Input, please? :-)

[altmer_aldmeri]

Hello! I am in the final weeks of my cna class. We have been at our ltc facility for our clinicals for a good while now, so when we are assigned to a cna, we know what the drill is (morning shift). I didnt have time to tell my instructor what the cna wanted me to do, so Id like to know what you all think..

So yesterday I got to work with a cna I havent worked with before. She had me brief and dress a resident who was paralyzed on her right side.. Ok, no problem, got it done.. Then she wanted me to transfer the resident from her bed to her wheelchair. So i asked for a gait belt, and she insisted that I didnt need one. So she lifted the bed higher and said, "show me, how would you do it without one?". I told her, "im sorry, i wouldnt feel comfortable doing that". She replied, "you're just scared.." So she bear-hugged the resident and sat her in the wheel chair.

Now, Im sure I should know this, but is it really OK to do that?? I barely got checked off this particular skill, (granted, she doesnt know this), but we use BELTS! Also, it just didnt seem right to me. Yes, i know corners are cut in the "real world" of nursing homes, but im still just a student.

I just didnt want to hurt the Resident if i messed up.

[duskyjewel]

It's not right, I know, but I haven't seen a gait belt used since I left school. However, as a student you were perfectly right. You cannot do that skill without the belt and if you get caught, you may fail your class and not be allowed to test.

[annieboo444]

Yes the proper way and safest way is to use a gait belt but I have never really seen anyone in the hospital use one,but physical therapy. You can always tie a sheet and use it as a gait belt too. Everyone just bear hugs and transfer that way, but if you don't feel safe get the gait belt you don't want the patient to fall.

[mvm2]

Yeah and you know that when this CNA is 50 years old and her back is wrecked she is going to blame everything under the sun except her own stupidity. Do now transfer people the bear hug way if you love yourself and your health. You could do 100 transfer this way, and number 101 you hear a snap in your back and you are wrecked for months to maybe life.

Not to mention transfering this way is so unsafe for you and the resident. You could trip over her feet or her feet to yours and you are both on the ground. Also you do not have as much control I feel and when I have seen people transfering this way it is never a pleasent and easy transfer on the resident. They usually get body slamed into the chair or onto the bed. Use a gait belt to help them transfer themselves, and if they are too weak, facilities either should have a hoyer or sit and stand to help with transfers.

[nlitened]

I have never seen a gait belt used, and I have worked in a hospital for 8 years now. When I went to CNA school, we weren't even taught how to use them. So I guess it all depends on how you are taught/trained. If gait belts are what your instructor wants you to use, then yes, your preceptor should have gotten you one.

[Missingyou, CNA]

In the LTC where I work, if you are caught not using a gait bel,t you are fired on the spot, no questions asked...that is how important it is to use it.

I still see CNA's transfer without it anyway.

The whole purpose is so you can help a resident keep their balance. If you place the belt on them snuggly under the breasts area so that you can just get your hand under it. Holding them there while they walk will help you steady them and prevent a fall.

Holding the belt in the back when you transfer gives you a place to get a good solid grip on them and again, keeps them steady.

You are asking for trouble both for you and for your resident if you don't take the 5 seconds to put it on them.

Yes, there are lots of short cuts in being a CNA but, when it comes to safety, there is never a shortcut. Stand your ground on this!

[altmer_aldmeri]

Wow, thank you all for your replies!! I guess it really depends on where you go to school/ work, huh?? All I know is that we have to use the belt thats required for our exam (red cross certification), so i'll make sure I at least keep one handy while still in clinicals for sure. Then once I start working ( IF i pass!), I would definately still keep using one :-/ lol..

Well again, thanks everyone for your expertise!!

[mvm2]

Also it just accured to me that if you are tranfering without a gait belt, and there is an accident and they fall there will be an incident report having to be done and one of the things that will be in it I am sure is if there was a gait belt or other safty devises used to transfer resident. If you were not using the proper safty devises you could be in trouble.

[monkeyhq]

Ditto to all advice given above.

Students are generally working at clinical under the license of their instructor, and through an agreement between the facility and the school. If an employee, or another student, asks you to perform something in a manner that you have not been taught or in a way that you know is incorrect, my advice is to seek your instructor for verification/clarification. Failure to do so could result in injury to the resident, your personal liability, the school's liability, the facility's liability, your instructor's liability, and may prevent you from working in healthcare.

As for the use of a gait belt, I always used it when I was in LTC. Accidents and slips can and do happen.

[SeattleJess]

Excellent comments! I second. You should never, ever, ever act outside your training or scope of practice. When I was a student I was told we were at our LTC training to practice the skills we'd learned exactly as we'd been trained. Our supervisor was the instructor from our school, not any CNA or nurse at the facility. Later we would have the chance to learn new techniques. I saw CNAs doing things differently during my live-training; I observed and absorbed but did not execute. We also had a checklist and could have told any CNA that wanted us to do a different technique that it was not on our checklist and I'd need to clear my actions with my supervisor. By the way, one CNA told me it was okay to haul a resident out of bed by pulling on her arms. (NOT offering your hands for the resident to pull herself up, put yanking on her vulnerable shoulder joints.) Just because you see it doesn't mean it's right.

Bottom line, you must ALWAYS check a resident's care plan before you do anything. If you move or transfer or feed a resident outside of his or her care plan, you are committing malpractice.

I'm just repeating what others have said here but it's important enough to repeat, I think.

You were correct to refuse to use the "bear hug" transfer. Good experience for you because you will face similar situations if you go on to work in LTC. Stay strong and focused on patient safety and practicing with integrity.