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Discussion

Bear Hug Transfer

I just had a job offer from a woman, and she seems pretty great, but the only part I'm worried about is this transfer. She is a paraplegic with limited arm movement, so she cannot bear weight and can't really assist at all with transferring. She does own a mechanical lift but doesn't like using it, and frankly, I don't feel comfortable operating one by myself.

She's short and thin, but in my experience, that doesn't make it much better. I had a job for about a day with a girl in her twenties who required this lift and needed a transfer where you carried her like a baby to get her to the chair- I had a lot of trouble with this transfer, even though this girl was tiny.

I'm generally frustrated that the state (this is not an agency job but one directly for the state, as was the one I couldn't do) will not make exceptions with refusing to pay more than one person at a time for this work. If the woman who just offered me a job was in a nursing home, she would have a hoyer transfer, and the girl would be at least a two person transfer. The girl had severe dyskinesia, and she had had multiple injuries from being dropped. It's possible, it's just not incredibly safe.

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    • Expert

    If you feel that uncomfortable, you probably should decline the case, or gently convince the lady to use the lift. You will need to get comfortable with using lifts, I know, I hate them too. But as long as there is a lift in the home, the state can say that the means to do the job are there. They don't care that the lady does not like the lift. I would try to convince her before quitting. Tell her that the lift is required to be used and that she will have a difficult time finding a caregiver that won't use the lift. Liability issue.

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    I'm always puzzled by the "two people required" lift situation except in cases of morbid obesity... as long as one person can roll the patient to put the sling under / remove the sling, why does it take two people to use a Hoyer-type lift???

    I can transfer an adult paraplegic, an adult vented quadriplegic, or a developmentally disabled adult by myself with a lift (all are under 200 pounds).

    What is it about the lift that you don't feel comfortable using it "by yourself" but that you feel would be safe enough if there was another employee standing in the room with you?

    If one nurse can bathe and change the patient by themselves, why can't one nurse also transfer the patient via lift by themselves? No actual "lifting" is required to use a lift....

    BTW, I totally agree with not dead-lifting patients. My agencies all have a fifty-pound limit (and even at that, nurses can refuse) -- any patient over fifty pounds MUST have a lift in the home or my agencies won't place nurses there.

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    • Author

    At this point, the mechanical lift is off the table, since the one she has is broken. I haven't attempted it on her, but lifting her seems doable. As for the girl that I had trouble with, I don't know if you can safely put someone with uncontrollable jerky movements onto a mechanical lift safely.

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    • Expert

    Broken equipment, you need to document what you have done to get it repaired, in order to cover yourself.

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    • Author

    Done, we'll see what happens.

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    Agencies try to find nurses that are a good fit for each case. You may just not be a good fit. Some nurses are fine operating lifts alone, others aren't. Maybe another case with less lifting would be a better fit for you.

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    Using lifts is a skill.....and a one person job. You should learn to use the lifts..ask if there is a instruction manual that came with it or call the equipment company and ask if the rep can come show you how to use it. They really are not difficult, just time consuming.

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