Opinions please? Lifting vs lift

[SDALPN]

I'm working with a pt who is about 80lbs. The parents don't want a lift in the house because they feel it is more work than just lifting the patient. The parents also make excuses like the carpet makes the lift hard to push and its too big and doesn't look good in the room. My concern is that I don't want to be injured lifting or have my patient injured. There is the possibility for seizures while lifting or severe agitation while lifting that can increase the risk of injury. The patient will also try to kick, bite, and arch her/his back.

I spoke with my agency about my concerns and have made a few comments multiple times. I was told it is up to the parents and that if I don't feel safe lifting the patient that I don't have to. I told the agency that I don't want the parents to let me go because I'm not comfortable lifting the patient. I'm pretty sure that makes the agency liable if I get injured because they aren't doing what they have to for my safety. I don't have any back problems and I'd rather not take a risk when there are reasonable options available. I feel the agency should tell the family that they have to provide the nurses with a lift for the nurses safety and that the family doesn't have to use the lift if they dont want to. The family would be ok with a track lift, but ins. won't cover it and will only cover a manual lift. We aren't even provided a back brace.

I'm wondering if its a violation of OSHA. But I don't want to upset the agency. Because I know if I put in a complaint to OSHA that the agency would let me go. I understand the agencies want to bend over backwards to keep the family happy so they don't lose the case. And they would be ok to replace any nurse who gets injured. I would like to stay on the case since they don't have any others. They are a smaller agency and only staff to the cases instead of keeping lots of nurses hired without work. Any other options? Opinions? One other option I have is if the patient goes to school, I can get the assistants to do a 2 person lift with me.

Thanks in advance for responses!!

[ventmommy]

This seems like a tough call for the nurse and for the family. You didn't say what issues your patient has and that might be a factor in the family's decision. Personally, I find the independent lifts to be obnoxiously large. Have you ever tried it out (as the patient)? It's scary and uncomfortable. Our agency asked us to get one. In all the years we had nursing, you know how many nurses used it or even asked if we wanted them use it? Zero! Want to know how many times we used it? Twice. Once on my son who desatted to 40% and turned blue from freaking out from the lack of support and once on me. It sat in the utility room for dozens of months after that.

Most of the nurses could move our son individually. I always did a team lift with nurses that got pregnant and with one nurse who I adored but was super tiny.

[CloudySue]

Lifting in regards to weight is subjective. 80lbs on one person is different on another, when considering the size of the ct, muscle tone, and weight distribution. I have a 65lb ct who is light as a feather to me, bc she had no large center of gravity and she can hold up her own head. I could carry her around all day if I had to. Another ct, a 30lb boy, is big in the middle and floppy as a rag doll. I never feel totally safe picking him up, especially carrying him down stairs! What parents sometimes don't realize is that when you pick up your child every day in a row since birth, they very gradually become accustomed to lifting a heavier and heavier child. It's very difficult to just walk in cold and muscle up like that. Being Hoyered is frightening if you are not used to it. It feels weird but very safe if done correctly. It could be a good idea to acclimate a child very early, even when not physically necessary, so there aren't resistance problems later. My 65lb teen is starting to get nurses who balk at lifting her, and she refuses the Hoyer, so her pool of nurses is getting smaller and smaller. Her dad isn't always home and mom is having serious back problems. So the potential for a problematic stalemate is always there. Also, she's developed eating disorders, trying to maintain her weight and avoid the Hoyer. Ironically this is much more dangerous than the Hoyer itself.

[sellafork]

good thinking girls. u take care of u. it is very true when a parent grows up with the child and constantly lifting them, it becomes normal at any weight. i have a kiddo i care for and he is almost 80lb. of solid dead weight. its not nice. parents are trying to do the ceiling tracking system because his bed is really big and a lift is not applicable for his situation. parents should be aware that the state will pay for ANYTHING medically necessary for a child. the problem starts when no one will spread the news about certain information available to parents and their disabled children. this happen for various reasons but its crucial that these families know what is avail to them.

*** hahaha *** now it may take a number of months or perhaps years to get it and to complete all the appeals process but heck..... its only time right? ohhh! and one more thing.... PROPER WORDING WITHIN THE REQUEST IS CRUCIAL. i remember my family needing xopenex svn instead of albuterol but they were D E N I E D... over and over again because on the perscription it read "pt has rapid heart rate". WRONG!!!! "pt has 'tachycardia'". gotta just love our world yah?

in conclusion.... watch your back girls!

[MBrickle]

LEAVE THIS CASE. PERIOD.

My company requires the use of a lift for patients > 50lbs. I had a non-ambulatory, vented pt who weighed about 100-110lbs. Even though he was in the lift for transfers to/from his bed and wheelchair or changing table, I am willing to bet that the torque on my body to lift him to get the sling under him, or to reposition him in his chair was greater than 50lbs. Combine that with the fact that his changing table at school could not be adjusted to my height, and that the table and his bed at home were up against the wall so I could not access him on BOTH sides of his body to provide care or diaper changes, etc. and I massively herniated a lumbar disc. Nerve compression, ungodly painful sciatica, loss of muscle function in my left leg and 6 months out of work. Ugh. Not to mention dealing with Worker's Comp which is pretty much the most awful organization ever.

Luckily I didn't need surgery, but I have to lift 2-3x a week and hit the gym almost every day, including doing about an hour of stretches 3-4x a week. I am back to work with an ambulatory patient, doing nights, but this injury has severely limited what I am willing to do in the future. I refuse to go through this again. I'm only 29. In fact, I'm currently fighting a shoulder injury (likely from lifting weights) and praying that I haven't slipped a cervical disc in my quest to rehab my lumbar disc!

You only have one back. A back injury is so debilitating and painful. It just isn't worth it.