One of the residents on my assignment is a sweet man but INCREDIBLY DIFFICULT to work with. He weighs 225 lbs, is 6'2, and has advanced Alzheimer's. He is extremely good with me, which means he's completely rigid and dead weight to move (instead of being combative as he is with most CNA's.) Officially, the policy at our LTC is that we're supposed to always have two people on any lift. Unofficially, we all do lifts solo all the time because we are understaffed. He was using a sit to stand lift and is very difficult to do alone that way, but at least possible.
Lo and behold I came back from the weekend to find out that the DON had written a note on his chart saying that all transfers were now supposed to be with a Hoyer lift. So not only do I supposedly have to get him on and off with the Hoyer, he also has to be turned from side to side now. I'm very strong, but... This is literally, physically NOT POSSIBLE
for one person to do by themselves unless they're Mr. Universe. If I try, he will roll off of the bed and onto the floor. It is difficult for *two* people to do-- one can NOT!!! do it. The charge nurse told me privately that if I can't find someone else to help me, then I can use the sit to stand lift. The thing is that it won't be enough to just have someone to spot me, the way it is with other people who have the Hoyer lift used on them-- I'd have to have someone with me the entire time I'm turning him, getting him dressed, etc. This is IMPOSSIBLE at this understaffed facility. So the basic reality is that I will usually have to use the old lift.
I just feel really uncomfortable with this even though the charge nurse told me I could do it. The official statement from the DON is that I'm supposed to be using the Hoyer, but there is no possible way in this world unless they hire more people. I'll do it whenever I can, but most of the time, it will be totally impossible. The resident's condition hasn't changed, he's doing the same physically as he was before, and he doesn't like the Hoyer at all, so nobody seems to know why the order was changed in the first place. I know that the person who has him on the other rotation sure isn't using the Hoyer lift. But what if the DON somehow walked in (very unlikely)? It just seems really unfair that the CNA's should be put in this position. I don't know... what does everybody else think?
Dec 3, '09
by Kitty-RN, RN
But sadly, the bottom line is, the help needs to just be found.. Perhaps you could pair up with another aide to take care of their resident as well as yours?
It's a sad situation that there never seems to be enough help, but.. A stand-lift transfer can go terribly wrong, very
easily.. Especially with a resident who has been known to be combative. Even if they are good with you, who is to say that one day they just get irked for no reason (with advanced alzheimers this can be very
probable) This is most likely the reason they made him a hoyer. This happened to me once with a confused man who tried to walk off of the standlift in the midst of a transfer. The leg strap was on and all the proper devices, and they were working but even with that he began to shimmy his leg out from the back and started slipping out, and letting go of the handles. We almost lost him, and he was then reevaluated. I tell you it scared the daylights out of me. I mean this guy could start swinging and even just tip the lift over with his weight and height alone!
The point is.. a stand-lift is meant for someone who can consistently follow directions and has the strength to bear at least some weight. It doesn't sound like this guy met the usual criteria for a stand lift.
And you really shouldn't go against the care plan and policy using the stand-lifts/hoyers by yourself. It's truly unsafe and I know it's not your intention but you really could severely hurt someone. It sounds like you really care for this guy. And you really don't want that on your conscience.
I'm positive this guy must be a total dependent of 2 for his bed mobility according to the careplan. You have to follow that care plan. Just demand help. Call nurses if you have to. If you don't get anywhere, call the supervisor, just call anyone. Bottom line is, your friend has to be cared for properly and while the staffing isn't your fault at all, make it your mission to do things the right way for his sake, and yours
Last edit by Kitty-RN on Dec 3, '09