Moving/lifting patients when short staffed

madwife2002, BSN, RN · Mar 12, 2005

Hi, basic care needs do get easier the longer you do them, as far as doing all the care of a dependent patient alone goes it is nigh on impossible to do much on your own. We always work in two's, you can manage to do the face and frontal areas alone if needs be but if you need to roll and clean other areas you will have to have 2 people.

we were talking at work today thinking back when we first started and how I thought I could never change a sheet whilst a patient is in the bed and how I used to worry and how simple it is now and I dont give it a second though. We do use hoist's but again you have to have two people to mange them properly, otherwise you are going to hurt your back.

Please dont worry i always work with the reasoning that if other people can do these things then so can I. I would hope that nobody would expect you to be an expert in your new job.

lee1 · Mar 12, 2005

Hello. I'm going to be starting a new job as a CNA, but I'm worried about how I'll ever be able to move, lift, and bathe residents/patients without hurting them. I've already done this in job training, but I always had a partner, and it seemed really difficult just to move a patient to a side of a bed with two people. I had many patients that were hard to move, even the ones who were small framed, so I'm wondering how I'lll ever be able to move a patient who can't move herself (for repositioning; perineal care; bed bath) when I work alone. I'm also worried about how I'll shower a resident by myself, especially if the resident is unable to help. The training program says that we should have partners to help us, but I've heard that many nursing homes are short staffed, so I'm not confident that I'll have a partner to help me. Should CNAs have partners for residents who are difficult to move, or are we expected to perform all tasks (except for hoyer lifts) alone? If anyone has any advice on how they managed to move/bathe patients who need total care alone, it would really help. Thanks.

Think of it this way. If you hurt your back who is going to do all the things at home and for you. Make sure you have a partner to do anything that involves lifts or movement which you know via an algorithym that you should have been taught either requires more than 1 person or a mechanical device.

What did your job description state. Do you work in a hospital or nursing home. If nursing home OSHA has started mandating safe patient and handling policies be in place.

grimmy, RN · Mar 13, 2005

as a former pct, i understand your concerns. i'm an or nurse now, and positioning is one of my key concerns. just don't try to move total-care patients by yourself, not even with a hoist. it is simply unsafe. my best advice is to make your job a team effort. if you manage to work with like-minded nurses and cnas, they will be well-aware of the safety issues, and won't want to do it all themselves, either. of course, the day (or night) will come when you are by yourself, your total-care resident will have had a bm for the 5th time, and all the call-lights are going off at once. :uhoh3: with proper padding, guard-rails, and super-vigilence by you, you can creatively use sheets and pillows to do a quickie cleanup, but i don't recommend it for all the time. i doubly don't recommend it for anyone in restraints. that will always be a two-(three-, four) person job. ergo, maintain good relationships with your peers...you want to be reliable and trustworthy so that folks will be willing and ready to help you when you need it. safety, your's and the patient's, should be your #1 priority.

Plagueis · Mar 16, 2005

Thanks for all of your advice. The place that I will be working at is a nursing home, and they really need help. I am just worried that I will end up hurting one of the total-care residents if I'm assigned to bathe/reposition one by myself. I have an orientation in a few weeks, so I don't have a specific job description, yet. However, the CNA instructor said that the nursing home where I'll be working does encourage aides to ask for help if they need it, and that there should be enough people on staff to help. But then I hear and read about nursing homes where there's something like 3 aides for 40 residents, and that makes me worry. I've also read about how some aides think that there should be two people for most tasks, just to be on the safe side. That's what we did in our CNA training, and it made doing the tasks a lot easier, but then other aides say that one person should be able to move/transfer/bathe a person by herself. I don't want to be perceived as some sort of "wimp" because I can't reposition/bathe certain residents by myself.

Nurse Ratched, RN · Mar 16, 2005

There are tricks that you will learn to make moving your residents easier. There is also equipment, including SLIPP mats and Hoyer lifts, among others, that will enable you to move even the largest resident, altho still not necessarily alone. The biggest thing you will lack is feeling like you have the time to do things safely and correctly.

Trust me when I say you don't have the time NOT to do it safely. The rest of your life is a long time to live with a painful and disabling back injury, as many nurses on this board can tell you.

Take care of your back, please. You will likely run into short staffing situations. Only you will be able to decide once you are in a situation whether or not it is tolerable from a workload standpoint.

Amethyst Veralyn · Mar 18, 2009

When you use the hoyer lift a lot of facilities require you to have someone

help you.

I asked my co workers if this is a facility rule or state law and

they didn't seem to know. I still would like to know if it's actually illegal

to use it alone.

Amethyst Veralyn · Mar 18, 2009

Thanks for all of your advice. The place that I will be working at is a nursing home, and they really need help. I am just worried that I will end up hurting one of the total-care residents if I'm assigned to bathe/reposition one by myself. I have an orientation in a few weeks, so I don't have a specific job description, yet. However, the CNA instructor said that the nursing home where I'll be working does encourage aides to ask for help if they need it, and that there should be enough people on staff to help. But then I hear and read about nursing homes where there's something like 3 aides for 40 residents, and that makes me worry. I've also read about how some aides think that there should be two people for most tasks, just to be on the safe side. That's what we did in our CNA training, and it made doing the tasks a lot easier, but then other aides say that one person should be able to move/transfer/bathe a person by herself. I don't want to be perceived as some sort of "wimp" because I can't reposition/bathe certain residents by myself.

Don't let any of them bully you into doing things you don't feel safe doing. This will protect both you and the patients.

If there are only 3 aides for 40 patients they should get together at one end of the wing and do all the transfers

at once moving right down through. This is very fast and safe.

sing_anyway · Mar 18, 2009

i love this question, because I feel like it is me a few weeks ago.

i just found that our facility is telling us that we are expected to use the lifts alone, that is why they paid for the lifts.

hmmm.

I just spent the night working alone, and I found ways, but I was also still there as day shift came on and complained about not having enough people "pre-dressed"....

I can't move today because my back is so sore,

my neck won't turn,

yet all the higher ups told me,

if you don't feel comfortable doing it by yourself, don't do it!

the solution my charge nurse had lst night was for me to use the sit-to-stand-lift on everyone.

We never get to work in 2's not enough of us,

I didn't use the lift, because how can you wake someone up that much in the middle of the night just to hang them in the air and give peri-care?

I don't know if we are even supposed to be able to do that, seems VERY degrading to be hefted up on a crane and have your rear hanging out to be wiped. I can't bring myself to do it, I just can't,

whatever you do, PROTECT YOUR BACK AT ALL COSTS!

Amethyst Veralyn · Jun 5, 2009

When you use the hoyer lift the facilities will require you to get help and this
is a state requirement. You should never move someone without help if you feel afraid or if you think you can't
handle them. You should not let anyone push you into moving someone alone just because they can, either/or
when a nursing order specifically tells you they are a hoyer lift transfer or a two person transfer.