Need advice

Nurses General Nursing

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Hi,

My name is Jessica, I usually pop in from time to time and read the forums, but have not really had anything to add until now. I have a situation at work that is troubling me, and I would love some insight from you guys!

We currently have an elderly hospice patient on our floor. Her family is the typical "pop in for 30 minutes to straighten the nurses up" kind of family. They do hire sitters to stay with her 24/7, which is a help to our staff. Our biggest obstacle (aside from the family's daily 5pm assault) is the family insistence that she be gotten up to the BSC for BM's (she does have a foley). This may not seem like a big deal, but she really can't tell when she has to go, which means we are getting her up 3-4 times a shift. This woman is also so weak, she can barely suck from a straw, so she is NO help. Completely lifting a 120lb woman 3-4 times a shift is murder on our staff.

Let me add that myself, and another nurse on our floor, is pregnant. Recently we both cared for her two days in a row, and with no tech to help us, put her on the bedpan against the family's wish. The daughter was livid and complained to the DON. Now, we have all been instructed to "NEVER" put her on the bedpan, and to get her up as many times as she demands.

So, my hands are tied. I have requested to no be assigned this patient, which I was told was not fair for the other nurses b/c we must "share" difficult patients. We do usually have techs on our floor, so I have to send the tech when she wants up. We have a great staff, and wonderful techs...they say they understand that I can not lift her. But I have begun to sense "displeasure" from them when I send them to the room.

I am simply at a loss, especially since this woman will be with us till her death. I know it isn't fair of me to put the task off on the techs, or other nurses when she is my patient, but I fear that doing it myself is a risk to my child. Anyone have any suggestions on better ways to handle this?

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Honestly, it sounds like you don't want to have to deal with her because she is a patient that requires additional time and has a difficult family and you are trying to use being pregnant as an excuse not to care for her.

Suck it up and share responsibility.

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A two-person lift for a 120 lb woman should not endanger anybody's pregnancy. If you and your coworker need pregnancy-related work restrictions, see your respective primary care providers ASAP.

You were wrong to put the patient on a bed pan, but your DON has already pointed that out to you. It's unfortunate that the patient cannot tell when she needs to move her bowels, but she should still be gotten up to us the commode whenever possible for as long as SHE is able. By your description of her, it sounds as though she won't be with you much longer. So why not allow her and her family the small comfort of still having some normal function left, even if it isn't much and isn't reliable? Offer to help the techs when it's time to get her up to the commode. Do something that helps them (straighten up the sheets, get fresh water, take the trash out of the room, etc.) while they do the lifting and they will remain willing to do something for you.

Incidentally, what are the "sitters" supposed to be doing while this is going on?

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Specializes in psych, addictions, hospice, education.

:yeahthat:

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Wow! After reading some of the above, I'm even more grateful now for the supportive staff and nurse manager that I work with!! I'm 8 months pregnant and I work 12 hr night shifts on a surgical floor. There are currently 3 pregnant RN's on my unit (including myself) and we were all told by our nurse manager that she doesn't want us to do any heavy lifting or take infectious patients (c-diff, TB, etc). Our CNA's and the other nurses have been completely supportive. I'm probably going to get bashed (or kicked off this board) for saying this, but I have to wonder if some of the answers you got were because they were from nurses that cannot "use that excuse" as one is male and one has 30 years of experience and is probably beyond child-bearing years. :twocents: In turn, there are several nurses on my unit who have had various medical problems and we have also helped them out when needed. It never occured to me that they were using their medical problems as an "excuse" to take it easy.

I'm well aware that pregnancy does not mean that you get to sit back with your feet up, but just a little support and can go a long way.

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Wow! After reading some of the above, I'm even more grateful now for the supportive staff and nurse manager that I work with!! I'm 8 months pregnant and I work 12 hr night shifts on a surgical floor. There are currently 3 pregnant RN's on my unit (including myself) and we were all told by our nurse manager that she doesn't want us to do any heavy lifting or take infectious patients (c-diff, TB, etc). Our CNA's and the other nurses have been completely supportive. I'm probably going to get bashed (or kicked off this board) for saying this, but I have to wonder if some of the answers you got were because they were from nurses that cannot "use that excuse" as one is male and one has 30 years of experience and is probably beyond child-bearing years. :twocents: In turn, there are several nurses on my unit who have had various medical problems and we have also helped them out when needed. It never occured to me that they were using their medical problems as an "excuse" to take it easy.

I'm well aware that pregnancy does not mean that you get to sit back with your feet up, but just a little support and can go a long way.

I really appreciate your post. I feel the above comments are judgmental and harsh, and uncalled for as the posters know nothing about me or my situation. I have never "backed down" from my duties, I cont to lift and care for patients as I did before pregnancy. I have cared for a patient a few weeks ago with active TB, and numerous contagious patients. This is the only situation in which I have "tried to use pregnancy as an excuse" as you put it. I am simply not comfortable lifting her, and feel it places my child in danger. As swirlygirl stated, I am glad I do not work with nurses like you and have a supportive staff.... A staff that I constantly have to remind "I am pregnant, not handicapped" because they don't want me lifting anything heavier than a chart!

I was under the impression that this community was supportive of other nurses, but I was obviously wrong. I am sorry I posted, but will not be bothering you with my petty problems again.

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Specializes in psych, addictions, hospice, education.

I'm wondering....how many staff members are there when you work? Can you negotiate switching to another patient when you're assigned this one? It's great when other staff members support each other and sometimes there aren't enough to do that.

If the lady can barely suck from a straw, how can she sit on the commode? It would seem to be a matter of safety, that she should not be put on the commode at this point, if she is in danger of falling off or sliding off. Is she wearing adult briefs?

I surely wouldn't want you to risk you baby.

Is the sitter just there as companionship and is not allowed to help with care?

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Granted, I am just a student right now, but the above comments seem extremely outrageous, rude, and unnecessary!

If you aren't comfortable doing something, speak up - that's fair. There is a difference between slacking off and being SAFE.

I have always understood that pregnant women aren't supposed to do heavy lifting.

I don't really have any advice, except to keep asking for help. It sucks that your techs are acting annoyed, but maybe it's just your imagination becaues you feel badly.

Don't worry, just keep safe.

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Specializes in LTC,Hospice/palliative care,acute care.

120 lbs is HEAVY if it's dead weight and that's what this sounds like. Do you have any lift equipment? USE IT..On my unit she would be on a Sara or Hoyer lift. Consider a bowel regimen-you can regulate her so she is moving her bowels on a regular basis and at a consistent time.I'm sure she would appreciate it-this is not comfortable for her and it also has a negative impact on her emotional well being,too.She can read your body language.She knows how everyone feels about this situation.

It's not clear from your post if SHE is asking to go to the commode or if her family demands she be taken so often.If she does not want to do this then I wouldn't..Our state surveyors found years ago that we must always consider the resident's needs ahead of the family's demands..

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Specializes in Med/Surge, Psych, LTC, Home Health.

Sitters that just sit there and don't offer to help are a huge pet peeve of mine. I never expect and certainly never ask family members or friends to help, but hired sitters... if they are able bodied, I feel like they should help.

We had this one agency that hired sitters and their employees had strict instructions NOT to do any type of helping whatsoever; they were just to sit with the patient. I don't know why that annoys me, but it does.

I guess it's just the thought of a hired, able bodied helper person sitting there looking on while someone busts their butt, and that person who is busting their butt also has 10 or so other patients to tend to, most of them incontinent.

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Specializes in Nephrology, Cardiology, ER, ICU.

I guess my question is what is the lifting policy at your facility? To lift 120# of dead weight is too much IMHO especially when it is a total lift transfer from bed to commode. You either need to get a Hoyer or some other type of lift because this isn't safe for the patient and if presented to the family that way, should be no problem.

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I don't think that being pregnant is an excuse for not lifting, or doing your job in general. If your doctor says that you need to be on lifting restrictions, however, that is a different story. There are things that a pregnant woman should not do, even without restrictions, but those have to do with infection control issues, although PPE is supposed to protect from exposure to pathogens. The infection control people should be able to provide guidelines for that.

Anyway, best wishes to you, and I hope that things go well for you, and your work situation improves.

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