CNA's are supposed to use unsafe lift!! - page 2
by Anise1 | 6,226 Views | 15 Comments
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... Read More
- 0Dec 4, '09 by NM nurse to beThis sounds like a tough situation I have a few rather large folks right now too.
I'm a little confused though. How were you getting him dressed before, with the sit-stand lift? Any time I've had to use that one, I still need to roll the resident to get their clothes on, pants pulled up, etc. So I'm a little unclear on the difference with the hoyer.
I have one large man who is a hoyer lift. He can (when he wants and if he likes you) hold the rails and help turn but doesn't always. I've figured out how to get his shirt and pants on and lay the hoyer sling ready next to him so that in the first roll, I get pants up and shirt down and the sling under that side of his body. I have to go around the bed for the second roll, which gets pants and shirt straight and the sling under the rest of him. It's way easier to do this way than roll for clothes, THEN roll again for the sling.
I TOTALLY understand the staff issue. I don't have any good thoughts for you there but agree with the rest, DON"T put yourself in the position to go against policy. Everything will be fine and dandy... as long as nothing goes wrong. Admin is well aware of the see nothing/hear nothing method... until something DOES go wrong. And you can bet they won't be standing behind you saying, oh we (nurse so and so) said it was ok she did that. No, it will be YOU were breaking policy and that's that.
This happened at my facility and they walked the girl out the door. We don't want to see you be that girl!
- 0Dec 5, '09 by fuzzywuzzyI actually don't really know what a sit-to-stand lift is. My facility doesn't have one. But maybe it's harder to get a hoyer pad under them or something.
What kind of clothes does this guy have? I know that dressing some people can be really hard depending on their clothes. Does your facility have a communal clothing bin that you can borrow from? Ours has a bunch of clothes that snap up the back and they're much easier to dress difficult people in.
- 0Dec 8, '09 by Kitty-RN, RNWhat about using the pad/draw sheet to pull him towards you? That always seemed easier to me, especially for the rigid ones.. And do his clothes fit well? If not, maybe you could ask his family to buy some extra roomy pants and pullover shirts? Or (if they're really awesome) some of those clothes/pants for the disabled that button in the back?
- 0Dec 8, '09 by Anise1I'm at home right now with kidney stones... awful awful... tons of Lortab and about to go to sleep! With the sit to stand, I got the undershirt and shirt on him but couldn't pull them down, pulled pants up as much as possible, put on socks and shoes. While I would push from behind and the other person got his feet up on the lift, I would pull down his shirt some more. Then we'd get him on the lift, change out his diaper, pull up the pants and button them, and put him in the chair. We would both lean him forward and pull his shirt down in back.
Pulling on the draw sheet... I'm not so sure see how that would help with turning him is the thing. It would be great if I just had to get a wedge or pillows under him, but this would be turning from side to side to change and put on clothes. But I will try. Roomier clothes wouldn't make any difference; that's not the problem, and fastenings being in the front is actually a whole lot better than if they were in the back. I've decided that I will never EVER try to put him on the Hoyer by myself, ever. I honestly don't know if I could roll him by myself (it seems so impossible, but I will at least try.) During the week, I will definitely never use that sit to stand lift to transfer, but what the care plan note said was to use the Hoyer lift for TRANSFERS only (not for getting him up and down and lying on the bed and turning and taking God-only-knows how long just to change him.) I talked to the other lady I work with on the hall and she said we would just have to use teamwork when the students aren't around (we're finally starting to get students again.) If I can JUST turn him by myself, using the Hoyer lift will be manageable.
The other thing was that I found out why the order was changed. A new PRN CNA complained that she thought it was too hard to use the sit to stand lift with this resident. (!!!!!!!!!!) So now we're stuck with the Hoyer, which is about a million times HARDER with him, and this CNA comes in once in a blue moon and doesn't have to deal with daily consequences. The change had NOTHING to do with patient safety. I am sorry, maybe this is an awful way to think, and I don't mean to be mean, but I can't help thinking that this person really caused problems for the rest of us.
- 0Dec 9, '09 by Kitty-RN, RNQuote from Anise1If the resident was anything like you described it most certainly was, and it sounds like the change took longer than it should have. Again, in order to be used safetly '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 gentleman fit the criteria?The change had NOTHING to do with patient safety.
I know what you mean about the whiny coworkers who come in once a month and raise holy hell though. Some of them need a whack..
Oh and by pulling the draw sheet I mean standing beside him, reaching over for the draw sheet on the opposing side and rolling him towards you. I always found it easier for the dressing, hoyer pad placement. etc
- 1Dec 9, '09 by fibro2003Quote from Anise1I understand exactly where you are comming from , the reason the order has changed because there are so many unreported injuries at nurseing homes and hospitals, not only that the cna's are getting hurt on the job and worker comp or restricted duty are risen. Not only the RN and LPN are shortaged there are a shortage of nurse assistants too. I been a cna for 14yrs and after a while lifting and pivotting takes a toll on our bodies and sometimes using a mechanical device to help lift a person might help or might not help if you don't properly use the device right and it is also take up a lot of time and can be dangerous if you don't have another person to help you. and its the state law to use a hoyer lift on the patients thats less mobile .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?