Is it wrong to tell patient that they might physically hurt you

AJJKRN · Sep 20, 2017

Not in my view, I have said things like "we don't want to end up in the hospital along with you" or even more bluntly "I am not willing to risk our backs and livelihood with being pulled on". My favorite is the 300lb 6ft plus male farmer, etc that just wants a "tug" on their arm or to pull on you...uh no!

JKL33 · Sep 21, 2017

Probably kindest to just say, "No, that's not safe."

Plenty of people assume I am going to move them but a couple of times they've been very rude when I declined. One disgusted person said to me, "You're just standing there and all I need to do is link my arms around your neck and I'll be able to stand." My discussion with that patient was a bit more frank.

djh123 · Sep 21, 2017

I'm facing a big problem related to this right now. A pt's condition is worsening, to where he is now needing more help with transfers, 'scooting up' in his wheelchair, pushing WC - and he weighs quite a bit. My aides are usually good, but sometimes they're busy elsewhere - and besides, I'm worried about all of us getting hurt with this guy, not just me. And he's a nice guy. I probably need to get a back brace at a minimum.

JKL33 · Sep 21, 2017

I'm facing a big problem related to this right now. A pt's condition is worsening, to where he is now needing more help with transfers, 'scooting up' in his wheelchair, pushing WC - and he weighs quite a bit. My aides are usually good, but sometimes they're busy elsewhere - and besides, I'm worried about all of us getting hurt with this guy, not just me. And he's a nice guy. I probably need to get a back brace at a minimum.

In which setting is this?

If possible I would suggest PT work with the patient to maximize whatever strength he has and to suggest methods and aids for moving and for teaching the patient how to move safely. I understand why you're thinking about a back brace, but to me that thought should merely serve as a clue that other help is needed. Human bodies are not meant to be large-people-moving-machines.

djh123 · Sep 21, 2017

It's LTC. I'm not sure whether he's still getting PT or not, but I do need to check into that. The thing is, he's still continent... so the sit-to-stand or Hoyers that we use with incontinent patients haven't come into play, and aren't practical for say, just going to the bathroom quickly to urinate.

And I totally agree that we're not meant to be big people moving machines...

JKL33 · Sep 21, 2017

It's LTC. I'm not sure whether he's still getting PT or not, but I do need to check into that. The thing is, he's still continent... so the sit-to-stand or Hoyers that we use with incontinent patients haven't come into play, and aren't practical for say, just going to the bathroom quickly to urinate.
And I totally agree that we're not meant to be big people moving machines...

Good luck! :)

I suggest remaining pleasant but firm in seeking a solution for this situation. I would not give anyone (the patient, PT, your charge nurse or DON) the impression for one second that you are willing to handle this situation individually. I am never derogatory when speaking about the patient nor unwilling to help, but at the same time I will not entertain suggestions that staff should risk their back health with incorrect solutions. Just keep those options off the table.

AJJKRN · Sep 22, 2017

It's LTC. I'm not sure whether he's still getting PT or not, but I do need to check into that. The thing is, he's still continent... so the sit-to-stand or Hoyers that we use with incontinent patients haven't come into play, and aren't practical for say, just going to the bathroom quickly to urinate.
And I totally agree that we're not meant to be big people moving machines...

Out of curiosity, would a sit-to-stand and a urinal not be both practical and safer?

Borisarah · Sep 22, 2017

It is well within your right to remain safe. If I have a large patient that is unsteady, I always remind them that they are bigger than me and can hurt me if the do not follow directions. In the op situation are you placing a front wheeled walker in front of him that he can hang on to instead of you? Also sound like time for a pt eval to se if he does need sit to stand.

Neats, BSN · Sep 25, 2017

I would just say no I cannot transfer you this way it is not safe for both of us. I would also make a note about the need for additional assist with transfers to protect my co-workers. I would also document this significant change in condition so the nursing staff i.e. MDS coordinator can update the patient condition. They will then refer to therapy or their physician for work up for the new condition.

martymoose, BSN, RN · Sep 26, 2017

pts usually dont care if you get hurt. They know there will be other employees to take your place.

Here.I.Stand, BSN, RN · Sep 28, 2017

Tell the pt/resident that a manual transfer isn't safe for either of you, and so it is not an option. The Hoyer is required. Of course you won't force him into the Hoyer, but without it he will stay in bed.

Never EVER compromise your safety. Years from now this person won't even remember you... but your back is yours until you die.