WCAT Decision Number:
A1903050 (March 3, 2022)
the hospital. Throughout these years, she worked as an instructor at a university and, while she
had some prior left shoulder concerns, these consisted of achiness. In the months leading up to
December 2017, these symptoms did not interfere with her ability to carry out any of her job
functions or activities of daily living.
[12]
[13]
In December 2017, the worker returned to working almost full-time hours at the hospital. She is
a casual worker, but worked essentially the same shift rotation that regular nursing staff work.
This involves rotations of 12 hours for four nights, followed by two to three days off, 8- to
12-hour shifts for several days, followed by two to three days off, and then a return to 12-hour
night shifts, but the worker usually worked 12-hour night shifts.
During the oral hearing of the WCAT appeal, the worker explained that the work activity of
admitting a patient requires that she fill in a number of screens on the computer. The first thing
she does is set out a clinical profile. This involves clicking and a lot of typing to enter all of the
patient’s medical and psychiatric history, including a history of what had happened and the
event that brought them into the hospital. This information comes from a multitude of sources,
including ones the worker accesses through the computer’s browser, but most of it comes from
the initial interview she conducts with a patient when they arrive. Depending on how sick the
patient is, the interviews can last up to an hour but, sometimes, it is not necessary to have an
interview. The worker also has to enter information from psychiatric, police, and other reports,
enter information the patient provides regarding whether they use drugs or substances, and, if
the patient is suicidal, undertake a risk assessment and type up a safety plan. The worker said
that there are about seven different screens she has to go into and entering the data is very
time consuming. Admissions on a normal medical floor are much quicker than the mental health
admissions she undertakes. She tries to do admissions in one sitting. However, as there are
only a few nurses on shift at any time, the process can be interrupted by answering the
telephone and by crises that arise. In these situations, she has to answer the telephone or go
and deal with the crisis, and then come back and resume the admission process.
[14]
[15]
By early 2018, the worker developed a burning sensation and constant pain in both shoulders,
with the left shoulder being worse. There was no specific precipitating event, but she was
spending multiple hours of each shift at a computer typing. Over time, the burning sensation and
pain gradually worsened and she developed a frozen shoulder.
During the oral hearing, the worker said that, after the burning sensation in her left shoulder
started, she went on to feel pain around the top of her shoulder and to have difficulty moving the
shoulder. Throughout 2018, the pain increased and became so bad that she had to take opiates
to sleep at night. The worker said that, prior to beginning to work full-time hours at the hospital
in December 2017, she had a stiff neck and left shoulder, but she did not experience the
burning pain she began experiencing in the beginning of 2018 and that worsened after that
point.
3
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