Help turning obese resident

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Hi! I'm a long time reader, first time poster. I love reading all the helpful advice given here. I hope you can help me. I'm a new nurse aide. This week will be my 3rd in the field. So far I think I'm doing OK, making sure all my residents are taken care of. However, I'm having difficulty caring for 1 particular resident. He is an obese man with a terrible attitude. I'm having a difficult time rolling him onto his side to change his briefs and place the hoyer pad by myself. The aides on my hall are busy taking care of their residents and I feel like a pest whenever I ask them for help turning him. I don't want to hurt him or myself but I'm starting to sense that the aides are getting sick of me asking for help. One told me yesterday that she can do him all by himself and she didn't know why I had such a problem. Am I wrong in asking for help? Thanks in advance for your responses.

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Specializes in Med-Surg/urology.

No you're not wrong with asking for help! The back you save will be your own :) I've had residents like that & there's no way I would even attempt to turn them on my own. I would just ask for help & in return offer one of the aides help with a task that they are responsible for. That way everyone is happy lol. But yea don't attempt to do him on your own, its just not safe..

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Specializes in LTC.

If I have someone like that I use a bath blanket as a draw sheet. That way it's something to pull them/hold them up along their entire length of their body. I've also found it's easier to pull someone towards you than to push them away. So I just roll them toward me, stuff the hoyer pad underneath, then walk around to the other side of the bed and roll them toward me again.

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Been there, done that. When I was a brand new CNA, I could barely turn ANYBODY, let alone a certain obese resident that wouldn't help at all. Every time I asked for help, I got the "rolling eye" reflex from the other CNAs and was told I needed to learn to do that myself. Eventually, I got it, through much trial and error. Like fuzzywuzzy said, put a big bath blanket under them. The longer the blanket sticks out at the sides (I found ~2 ft works great), the better. I would brace my shins against the bedframe and pull the far end of the bath blanket towards me with all of my might until the resident was turned. I'd continue to hold the blanket with one hand while I stuffed the hoyer pad under them, pulled up pants, etc. with the other hand. Then I would run over to the other side, set them on their back, and repeat the process. You can even leave the bath blanket under them the whole shift (under the draw sheet and chux) as long as there are no large wrinkles or any places putting excess pressure on the resident's skin. The floor was linoleum and my shoes offered very little traction (and I don't know WHY I didn't buy better shoes), so it was all I could do to brace my shins up against the bed so that I wouldn't slide all over the place. Can't tell you how many times I went home with purple, bruised shins.

BUT

Asking for help is optimal. I had a *LOT* of back pain that first year from improper lifting and doing things only by myself when I knew I should have had a partner. In time, I found that if simply asking another CNA doesn't work, getting a nurse involved sometimes helps. Make them make the CNA help you. If they won't, you can say something like "Let me get this straight -- you are asking me to improperly lift a resident, posing a danger both to the resident *and* myself. What do you think (insert administrator name) would have to say about that? Perhaps we should give him/her a call right now." It may make people mad, but you need to be safe. You're there to provide the best care possible to your residents, not to win a popularity contest among the nursing staff. Things got a lot better when I discovered that. :)

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We work in pairs when we have to. If you can't do somebody on your own, then ask another CNA for help. If you help in exchange, they will be willing to help you.

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Thank you all for the suggestions! I will try the draw sheet technique. I hope I get better at turning residenst with practice. At KatieP86, I wish we could work in pairs at my facility, but it's every woman for herself, which is sad and can be dangerous.

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Specializes in 6 yrs LTC, 1 yr MedSurg, Wound Care.

I've been a CNA for about 7 months and I still have trouble lifting and turning people. You will get better at it with practice, and practice is very available! :)

I was also going to suggest rolling the patient towards you. If you get them all the way on their side--not leaning forward or backward much at all--then you will be balancing them more than holding them up. Be sure the bed is raised to a comfortable level.

Since this guy is a grouch, you might try seeing what his problem is. Sometimes, if you take the time to listen, you can help resolve an issue or at least show that your friendly and willing to listen. But then again, that might go straight out the window!

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I feel your pain I am small girl and I have an obese patient also.Some cnas are like he is so easy to turn and I am like hello we are not the same size you are bigger than me so of course its not a problem for you.I just dont ask the ones who feel irritated to help me.There is always that one cna who doesnt mind helping.I mean I dont mind helping a coworker.What you can do is find that one person who doesnt mind helping you.You do not want to hurt yourself.What I do is tell my coworker if you help me with one I will help you with one.That usually does the trick!!

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Specializes in LTC.

Also you can play with the bed. Sometimes raising or lowering it just a little bit makes a world of difference.

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HI,there,

I,am also a CNA nurse. When you work in a nurseing home. Everybody helps each other out no matter what the task is those are real team members. Wow sorry at the time no one helped you out.With that man that you posted. There are ways to get his cloth underwear off.

Called a log roll.

1. Ask him to hang on the raills with his two hands and ask him to try to move his

body side ways. If he cant then you are going to have to help him move his

body. Then tear off one side of his cloth underwear.Than ask him to hold on to

the rail on the other side and to the same thing. IT. then should come off all

the way.

Good Luck!!

Sweety4227:nurse:

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Specializes in CNA in LTC.
Been there, done that. When I was a brand new CNA, I could barely turn ANYBODY, let alone a certain obese resident that wouldn't help at all. Every time I asked for help, I got the "rolling eye" reflex from the other CNAs and was told I needed to learn to do that myself. Eventually, I got it, through much trial and error. Like fuzzywuzzy said, put a big bath blanket under them. The longer the blanket sticks out at the sides (I found ~2 ft works great), the better. I would brace my shins against the bedframe and pull the far end of the bath blanket towards me with all of my might until the resident was turned. I'd continue to hold the blanket with one hand while I stuffed the hoyer pad under them, pulled up pants, etc. with the other hand. Then I would run over to the other side, set them on their back, and repeat the process. You can even leave the bath blanket under them the whole shift (under the draw sheet and chux) as long as there are no large wrinkles or any places putting excess pressure on the resident's skin. The floor was linoleum and my shoes offered very little traction (and I don't know WHY I didn't buy better shoes), so it was all I could do to brace my shins up against the bed so that I wouldn't slide all over the place. Can't tell you how many times I went home with purple, bruised shins.

BUT

Asking for help is optimal. I had a *LOT* of back pain that first year from improper lifting and doing things only by myself when I knew I should have had a partner. In time, I found that if simply asking another CNA doesn't work, getting a nurse involved sometimes helps. Make them make the CNA help you. If they won't, you can say something like "Let me get this straight -- you are asking me to improperly lift a resident, posing a danger both to the resident *and* myself. What do you think (insert administrator name) would have to say about that? Perhaps we should give him/her a call right now." It may make people mad, but you need to be safe. You're there to provide the best care possible to your residents, not to win a popularity contest among the nursing staff. Things got a lot better when I discovered that. :)

I hope you don't use the hoyer by yourself.

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I hope you don't use the hoyer by yourself.

My facility has around 80 residents, less than 10 of which can walk, stand, or bear weight. We have 12-15 residents each on 1st and 2nd shift. If you don't use the Hoyer by yourself (when you can even find one that works), you're not getting done.

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