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Discussion

Is pulling a 200 lb patient different than lifting them

I was asking my supervisor about this 200 lb client(quad). I told her I thought the max we are supposed to lift is 75lb. She said it really isn't lifting, its just pulling because what we do is take the cotton pads and slide her up in bed, rather than actual lifting. Is what she saying true? My back sure doesn't seem to know the difference. It hurts for sure. I'm in homecare and there isn't anyone else around to help pull her up in bed.

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    Can you get one of those plastic slippery pull-sheets to help reduce friction?

    It made sliding the pt up in bed so much much better!

    I don't know what those are called, but I used them in my LTC rotation and I thought they were brilliant.

    Also, if lowering the head of the bed lower than the foot is an option, that allows you to use gravity in your favor.

    If the headboard is low enough, I can pull a patient up with the draw sheet easier from that direction.

    But I won't do anything if I think I feel my back doing the work.

    I try to use my weight and gravity to help.

    Is your supervisor not willing to provide you with assistive devices?

    I would not think much of anyplace that won't give you the tools to do your job safely.

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    What Hygiene Queen is referring to is a Maxi-Glide, and no facility should ever be without this lovely device! Many a patient simply would not have moved with less than a tow truck if it had not been for that, believe me. Homecare may be tougher to get supplies, but this is an important one.

    Dropping the head down and raising feet up can sometimes help for a VERY brief time to drag a patient up the bed, but they can sometimes have difficulty breathing like that.

    Maxi-Glide. All the way :)

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    A straight lift is the safest way to move weight. Sliding or pulling weight is about 1000 times more dangerous.

    Most warehouses and retail limit lifting to 30-50lb maximum. That is lifting, not pulling or sliding.

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    What Hygiene Queen is referring to is a Maxi-Glide... Maxi-Glide. All the way :)

    Ah yes!

    The Maxi-Glide!

    A beautiful beautiful thing!

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    Then insist on more help or a Maxi-Glide. I've discovered in my home health journey that when something sounds like it's a threat to somebody's bank account or their convenience, unsafe transfer situations gradually inch toward "not really that bad". We have to advocate for ourselves!

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    As stated, pulling is much more risky than is lifting. This is due to simple body mechanics. Proper lifting, with the hips tucked under the shoulders, shoulders back, knees bent, and core rigid transmits the loads longitudinally onto large muscles, ligaments, and tendons, and compresses the spine. Pulling requires a degree of twisting and bending which puts muscles into shear and imparts asymmetric loads on the disks which can lead to herniation and rupture.

    If it can't be done safely, don't do it at all.

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    • Experts
    I was asking my supervisor about this 200 lb client(quad).I told her I thought the max we are supposed to lift is 75lb.She said it really isn't lifting,its just pulling because what we do is take the cotton pads and slide her up in bed,rather than actual lifting.Is what she saying true?My back sure doesn't seem to know the difference. It hurts for sure.I'm in homecare and there isn't anyone else around to help pull her up in bed

    Who takes care of this quad when you're not there?

    If this is a quadriplegic patient, is there a Hoyer lift to get him in and out of bed for showers, maybe for meals, therapy, doctor's appointments, etc.?

    Maybe I misunderstood. I though at first that you were making home visits. Now I am wondering if maybe you are there for a full shift, which would require you to move him at times.

    Whichever is the case, do not think you need to hurt yourself in order to make a living. It's likely that the patient's insurance will pay all or most of the cost of equipment that is necessary to take proper care of him.

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    Back before I was in nursing, I was in a manufacturing plant. I used to load a machine. I'd pick it up off the floor, put it on the machine, lather rinse repeat about 1000 times per day.

    I hurt my back.

    So their solution?

    I was put at the other end of the machine, to take off the machine and put it down on the floor. About 1000 times per day.

    Which anybody that had worked both ends of that machine would tell you, unloading was worse. Strangely, my back didn't get better.

    Bosses seem to have interesting ideas about back safety.

    Pulling is worse than lifting.

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    Tip the head of the bed down, and use whatever sliding type sheet you have, and have gravity work with you.

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    Take a look at this resource http://www.safeliftingportal.com/documents/safelifting-practices-for-nurses.pdf . Many organizations are adopting 'no lift' policies because of the increasing problems with back injuries. A lot of organizations are still trying to enforce outdated 'lift limits' of 50 lbs - but research has shown that it should be 35 lbs. We all need to be lobbying for changes in this area... your back will thank you.

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    I am in the same situation. I have been working as a home health aide privately for almost 5 years with a 210lb quad patient. He has a Clinitron bed which makes it easier, and a Hoyer, but I still need to turn him and readjust him in the bed alone (pulling him either up for a boost or over with the draw sheet). I thought I was protecting my back, but for the past 6 months I have had terrible back pain on my spine between my scapulae. I just called my NP this week to make an appointment to see if anything is wrong. It is a tough situation if you are alone, it's not like I can just leave him that way. I am planning to try changing my techniques but I don't know if there is any better way yet, a coworker is supposed to work with me this weekend and see if she can offer any suggestions. No job is worth your physical health, and from what I understand if you hurt your back it is never the same. Good luck and take care of yourself!

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