Is anyone else annoyed by the expectations of male nurses in transferring patients?

[WillRegNurse]

At my new job on a med-surg floor, we have only two pieces of lifting equipment: a sit-to-stand machine and a hoyer lift. When you want to use them, they never seem to be around. They are shared with other floors and are underused because the experienced nurses see it as a big to-do to scour the floor for them and get the patient into the harness. For that reason, most of the experienced nurses never want to bother using them. They see it as more convenient and efficient to just recruit a bunch of personnel from the hall, including as many male nurses as are around, and utilize these 4 to 6 people to, in my opinion, unsafely transfer patients who are as heavy as 250 lbs, have dementia, and hit people.

Just the other day, my preceptor asked me to "get in front of this guy" who was 71 years old, 300 lbs, demented, and combative. He also had sprained something in his leg from falling a while back and was unwilling to stand. So 4 other people and me had to reach under his arms and bear all his weight onto our backs to try and shuffle him from the bed to the wheelchair so that he could be discharged. We did get him into the wheelchair but he was about to fall forward at one point and so my preceptor had to charge forward into his gut and ram him with her head in order to stop his fall forward and send him backwards into the wheelchair instead. It was one of the most absurd things I have ever taken part in.

I made a point to say it would be a better idea to take time to use the lifting equipment on a patient like that next time and she agreed, but I believe that when transferring heavy patients, many nurses feel that it is quicker to just get a whole lot of people and get it done without the use of equipment, regardless of how much it hurts our backs.

What I resent is that the next time this happens, and I refuse to transfer a heavy patient that should really be transferred via equipment, that I will be seen as unskilled, lazy, or a weakling for not wanting to have a work related injury during my first year out of nursing school. I especially despise comments from nurses who say "it is nice to sometimes have a male nurse help move the patients" as if being a man and having more upper body strength does jack for saving your back when you got some huge person falling down onto you!

What does everyone else make of this?

[xtxrn, ASN, RN]

Ha most hospitals DO NOT HAVE THAT EQUIPMENT. just my observation. i have never actually verified this. if they do have it , good luck finding the one lift and a couple of boards..............................

I think this is changing considerably- at LTCs and hospitals...at least in the areas I've worked/seen. Obviously it needs to be better, but people also need to use the stuff :)

[Jenni811, RN]

yea you do have the right to refuse to assist in moving a difficult patient without the use of a lift. your employer might not be to happy with you but the way i see it is you only have 1 back and there are many different employers out there. I will not risk hurting my back over my job. If my employer wants to get rid of me because i'm putting my own safety first, then i don't want to work for them anyway.

[xtxrn, ASN, RN]

yea you do have the right to refuse to assist in moving a difficult patient without the use of a lift. your employer might not be to happy with you but the way i see it is you only have 1 back and there are many different employers out there. I will not risk hurting my back over my job. If my employer wants to get rid of me because i'm putting my own safety first, then i don't want to work for them anyway.

Very true. :) Stick to your guns on that one !! There are "lift-free" facilities, that have lifts that go all the way to the ground that are great (along with the sit-to-stand, and normal bed-to-chair lifts). With injuries being so expensive (not even considering the toll it takes on the employee- since they really don't care), there isn't really a good reason to not have the equipment now that it's so available.

[locolorenzo22, BSN, RN]

This happened to me last shift...big 300 lb man(with it, but with a trach), got up by self, popped his vent off, had poop everywhere, trying to wriggle around smearing it, etc. We (me and 6 women) got the bed/him/equipment/etc cleaned. Somebody talked to the patient and he wanted to "try" to get back in the bed...he looked like a fish flopping/reaching for the rail/etc.

Somebody didn't want to wait for the lift, somebody did. Guess who got talked about later as I was walking by to go to the break room? You got it, the one who wanted to use the lift. Not my regular unit. I have no problems moving someone if it's safe....but I've thrown my back out before and have no wish to do it again.

And If YOU throw it out and not use equipment, the hospital will say they're not responsible. Sometimes being a guy is a hinderance.

[ZippyGBR, BSN, RN]

The answer to this dilemma is the same as the answer to many others ... safe staffing levels.

Even if there is equipment available, utilizing it safely with 400 lb+ patients takes considerable time from multiple staff. It is not a magic fix-all.

I can understand your frustration at feeling targeted as the designated heavy lifter.

I think hospitals should staff multiple "lift teams" - trained, wearing back supports, and physically capable, and available 24/7 -- that would be a better option than most of the extremely cumbersome equipment I have observed.

JMO.

PPE is the last resort in the hierarchy of risk control , the first resort is task redesign which means a suitable number and range of pieces of lifting equipment .

there are no excuses from an Occupational Health/ Health and Safety reason why hospitals and nursing homes shouldn't have a decent number ( i.e. easily available to every unit) of the following handling aids

- slide sheets -of all varieties including one way chair sized and mattress covers

- conventional (?hoyer / engine crane type) hoists - with single patient use slings of the appropriate size and if necessary (ortho/ trauma/ spinal) a scoop type stetcher as well allowing for in-line immobilisation to be maintained when transferring between surfaces)

- sit to stand hoists - with single patient use slings of the appropriate size

- lateral transfer devices e.g. Patslide or the large padded slide sheets

in areas where there are significant numbers of patients who will require hoist transfers consideration should be given to overhead tracking hoists ( one per room so semi private or bays have one hoist and track per 2/ 4 patients)

cost if often raised as a reason why not but the costs of doing this are saved if it prevents one large lawsuit against the organisation - which could come from a patient ( for being dropped or injured by poor handling) or from a member of staff expected move and handle patients

hoists don't have to be cumbersome , especially the sit to stand ones and ceiling track hoist takes up zero floor space , it's there at the push of a button ....

[ZippyGBR, BSN, RN]

This is why my hospital is wasting millions of $$ to install lifts in every room.

if it saves them one payout to a member of staff who has to medically retire or one payout to a patient who is dropped by the negligence of staff they will have paid for it many times over ...

don't know what the fines regime is where you are for Health and Safety Breaches, but i nthe UK there is the potential of unlimited fines for an organisation and jail time for individual managers under both Health and Safety and Corporate Manslaughter legislation

[JRP1120, RN]

You have the right to refuse if you feel it is harmful to yourself. I will NOT move a patient that i feel needs a lift. Im 5'2, 110 lbs and cannot do it and will not hurt my back over it.

Our hospital has a new set up that has every single room equipped with ceiling lifts. The are super nice, we can bring patients all over the room, including the bathroom and shower. The lift sheets are easy to get under them, have a hole in the butt area so we don't have to take it off if they are just getting up to use commode or toilet. We can use them as "walking pants" so someone that is needing to start walking, PT uses it mostly, straps what looks like those baby swings. Strap those on the patient and they can walk all over the room without falling. We can set it to different heights depending how much weight bearing they are. we have sheets on the bed that are specifically designed to attach to these ceiling lifts so we can boost a patient in bed without 7+ people assisting.

It just requires 2 people to be present whenever the patient is using it, one on each side. One can lift up to 450 lbs, some of our rooms are labeled bariatric rooms, and the lifts in these rooms do the exact same thing but can lift up to 900 lbs.

They are GREAT!!! i couldn't do my job without them. I depend on these things everyday. I realize some hospitals don't have the luxury of this, and i've done clinical rotations in a hospital that did not have them.

It was really hard, there was a lot more demand on the male nurses. I remember they had a special code word that came over the intercom and whenever this code word came over, it meant ALL avaliable male staff please come to _____. It meant there was a combative patient, they got out all the female staff and put in the male staff.

But yes, i agree i believe there is more of a higher demand on male nurses as far as dealing with combative patients, or difficult patients.

Wow! This is what we need on my rehab floor!!

[bradleau]

Before I had to quite nursing,our floor purchased this HUGE lift that could barely fit in the patient room. Just a good lift would have been better. Or as one of my patients suggested "go buy an engine hoist" for a couple of hundred dollars. But NO we had to buy this huge expensive lift and share it over several floors in this hospital. By the way until I went to work there in the 90's I had never seen a WORKING pt. lift. I personally injured my neck, rupturing my C6-7 assisting an able bodied patient off the floor...with the assist of a male nurse. Sometimes your body just can not take the strain anymore. Years earlier I lost use of an arm for 6 months...it just hung there. The patient was 89 lbs, my charge nurse was helping, using a draw sheet to move the pt. up in bed. I thought I had just pulled a muscle. Pain over clavical. Turned out that my neck was the cause. I became very good at order entry, using my one good arm. When the disk ruptured, and I had it fixed, I finally got full use and strenght out of that arm. Use had returned on its own, but it was 50%weaker. Anyway, besides lifts and the like, how about having beds that are wider. It does not help to have a regular width hospital bed for a 400 lb patient. They can not move or help move themselves. A full size bed would be a better solution. Again the powers to be do not let the actual users try the product before forcing us to use it.

[johnnybravo8802]

When I was in nursing school, I had an OLD MD tell me to "be careful" because women will use you up when you're a man in the hospital-That happened to him in medical school back in the 30's/40's. You know what, he was exactly right-My entire career has been riddled with female nurses getting me to do their work-Even lifting a heavy patient when they weren't even in the room. I kept doing it because I'm way too nice and I wanted to be accepted and it got me absolutely nowhere. I can remember using pure brute strength to move a patient because I was 22 and didn't know better and had no help. Guess where it got me-Years of lifting, playing sports, and being physical outside got be a pinched nerve and sciatica and now I don't do those kinds of things anymore. If I start to see several nurses starting up, "let's get the male nurse to do all the lifting," routine I'll tell them real quick that I have a back problem and refuse to do it. I'll help anybody on the floor but I WILL NOT do someone else's work for them. The female nurses will use you up all day long with the "I'm a female and you're stronger than me" routine but don't fall for it-If you can't do the job, find a different profession is my opinion. Also, with experience comes wisdom-You have to think of a patient's safety first and you can't be snatching a patient around simply because of their condition.

[royhanosn]

whats a preceptor?

AZ patients are like that, combative, therefore team work and knowing what machinery is around to lift heavy one transferred. Dont perform heroics, its your back, legs, especially around someone that is or KNOWN DEMENTED, Use your head, not your body. Your employer has spend thousands on equipment, USE IT! Plus if someone gets injured, the first thing will be ask, what equipment was used.

[Overland1, RN]

...What I resent is that the next time this happens, and I refuse to transfer a heavy patient that should really be transferred via equipment, that I will be seen as unskilled, lazy, or a weakling for not wanting to have a work related injury during my first year out of nursing school. I especially despise comments from nurses who say "it is nice to sometimes have a male nurse help move the patients" as if being a man and having more upper body strength does jack for saving your back when you got some huge person falling down onto you!

What does everyone else make of this?

Geez... that's why G-d invented male nurses, no?

Seriously, using equipment that is appropriate to the task is a much better choice for the patient and the staff. Your facility staff generally needs some updated and proper education (along with P&P's) to cover this sort of thing before somebody is injured.

[Guest372004]

How about the huge patients who want to use you to pull themselves out of bed???? I tell them "look at you, and look at me" (I am 115 lb). That sort of gets their attention. I agree. The best would be to have a "lift team" but that cost too much $. It is always talked and talked about but only talk. When a patient starts to pull at my neck I immediately yell "NO you cannot do that". The loud voice somehow stops them in their tracks.