Sure, I may have acquiesced to standing at work, but I didn’t exactly suffer in silence. I can pour more eloquence into describing the pain in my knees, calves, feet, and heels, than I could into a love letter. But yesterday I learned I had something to be grateful for – at least nobody’s going to die because I’m uncomfortable.
That isn’t necessarily true for nurses assisting in surgical procedures. It’s not like they can just pop out of a delicate operation and lay down because their feet got tired. And if their exhaustion gets the better of the them and they stumble, they risk contaminating the carefully sterilized equipment and furnishings in the operating room.
Nurses, apparently, have also spent some time ruminating on the problems of standing. But instead of complaining, like I do, they put together thoughtful and well-supported policy guidelines that outline the risks of standing and give recommendations for improving working conditions.
As part of a larger effort to catalog patient handling pitfalls and offer ergonomic solution, the Association of periOperative Registered Nurses (AORN) wrote a detailed article on the dangers of prolonged standing, and offered suggestions for improving working conditions.
Of course, for those with sitting disabilities, standing isn’t just a job hazard. It’s a life hazard. But many of the problems, and suggested solutions, still apply.
1) Standing Is Bad for Your Circulation
Oh, really? (Pardon me while I turn up my sarcasm dial to 10.) So is THAT why my legs hurt after a day at the office? Gee golly, so it’s not a COINCIDENCE that I’m walking around on water balloon legs?! I thought my veins were SUPPOSED to look like a river map of the Amazon!
This is kind of a “Well, duh” statement for anyone who has tried them both. Still, it was nice to see a succinct explanation for my subjective experience.
The article authors note that, “When a person is maintaining an upright posture and standing in one position without the relief of walking periodically, circulation of the blood and other body fluids is compromised. The resultant pooling in the lower legs and feet causes swelling that may progress to inflammation of the veins and varicose veins.”
2) Comfy Footwear Is a Must
An entire section is devoted to the importance of good shoes. Good shoes, by AORN’s definition, are those that maintain the natural shape of the foot, have closed toes, have shock-absorbing insoles with arch support, and a heel that firmly grasps the foot. Shoes with laces are preferable to those without, since laces make it easier to adjust the shoe’s fit.
I’m sure any nurse would laugh at me, but I used to wear high-heeled shoes to work almost every day. My justification? Comfort.
Needless to say, THAT changed when I couldn’t sit. I got actual comfy shoes, and a cushy mat at work. Eventually, I made a pact with the world. (Needless to say, I did not consult the world.) If I had to stand everywhere, I could wear whatever shoes I wanted. Even at work. Even at weddings.
Now, about three years in, I’ve become fanatical about proper footwear. I wear my Croc slippers in the house. I have dedicated standing shoes, which are different from my walking shoes. My flats have high-arch insoles. I am passionately in love with my Merrell hiking shoes, which are completely waterproof and have treads that would allow me to scale Everest.
3) If You Stand Too Much, You’ll Mess Up Your Joints, Tendons, and Ligaments
Since I heard from many sitting disabled people about the downstream consequences of standing, this one was no surprise. Knee and foot pain seemed to be a common theme, and until I got a sitting disability, I didn’t realize tendons could hurt so much.
Standing all day stresses your body a little too much. The papers says, “As well as musculoskeletal implications, the weight of the body plus any load being carried or held can result in injurious compressive forces on the joints, leading to joint damage and arthritis. It is also suggested that the immobilization or locking of the joints in the spine, hips, knees, and feet that can occur during prolonged standing can facilitate degeneration in the tendons and ligaments and even rheumatic diseases. Plantar fasciitis, heel spurs, and other foot problems are also linked to standing for long periods.”
4) Your Feet Need Friends
Were you aware that antifatigue mats are different from thick foam-rubber mats? I was not, but apparently it’s an important distinction. Antifatigue mats are textured in such a way that they encourage slight movements, which may be enough to keep the blood flowing properly. Thick foam mats discourage postural adjustments, and can cause a person to tire more quickly.
AORN recommends the use of antifatigue mats, especially in places where it’s not practical to install flooring with more give. (Apparently no one wants to clean carpets in the operating room.)
They also recommend the use of footrests, which allow workers to shift their weight from one foot to the other periodically.
5) Standing Might Be Even Worse if You’re Pregnant
What’s worse than a nurse who imperils her own health and a patient’s? A nurse who imperils the health of herself, her patient, and her baby.
The guidelines referenced studies which showed increased risks of premature births, spontaneous abortions, and low birth weight babies, for women who were required to stand at work for several hours at a time.
They also noted that pregnant women were more likely to suffer low back pain, which is not exactly shocking, considering they are basically carrying a watermelon on their front at all times. (Personally, I’m more surprised that there are pregnant women who don’t have low back pain.)
How Much Standing Is Too Much?
One rather sobering observation from the article was, “The deleterious effects of prolonged standing have been described as aging a person by 20 years and as equivalent to the damaging cardiovascular effects of smoking, high blood pressure, and high cholesterol level.”
Consequently, AORN suggests limiting continuous standing time to two hours (or one hour, if lead aprons are required), or to 30% of the workday.
For sitting disabled individuals who have some flexibility built into their working conditions, this might be a good rule of thumb. Certain open-minded employers that are not hospitals might also find these guidelines instructive.
I’m still waiting for the day when nurses recommend couches as workstations. Then we will have progressed as a society.
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