Ouch, my back!

firstinfamily, RN · Oct 5, 2014

I have a few suggestions. First of all did you have a previous back problem? If so, then this is not going to get better, so you may need to re-evaluate your private duty case. There are exercises one can do to improve back strength, look for them on line "lower back strengthening". You might see if there is some type of lift machine that the family can purchase or their insurance will cover, such as a hoyer lift. You may have to get the case manager/social worker involved with this. It might also depend on the insurance the pt has. Are others having problems with their backs?? Just a few ideas. It sounds like this family really needs the nursing care, and want the best for their loved one. I don't think you should feel guilty if you cannot provide the care due to the physical demands, you do have to look out for yourself first. I don't feel it is a negative thing for you to approach your supervisor to ask if a hoyer lift could be provided for this pt because of being a quad he/she should qualify for one. Good Luck!!!

NightNurseRN13 · Oct 5, 2014

The patient has a hoyer lift and that is not a problem for me. It's moving her up in her recliner or in her bed and turning her that is the problem. I have been working PDN for over a year and have had no problems with my back until this case. She is at least 150 pounds of dead weight. The other nurses that I know have not had issues, but I have had issues with my back in the past. I lift other patients without a lift, but because of the height of the bed/chair etc. it's not an issue for me.

edit: clarification- I have had issues with my back before even being a nurse and since working have not had any issues until now.

UnaNayeli · Oct 5, 2014

I'm a little confused: If a lift is available, why aren't you using it every time you reposition your client? Doing so would be easier/ healthier for BOTH of you!

NightNurseRN13 · Oct 5, 2014

Part of the issue is positioning the seat underneath her when she sitting in her recliner. You can't use a lift to roll her.

amoLucia · Oct 5, 2014

Do you wear a back support for yourself while working? Might help.

NightNurseRN13 · Oct 5, 2014

Yes, I have a back brace that I use and I promise I use good body mechanics, but imagine a quad in a recliner that is low to the ground and her hoyer lift seat is too far up.... I can lean the recliner back, but I can't lift it up and I have to practically climb over the back of it to get underneath her shoulders, then get in front and pull the seat down so it's in the correct position.

Using the hoyer lift to transport her from recliner to bed is no problem.

NightNurseRN13 · Oct 5, 2014

Maybe this should be moved to private duty nursing so I can get suggestions on how to bring it up to my boss.

firstinfamily, RN · Oct 6, 2014

So the height of the recliner is the issue?? What about a "lift chair?" I am not sure if they come in a recliner type style, but the height would be adjustable. The problem with this kind of chair is that Medicare does not cover the actual chair, the motor only. Nice to know!! How about using a grippy under her to keep her from sliding down? We used these in the sub-acute area, it is the grippy stuff you see being used for shelf liners, but works great in keeping pts from sliding down in their chair. You still have to reposition at least every 2hours to prevent breakdown, but this might help prevent her from sliding down.

BSNbeauty, BSN, RN · Oct 6, 2014

And this is why I personally could not do PDN. The lifting and rolling of dead weight always but a strain on my back. It would be nice if the family could help. You only get one back so take care of yourself!