Hopefully someone can offer me some helpful advice. I am starting nursing school in a few weeks and just got a job as a PCA for a quadriplegic man who needs to be transferred from his wheelchair to bed and back, plus the shower chair. When I was hired they said they usually hire more seasoned nursing students but were willing to take a chance. The girl who trained me made transferring look so easy, she didn't even get out of breath! I had my second shift yesterday where I actually worked and didn't just observe and I still can't get the lifting right!
I can do the transfer from the wheelchair to the bed since that's a little easier, I don't have to worry about positioning so much. From the bed to the shower chair was also not so bad. But, from the bed to the actual wheelchair I cannot do. The wheelchair is slightly higher than the bed, and even when I manage to get my patient on the chair I still don't do it right and his wife, who is a former nurse, ends up having to assist me with positioning. My patient is also my employer, so I really worry that if I don't start getting this right soon I will be fired. Can someone give me some helpful advice on how to do this? He is around 150 lbs. so not too big. Like I said, I haven't had nursing school yet or any formal training so I wonder if it's just body mechanics that I am not getting right.
Jan 7, '13
Transferring patients is terrifying at first, but it definitely gets easier and easier with practice. Eventually you learn the best ways to position the wheelchair and the patient, and it becomes second nature. If the patient is able to speak, it often helps to ask them how they usually transfer, how the wheelchair is positioned, etc. A lot of times, the patients can tell you what works best for them, especially if they've been injured for a while. If you can't ask him, maybe his wife could help you get the hang of it. Maybe she could spend a little time teaching you the safest/best ways to help her husband, especially since she was in your shoes years ago. Best of luck & please don't get discouraged! I was scared to transfer patients by myself even after nursing school! It's something you learn on the job, and this sounds like it'll be great experience for you!
Jan 7, '13
Never be afraid to ask for help! No matter who the patient is! I still ask for help if I am not familiar with any new patients. If your worried about what other people will say or think, don't pay any mind to them. It's better to be safe than sorry, especially in patient care. You can even watch videos on YouTube that show techniques, but just ask another coworker of a family member for some help.
Jan 7, '13
Thank you guys. The situation is that I just work in their home, so it's just me and his wife is usually around. He is very much able to talk and very active and employed. He does have partial use of his arms, only the tricepts and (so I guess maybe I shouldn't say he's quadriplegic!) He's just very particular about how he wants everything done ( he has been disabled for 30+ yrs, so definitely has a routine down) and since he is the one who hired me and pays me I am very nervous about getting things just right. Right now he is fully staffed ( he just needs help in the mornings and evenings) so I will just fill in for now, but they anticipating some of the other attendants leaving soon as they are done with NS. I really want to keep this job, the hours work so well for me too.
I have tried to look at youtube videos, bu they all show transfers with help, like in a nursing home. it's frustrating bc I want to do a good job, but physically feel unable to. I am going to start doing daily squats, maybe I am just out of shape.
Jan 7, '13
Do the arms of the wheelchair come off? If you position the chair perpendicular to the bed and take the arm next to the bed over, you may be able to more-so slide him over into the chair (or out of it). Since he has partial use of his arms, I would see how you can work that to your advantage.
Jan 8, '13
I'm with the pp about asking him what transfer works best for him.
Jan 8, '13
Doesn't sound safe to me. You need a hoyer lift.
It's only a matter of time before you hurt your back. Be careful, you only get one.
Jan 8, '13
Has he tried a slider board? If the arm lifts upon the wheelchair and can use his arms a board would be ideal.
Give it time and it should get easier.It's always difficult until you get to know the person.I also agree with asking him what works best.
Jan 13, '13
The important thing is safety, and that includes YOUR safety. A serious back injury can end your nursing career before it even starts. If you cant transfer him without possibly hurting yourself, then dont do it, period. If this means you have to quit, then quit. Maybe take a CNA course or try something else after youve had more Nurses training.
It may be that transfering this guy with only one CNA is inherently unsafe, but you dont have the training or experience to recognize this.
Jan 27, '13
Is he in a bed that is adjustable, so you can move it up or down? I had a patient similar to yours and I had to get her out of bed and into her wheelchair. I found the best way is to raise the bed up slightly above being level with the wheelchair. Then I would position the wheelchair at an angle to the bed so that I wasn't having to pivot a lot to get her in the wheelchair. And removing the arm rest really helps a lot!!! Sit the patient up and have their legs dangling from the edge of the bed. Do you use a gait belt?? If not you really should. I would stand in front of the patient with my feet touching their feet, so their feet don't slide out. Get a good firm grip on the gait belt and lift and turn slightly and position in the chair. If the bed is a little higher than the chair then gravity helps a lot in getting them into the chair with less effort.
If you don't feel comfortable with this you should ask for more training. Did you do the transfer in front of the someone so they made sure you were doing it right?? I also agree that a hoyer lift maybe a good option as well. Transferring shouldn't be done if you have no training and don't feel comfortable with it. It is too easy to get hurt doing it. Are you employed by an agency, because if so I would bring up your concerns with the case manager or director of nursing.