Blame the nurse

Lana Robertson’s story – not untypical of nurses who suffer manual handling injuries – highlights the dangers posed by suggested changes to the NSW workers’ compensation scheme.

Lana: “I can’t take care of my family and my home the way I used to.”
Lana: “I can’t take care of my family and my home the way I used to.”

Despite two rounds of back surgery, and endless medical appointments far from home, doctors say she will never be well enough to resume all her former nursing duties.

“I’m 38 years old and my life has completely changed because of this injury,” says Lana, an endorsed enrolled nurse and mother of two from Lake Cargelligo, an isolated township in central west NSW.

When she is fit enough for part-time work, Lana’s wage from restricted-duties nursing at Lake Cargelligo Multi Purpose Health Service (MPHS) is supplemented by workers’ compensation payments.

When unable to do any work her compensation falls to the statutory minimum of $17 an hour. Her income has sometimes dropped to as little as half her pre-injury level.

Each of the dozens of medical appointments – tests, treatments and operations – have involved long, painful drives: to the physio at Griffith (a 260km round trip), to Wagga for an MRI (560km), to Lana’s neurosurgeon in Canberra (800km) and to the insurance company’s Sydney neurosurgeon (1100km).

Now, a state government issues paper is proposing that weekly compensation payments be capped in order to “give workers a fixed time frame during which they know they need to work toward a certain level of work readiness.”

It also recommends a cap on payment of medical treatment for injured workers because “many workers have access to medical treatment many years after their date of injury.”

Under the present system, Lana’s insurance company pays for her treatment and medications, some of which cost as much as $150 a month. Insurance also reimburses her travel costs. Lana is appalled by the “blame the victim” approach taken by the authors of the issues paper. She says the stigma of being on workers’ compensation is hard to bear.

“I hate the perception some co-workers have of you. They think you might be shirking, because they can’t see the injury. But what type of neurosurgeon would do two back surgeries in 18 months, which I went through, if there was nothing wrong with you?”

She accepts there may be a need “to weed out people who aren’t fair dinkum” but asks, “What about people like me who are fair dinkum? Why should I and my family have to suffer any more than we have?”

Lana’s husband works as a shearer. They have a son, 15, and a daughter, 12.

“My husband shears up to 10 months of the year. Before my injury we were able to put money away for the periods when there’s no shearing, but now for the first time in 10 years we have nothing in the bank.

“I can’t take care of my family and my home the way I used to. Luckily I have a very supportive husband. But it’s terrible having to say no to the kids.”

In 2007 Lana thought she strained a back muscle while stopping a resident from falling. A CT scan showed she had two bulging disks. She had physiotherapy and resumed her normal job. In 2009, while squatting down to help a resident get undressed she felt “a pop in my back and pain down my leg. I ignored it at first but it got worse. I took sick leave thinking it was just a pinched nerve and it would get better.”

However an MRI scan confirmed a bulging disk and compressed root nerve. A neurosurgeon advised a microdisectomy to try to take compression off the nerve.

Lana underwent the operation in January 2010. It eased the pain so she went back to work on light duties, gradually building up her nursing hours.

A year later the pain down her leg had returned to pre-surgery levels. Another MRI scan showed the disk was once more compressing on the nerve. And the disk had split and was leaking.

Her neurosurgeon then performed posterior lumbar interbody fusion surgery in August 2011, with the aim of stabilising the spine and reducing pain. The fusion took but the severe “pins and needles” pain is back to the level of a year ago. “It’s a horrible pain. I wouldn’t wish it on my worst enemy,” she says.

Doctors have told Lana’s employer she will not be able to return to her normal EN job full time. She currently does nine hours a week.

“Our manager has been wonderfully supportive in finding me light duties. I do medications, feed the residents, do hazard inspections and paperwork, and sometimes observations depending on the state of my back.

“Lake Cargelligo MPHS has a hostel and nursing home, plus acute care and A&E, so there’s a lot of manual handling that I can’t do. And I’ll never be able to do CPR again. Fusion puts more pressure on other disks, so I could very easily blow another disk if I’m not careful.”