Loretta Pierce is only 46, but she has already retired from nursing in favor of a desk job.
After years of lifting heavy patients and equipment that resulted in a herniated disc, she said she knew her body just couldn't handle the work anymore.
"I'm almost fearful as a nurse of going back to taking care of patients unless I have proper equipment," said Pierce, who worked in organ recovery, the intensive care unit and the emergency room. "It's kind of sad when you have to end your nursing career because you can't physically do the job anymore because your body's so beat up."
Nursing aides, orderlies and attendants suffer more musculoskeletal injuries than people in any other profession – including firefighters, according to the latest data from the Bureau of Labor Statistics. Registered nurses also edure more of these injuries than the average worker.
Even worse, patients are getting heavier -- especially in the Midwest where Pierce spent her career, she said. She recalled taking a patient to a dock to weigh him because no scale was available in the hospital that could do the job.
Still, she'd never think of saying "no" to helping a fellow nurse move a patient, no matter the toll on her body.
"It's kind of ingrained in you when a colleague asks for help, you go and you help. You don't even think twice because they're in trouble," said Pierce, who works in Nebraska. "We're a team. You don't leave a man down."
The American Nurses Association has been pressing for years to pass a federal law mandating nationwide standards to protect nurses from injuries, but an effort undertaken a few years ago was thwarted, they said.
In a report titled "Health Care Workers Unprotected," watchdog organization Public Citizen said the Occupational Safety and Health Administration, or OSHA, needs to develop standards for nurses and perform more inspections to ensure their safety.
"Nurses consider a 90-pound little old lady light," said Suzy Harrington, the safety and wellness director at the American Nurses Association. "In what other profession is 90 pounds considered light?
"Patients aren't boxes," she said. "They don't have handles and they don't move on their own."
That's why her association spent a year drafting national safety standards, which 3,000 hospitals have already bought since the end of June when they were first published, Harrington said.
The American Nurses Association is also pushing a federal bill to make uniform safety standards mandatory, Harrington said. Currently, hospitals -- and some states -- go by their own standards, but Harrington said it's not working.
"When we're losing skilled folks to back injuries and other musculoskeletal injuries, that's a problem," she said. "We need a whole paradigm shift toward a true culture of safety."
Sometimes, the standards call for better lifting equipment. Other times, they call for better training and more people.
In California, a safe-patient-handling bill was enacted in 2011, but nurses there testified before California's OSHA earlier this month about how safe practices had yet to be established at hospitals in the state. Former Gov. Arnold Schwarzenegger vetoed similar bills five times before the current one passed under current Gov. Jerry Brown, according to the association's website.
California nurse Debra Amour, 55, said even though nurses were supposed to lift patients with help of some kind, she has no lift equipment and no designated lift team. Although nurses hoped the 2011 bill enactment would get them these things, the hospitals interpreted the law differently, she said.
"The problem is our population is getting bigger and bigger and bigger," said Amour, who has been a nurse 25 years.
Instead, Amour -- at 5 feet 2 and 120 pounds -- said she has struggled to move 400-pound patients, many of whom are sick and confused, rendering them unable to hold themselves up or take directions.
"When you weigh that much and you're trying to move somebody, it's really hard," said Pierce, who weighed between 110 and 140 pounds over her nursing career.
But it's not just about overweight patients, the nurses said. Amour said she dislocated her neck when a patient thought he was going to fall and grabbed her neck -- a common injury among nurses. It's one of many injuries she's received during her 25 years on the job.
"It's risky," Amour said, adding that lifting patients can be like rescuing someone from drowning. "You try to save the swimmer's life, but you can sometimes drown with them."