I can't believe this!

barb4575 · May 11, 2004

You should be using a gait belt and never hook your arm under someone's arm...I hope you did learn the correct way to transfer and that your teacher was informed as well.

Barbara

Hey all...I just have to vent here. I had my CNA state test at our LTC facility today. Should have been no sweat, right? We took the written first, I did just fine on that, then we get to the skills portion, we have to do five procedures, two of which are taking off gloves and handwashing. The other three I get are assisting a patient to the edge of the bed, assisting to a bedside commode, and assisting to a chair.
I did the sitting on edge of bed just fine, then I go to assist her (our training nurse playing patient) to the commode. Well, I hook my right arm under her left shoulder and support her wrist with my hand JUST LIKE I HAD BEEN TRAINED TO DO in class. Well, the tester stops me and tells me that thats wrong because I could injure her shoulder...so she has me do it again, this time I didn't actually lift, I just let her move on her own, but she STILL said I lifted her and told me that I failed.
The nurse called me later and told me she couldn't believe that this lady failed me over that...she said this same tester has NEVER even mentioned this method of transfer at any other test she's gone through. Now I have to retake the skills test in a few weeks. I am so mad. We have some people in our class who can barely tie their own shoes, who passed the thing, and here I fail for doing exactly what I was taught. God knows what procedure I'll get stuck with next time. At least they didn't make me work my shift like I was scheduled, our DON said I was in no shape to work. :angryfire

tmiller027 · May 11, 2004

You should be using a gait belt and never hook your arm under someone's arm...I hope you did learn the correct way to transfer and that your teacher was informed as well.
Barbara

Gait belts are never mentioned in any curriculum on the state's guidelines. Our facility teaches using them, but a lot of us don't. I for one, don't feel comfortable using it. I dont' feel I have enough control of the patient, though I rarely do an "assist" to a chair. Most patients I end up with need a full transfer, mostly since I'm 6'0 and 240 lbs I don't have trouble lifting anyone.

But back to my original point, the states procedures don't even say specifically how to transfer or assist other than "safely assist the resident from the bed to the chair".

Headhurt, ADN · May 11, 2004

I have to agree with Barb on this one. Gait belts are the only way to go for safely transferring a patient. You can damage the patient's shoulders, muscles and nerves by doing the "underarm hook and transfer". The point of the gait belt is to not "have control" of the patient when transferring, but to have a good grip on them should they happen to lose their balance. The only control you should have with a gait belt is if they do lose their balance, you can control their descent to the floor be slowly lowering them...rather than play the hero and keep them from falling by lifting them. Those type of antics can shorten a promising nursing career with chronic back problems. It doesn't matter how big and strong you are...a back injury can happen to ANYONE if they are not doing it correctly. I've worked in Orthopedics for almost 8 years...this is something I do know about. Take the time to learn about proper body mechanics and safe patient transfers. It's probably one of the best habits you can get into.

Good luck!

tmiller027 · May 11, 2004

I have to agree with Barb on this one. Gait belts are the only way to go for safely transferring a patient. You can damage the patient's shoulders, muscles and nerves by doing the "underarm hook and transfer". The point of the gait belt is to not "have control" of the patient when transferring, but to have a good grip on them should they happen to lose their balance. The only control you should have with a gait belt is if they do lose their balance, you can control their descent to the floor be slowly lowering them...rather than play the hero and keep them from falling by lifting them. Those type of antics can shorten a promising nursing career with chronic back problems. It doesn't matter how big and strong you are...a back injury can happen to ANYONE if they are not doing it correctly. I've worked in Orthopedics for almost 8 years...this is something I do know about. Take the time to learn about proper body mechanics and safe patient transfers. It's probably one of the best habits you can get into.
Good luck!

Like I said above, the state guidelines NEVER mention gait belts. Thats why they don't have us use them on the test. They only want us to do EXACTLY what the state guidelines say. I should have never posted this. I was just trying to vent my frustration at failing a test for doing exactly what I was told, and I'm now being criticized for not using a gait belt. Which by the way, when I move patients I'm NOT trying to play hero or anything like that. Whenever i"ve used a gait belt, or seen others use them, I've seen them leave marks, I've seen them slip on the patients clothing and everything else. When I transfer them (when not being tested) I have both my arms around them and onto their shoulder blades, they are NOT going anywhere. I haven't had any one fall yet. I've seen more people fall with a gait belt than without one. That and I DO practice good body mechanics. I always lift with my legs, etc. EIther way, that wasn't the point of my post, so I guess it doesn't matter

zenman · May 11, 2004

Talk to the people who taught you according to the guidelines. I don't think you are being criticized for not using a gait belt but being informed that a gait belt is the safest way to transfer a patient. It was "required" by RNs, CNAs, PTs and OTs in the rehab unit I worked in. Do as you are taught to pass a test, then go to the right way!

Noney · May 11, 2004

If you want to know why you shouldn't lift under the arms, try sitting in a chair and having someone hook their arm and your arm and pull up. After you've felt it fisrt hand you'll know why you shouldn't do it.

It sounds the teacher at your facilty needs some teaching.

Noney

tmiller027 · May 11, 2004

If you want to know why you shouldn't lift under the arms, try sitting in a chair and having someone hook their arm and your arm and pull up. After you've felt it fisrt hand you'll know why you shouldn't do it.
It sounds the teacher at your facilty needs some teaching.
Noney

Its not a full transfer, but an assist. The patient is actually moving themselves and the CNA is assisting, but having your arm laced under their arm and holding their wrist, they taught us thats the best way to support them as they move. You're not applying pressure, just bracing yourself on their affected side so they dont' fall.

So the tester stops me during the test, which was an EASY procedure. Its just so frustrating it took them THREE months to come down to test us, and here I get failed when I'm doing things exactly how I am taught.

I should also mention that our instructor said that every time this tester comes through, she finds a new thing to fail people for. Last time, she never picked on the assisting method, but failed someone for not removing dentures by grabbing the front teeth and wiggling up and down.

Noney · May 11, 2004

Sorry about this. How soon can you retest? Can you just retake the hands on portion?

Noney

tmiller027 · May 11, 2004

Sorry about this. How soon can you retest? Can you just retake the hands on portion?
Noney

Yeah, I just have to re-take the hands on portion. She said it may be two or three weeks, but I'm going to have to go to another facility to test now. Not to mention the flat out humiliation. Especially when our group had 2 or 3 people who can't do their jobs without someone holding their hands who passed and here I'm one that people always go to for help and I failed over nit-picky nonsense.

Headhurt, ADN · May 11, 2004

Doesn't matter what kind of transfer/assist it is, and no matter how good you do it...use a gait belt. This isn't an arguement you are not going to win on this board, or so it would seem. Proper transfer guidelines are not nit-picky...doing it wrong can injure a patient.

However, it is puzzling that gait belt usage isn't taught in class if it is one of those things you should do on your test. Maybe the state deems it more a common sense thing that falls under "safely transferring a patient", I don't know. I remember being taught how to use a gait belt when I went through my CNA classes 10 years ago. I would definitely go grill your instructor as to why you weren't taught what you needed to know for boards. You did what you were taught, and that ultimately caused you to fail. I agree with the previous poster...that instructor needs to go in for more training because she is not teaching the correct way.

tmiller027 · May 11, 2004

Doesn't matter what kind of transfer/assist it is, and no matter how good you do it...use a gait belt. This isn't an arguement you are not going to win on this board, or so it would seem.
However, it is puzzling that gait belt usage isn't taught in class if it is one of those things you should do on your test. Maybe the state deems it more a common sense thing that falls under "safely transferring a patient", I don't know. I remember being taught how to use a gait belt when I went through my CNA classes 10 years ago. I would definitely go grill your instructor as to why you weren't taught what you needed to know for boards. You did what you were taught, and that ultimately caused you to fail. I agree with the previous poster...that instructor needs to go in for more training because she is not teaching the correct way.

Well apparently not, and I didn't post this to start an arguement, I posted because I was and still am really upset and could have used some support, not criticism. Like I said I did what I was taught, I dont' know how else to put it. I've emailed the moderators to remove this thread. Needless to say I'm a bit disappointed.