came to the second.

Oh, we knew what should be done. We had grand plans, but execution was beyond all our best efforts. And the problem continues to this day with no end in sight.

When we studied the problem of back injury prevention in the nursing industry back in 1984, these are the things that got in the way of a successful result then, and where they stand today:

• The vast preponderance of back injuries happened while nurses and nursing assistants were trying to lift or move patients. That is still the primary problem.
• In nearly all back injury cases, patient lifting or moving was being performed manually. It still is.
• Although mechanical lifts were available, they were expensive and took time to set up and use, time that was often in short supply. Today, a Hoyer Manual Hydraulic Lift costs anywhere from $900 to $1,400; slings are about $370. Hospitals should have a couple of units per floor. Employees need to be trained in how to use the equipment. A few hospitals, very few, have specially designated and trained teams. Although not a really big ticket item, the costs do add up, and the administrative logistics can be daunting.
• There was no limit on how much a nurse or assistant would be required to lift, and more and more obese patients were turning up in the hospital. That issue is much worse now.
• Many nurses and nursing assistants were themselves overweight or obese and, consequently, even more unable to lift overweight or obese patients. Today, in addition to the weight issue, which still remains (a 2012 University of Maryland study found 55% of nurses to be obese), the average age of nurses is higher than it was in the 1980s, and, because of budget constraints, there are fewer of them per patient.

While back injuries are the greatest source of loss with respect to nurses, the situation is even more problematic for nursing assistants.

Nursing assistants suffer more back injuries than any other occupation. And as America continues to age — baby boomers turn 65 at the rate of one every nine seconds — the problem is only going to get worse.

This horrendoma that nobody seems to want to address is so severe that injuries in the health care sector dwarf any other industry.

As we careen, helter-skelter, down the Make America Great Again pothole-pockmarked highway, you’d think some genius would finally figure out how to fix the problem Mrs. Robb identified back in 1898.

Then again, maybe not.

Tom Lynch is a principal with Lynch Ryan & Associates, a Massachusetts-based employer consulting firm. This column was reprinted with his permission from his Workers' Comp Insider blog.