Should I quit my patient?

[Jandomz91]

I'm a home health nurse who cares for a pediatric patient who is non ambulatory (cannot walk at all). His care is extended care where I'm with him for 8 hours. My my patient constantly needs to be repositioned and transferred without the help of assistive devices since the home has none. My patient is going on 70lbs and will only grow bigger. My back is now constantly popping and cracking.

[caliotter3]

It is up to you if you want to seek another patient. I work with a patient that weighs several pounds more. I am required to do a two person transfer per the POC, but there is never anyone willing to help me, so I do it by myself anyway. Fully aware that when I hurt myself one time too many, I am in the wrong when the truth comes out. One thing I found helpful is to move the patient "inch by inch" when they are in the bed. Seems like more work, definitely takes longer, but is easier in the long run. It doesn't take much of a move to effectively "reposition" the patient. I even had one mother instruct me to reposition her child by rearranging the pillows to relieve pressure points. She was aware that the patient weighed too much for people to move him extensively at one time.

[Orca, ADN, ASN, RN]

It sounds to me that your body is already telling you that you are reaching a physical limit. I would listen.

[WeirdNurseKelly, BSN, RN]

I worked in home health for almost 3 years but I worked with adults so I am not sure what kind of resources are available to you. Have you thought of calling the doctor to request PT and OT to come out and evaluate the patient for equipment needs and to instruct you, other RN's and parents (or whoever is taking care of the patient other times) on how to properly and safely transfer. The patient may qualify for a hoyer, some even qualify or receive grants for ceiling lifts.

[4boysmama]

have you exhausted all options to get assistive devices for repositioning/transferring? I would start there before quitting...

[SheLaughs]

I work in home care as a nursing supervisor. Let your nursing supervisor know that the child is too heavy and requires equipment

[Kitiger, RN]

I assume that rolling him is not a problem. Rolling him toward you will be easier than pushing him away. Are you using a draw sheet to slide him up in bed?

For a heavy patient, you can put a leaf bag under the draw sheet to slide him up, or to reposition him to the side of the bed so you have room to turn him. The plastic bag slides on itself, making the repositioning very easy. Do pull the bag out when you're through, as the plastic will let him get hot.

A disposable waterproof pad (blue chux) also works to help him slide. The plastic side slides on the sheet.

Another trick is to lower the head and raise the foot of the bed when you do a diaper change. By the time you've turned him back and forth, gravity will have helped him slide up in bed.