To stand or not to stand? Implications of prolonged standing for perioperative nurses: A discussion paper

Perioperative nurses, including perianaesthesia, instrument and circulating nurses, stand for most of their shift – anywhere from one to eight hours at a time. This prolonged standing has been linked to negative effects on health, increasing the incidence of musculoskeletal disorders, such as lower back pain and neck pain, and cardiovascular diseases, such as oedema, varicose veins and venous pooling. Given the impact these workplace injuries have on nurses, and on workplaces through financial costs associated with sick leave and/or workers compensation claims, surely prevention would be better than cure. While limited research exists to categorically suggest what prevention strategies are best, several options are available for consideration. The use of anti-fatigue mats has been associated with lower incidence of back pain. It is suggested that perioperative nurses consider using sit–stand stools, if available, and compression socks at 15–20 mmHg, if standing in a static position for long periods. Proper posture while standing – described as a neutral pelvis, natural thoracic curvature, flat abdomen, aligned shoulder, hip and ankles and an erect head – can assist in preventing disorders associated with prolonged standing. A combination of stretching and strength training for perioperative staff can help improve musculoskeletal symptoms experienced due to poor posture and tension, and the introduction of microbreaks has also seen improvements in concentration and comfort while reducing fatigue and discomfort. This paper will discuss the health effects of prolonged standing and provide information about ergonomic interventions, compression socks or stockings, stretching programs and microbreaks for perioperative nursing teams to consider.