First Year Nurse Falling Apart!

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Specializes in Pediatric Oncology, Pediatric Neurology.

Hey Guys!I have done a ton of research about manual lifting vs lift requirements but haven't been able to get the answers I need so I'm reaching out to anyone that may be able to assist me with my particular situation. Here goes...I'm a fairly new nurse (I've been licensed for one year now, yeah!!) currently working in Pediatric HH (I'm working block 8 or 12-hr shifts with one pt per shift) and one case in particular has become super trying on my body physically. She's an 8 yo spastic CP and weighs 44lbs, (as of 4 months ago, and I'd wager a bet that she's added a few lbs since then) requires complete care for all ADL's, is non-ambulatory and requires total transfer assist. Because of her condition, she flails constantly and her muscle tone can be either flaccid or very rigid and changing at any given time...and many times, her tone resists the care I am attempting to complete (ie: donning clothes, changing her diaper, putting on splints, etc...she's a kicker!) I've been working with her twice a week since January '15 and feel it's taken a toll on my back and knees and most recently, my hips. I've consulted with other nurses in person and asked for feedback on my lifting technique which they all say I am doing correctly. I also consider myself physically fit and have been working on my core and leg strength to help out but something tells me it may be time to either give up this case or request from my employer that we put in a request for a lift in the home. I'd also like to add that we are required to do a lot of lifting the patient from the floor because she has a rubber "playmat" she spends most of her time on due to safety concern of her constant flailing and flipping herself over. I also transfer her on average 12-14 times per shift. Does anyone know the requirements as far as when it's absolutely required that a patient has a lift? (I've heard >50 lbs. but haven't found concrete documentation of such.). Or any other advice and feedback is GREATLY appreciated. I absolutely LOVE what I do and would like to continue with nursing for years to come without sacrificing my body entirely 😁

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First of all, congrats oncompleting your first year as a nurse! Home health/ private duty ( I'm not sure which you are referring to, it sounds like you may be in PDN if you are working full shifts in the home) presents many unique challenges, and I think I know just how you feel. I have been with a patient for over 3 1/2 years ( he was an infant when I started with him, now he is a tall, heavy almost five year old with mobility issues requiring total care and complicated transfers. I noticed I was having problems with my back recently, and I discussed the issue with he family, the school (I attend preschool with him during the week. Not now though... Summer vacation!), and the other nurses on the case.

We are now doing two person transfers at home and at school. I couldn't be happier.

According to my agency's policies, patients weighing more than 50 pounds must have either a lift or a two person transfer. Remember, your patient is only going to get bigger, and the family and agency will have to deal with them eventually. Please don't let it be at the expense of your body. Also, my agency provides back braces for support upon nurses request.

This issue is important, for your patients safety and for your own. Talk to your supervisor, educate your patients family, and get the support you need to safely transfer your patient in the home.

Best of luck to you, and again, Congrats on your first year!!

(sorry for the format, I can't seem to make my paragraph indents stay there after I save)

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Specializes in Pediatric Oncology, Pediatric Neurology.

Thanks for your reply and advice! It's considered home health nursing but instead of visits, I'm doing one on one patient care (I guess it's different with Pediatrics) and I also attend school with my patients but like you, we are currently in the summer session of being home by ourselves which means no assist with transfers, etc...I do work with Para-Educators during the school year however they have not been formally trained on lifting so I've always been a little on the fence about them assisting me for their safety as well as my patients'. Thanks for confirming the 50lb lift requirement, I was almost positive that was correct! My pt is scheduled to have a physical this week so here's to hoping for >50lbs so the family qualifies for a lift.

Good luck to you with your cases and thanks again for your input, it's nice to know I'm not alone with my concerns ☺️

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Specializes in Critical Care, Education.

I can't locate the exact reference right at the moment, but in the US, OSHA (workplace health and safety) recommendations are for lifts of no more than 35 pounds. There is increasing literature - even a recent series on NPR documenting injury rate and potential remedies - but employers have been very slow to respond.

In this case, I believe that a mechanical lifting assist is mandatory... the problem will only become worse as the child grows. It is needed to maintain safety, not only for the caregiver, but also the patient.

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Specializes in Pediatric Oncology, Pediatric Neurology.

Thank you for such a great resource! Those illustrations of the damage being inflicted on the discs are pretty intense and I wish more nurses/employers would be mindful of the trauma we are all voluntarily doing to our bodies. I changed professions from being an accountant to becoming a nurse because like I said before, I LOVE what I do and plan to continue patient care for years to come and would be devastated if my body wouldn't allow me to continue. I will be talking to the case manager tomorrow to come up with solutions for this case in particular, for my safety as well as my patients' and other nurses on the case. It baffles me that no one has brought this to their attention before especially since other nurses have shared their concerns with me regarding their own back pain r/t this case.

I was also able to find the following documentation mentioning the 35-lb wt recommendation, is this what you are referring to? http://www.asphp.org/wp-content/uploads/2011/05/When_Is_It_Safe_To_Manually_Lift_A_Patient.pdf

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