Hoyer Lift

[MisMatch, LPN]

I am new to home health after working in LTC. 

My client has ALS, weighs ~200 lbs, no muscle control.  They are transferred via hoyer lift from recliner chair to shower chair; after shower from shower chair to bed. Sling must come on & off each time & doesn’t go in shower. 

I am expected to do this by myself and am not comfortable with this. I have always had 2 people for a hoyer transfer. 

I appreciate any thoughts, feedback or suggestions   Thank you. 

[Hoosier_RN, MSN]

Unfortunately,  at least in Indiana, home health does not provide x2 assist for hoyer transfers. You will get better with it in time. Always double, and triple, check that the patient is secure prior to moving. The same as you would with an assist

[Crystal-Wings, LVN]

I’d ask for another case.

[caliotter3]

When I worked in facilities, we were required to have two people use the lift for safety sake.  Since I have been in home health, me, by myself, and I.  One time, the patient was barely in the sling after sliding, and I just barely got him into his chair.  Whew.  I don't like to think about that one.

Now, when I can't handle transfers or repositioning by myself, I just ask for another case. 

[Kitiger, RN]

I've used the Hoyer lift and ceiling lifts for most of my career (2 1/2 years as an aide in a nursing home, then as an RN - after 7 years mostly hospital nursing - I've done 34 years in home care private duty.

In the home, lifts are routinely done alone. When the client is too large or too heavy for manual lifts, we use a mechanical lift. 

Always double check that the patient is secure, and never activate the lift if your attention is not fully on the client. Always watch the client.

I am confident of my ability to do the transfer safely, and I am VERY experienced. ?

If you are not confident in your ability to do the transfer safely, ask your supervisor to teach you. If that teaching is not forthcoming, then, yes, ask for a transfer to a different client.

[MisMatch, LPN]

Thank you all for your responses.  
As the night shift nurse, I was only getting this client to bed once a week which was not often enough for me to become proficient.  The solution was to tweak the schedule so I am not getting them in bed!

MisMatch

[SilverBells, BSN]

I'd probably decline the case myself.  I feel there is a reason that it is recommended that two people assist with Hoyer lifts.  With that said, I've never worked in Home Health so maybe this is more common than I would think.  Anyway, I can definitely understand your hesitation and glad you were able to work out a schedule that doesn't require you to assist them to bed.  

[Kitiger, RN]

There is another reason to become proficient with the Hoyer lift. If a client falls or slides to the floor, you can use the Hoyer lift to pick them up and place them in bed. The lift goes all the way to the floor.

[Hoosier_RN, MSN]

13 hours ago, SilverBells said:

I'd probably decline the case myself.  I feel there is a reason that it is recommended that two people assist with Hoyer lifts.  With that said, I've never worked in Home Health so maybe this is more common than I would think.  Anyway, I can definitely understand your hesitation and glad you were able to work out a schedule that doesn't require you to assist them to bed.  

There is only 1 person in a home, at a time, to a case in home health for cost containment reasons 

[MunoRN, RN]

I've never worked in a hospital where we used or were expected to use two people with a lift, either hoyer or ceiling lift, what is the reasoning for thinking a lift can't function with only one person?

[MisMatch, LPN]

The issue isn’t operating the lift.  The challenge is getting the client safely  in/ out of the sling 4 times during the HS routine without risking injury to myself.  “Safe body mechanics” are not possible given the equipment, tubes, supply shelves, client’s furniture placement, ect.

Thank you.

[caliotter3]

1 hour ago, MisMatch said:

The issue isn’t operating the lift.  The challenge is getting the client safely  in/ out of the sling 4 times during the HS routine without risking injury to myself.  “Safe body mechanics” are not possible given the equipment, tubes, supply shelves, client’s furniture placement, ect.

Thank you.

Safety is the same reason two CNA's, or two anybodies, were required for using the lift at the LTC facilities where I worked.  And yes, there is a possibility that the lift would not work properly, causing a safety breach, and for which the second person might be very necessary at the time.  It was the reason that the CNA who left a resident dangling, midair, to run get somebody to "help" him, got reprimanded one time.  He seemed to think he was getting himself quicker to the end of his shift by using the lift by himself, until he figured out he had surpassed his transfer "abilities".  That CNA didn't last long.  He left the job before the end of his last shift.  Just gave up and went home, leaving his fellow CNA's to finish his work.