I'm going to try to avoid this being a rant, but my apologies if I fail. I find patient positioning and mobilization to be the worst part of my job. We have lift equipment, and I will say it is helpful with getting patients out of bed more safely, but it doesn't help much in the moment to moment repositioning requests. Any words of wisdom for dealing with the following complaints/issues?
1) Pt: I'm uncomfortable
Nurse: Ok, how can I help you?
Pt: I don't know, just do something. I'm uncomfortable!
I just don't know where to start. If they've slid down low in the bed I may help boost them up, but really, I can't read minds and I'm not going to play goldilocks with them until I hit 'just right,' it's not feasible.
2) Pt: Just pull me over! No pushing that hurts!
My understanding is pulling=back injury. Using my entire body helps a bit, but it's not sustainable and none of the equipment is made to help with that.
3) Pt: You're being too rough/going too fast!
I've tried explaining to people that going slowly is often not possible and/or will not make anything better/easier, and sometimes they get it sometimes they don't. Stopping midway through though and/or letting them retract and then starting over is too much strain on staff both physically and time-wise. Also, lift equipment and friction reducers still require a lot of side-to-side turning.
4) Large pt who requires at least 2-4 people to move them who is probably also incontinent and/or on contact isolation but rounding up people to help is a constant struggle.
I just get so frustrated with it. People on my floor are generally helpful but it's draining to have a heavy patient who you constantly need to be recruiting people to come in because even if they will come it's always "in a couple minutes" which is maybe ok if you only need one but god forbid you need >1 and need to coordinate all those "in a couple minutes".
I sort of feel bad because I imagine it must suck to be unable to reposition yourself and be uncomfortable and/or sitting in your own excrement, but it's not worth a back injury and I'm not able to regularly spend large amounts of time in any given room to deal with it. I've had little old ladies threaten to hit me because I'm "too rough" (who subsequently forgave me) and I've had 400lb women yell at me for making them uncomfortable and demanding I "put them back how they were" after all the help has already left (who I walked out on after telling them yelling at me wasn't helping anything). I've walked out of rooms and when the resident asked what's wrong said "I don't think I like caring for people." I just don't know if it's a lack of training or technique or it's just one of the realities of the job and either you care so much you don't mind or you just get hard and tell patients they're fine and just to suck it up.
Thanks for all the responses, I appreciate it! Getting the bed lower for pulling is an interesting thought, I usually bring it up high so I'm not bending down, but potentially it is better lower. As for the too fast/rough thing, usually that complaint comes in more with the lift equipment which in my experience most people hate. I don't ostensibly have an issue with the time it takes, but the reality is, for example, the edema that's making the legs tender isn't going to get better by waiting 30 sec and it'll be worse to continue having to start over than just move the leg once and be done with it.
I work on a surg onc unit, so, a lot of abd surgery which is one of the worst for people helping themselves since every motion really does hurt a lot and could even be potentially risky.
Also, love the bed pan comment - so true! Random side thought, does anyone have a bariatric bed pan at their hospital?
CharmedJ7
193 Posts
Thanks for all the responses, I appreciate it! Getting the bed lower for pulling is an interesting thought, I usually bring it up high so I'm not bending down, but potentially it is better lower. As for the too fast/rough thing, usually that complaint comes in more with the lift equipment which in my experience most people hate. I don't ostensibly have an issue with the time it takes, but the reality is, for example, the edema that's making the legs tender isn't going to get better by waiting 30 sec and it'll be worse to continue having to start over than just move the leg once and be done with it.
I work on a surg onc unit, so, a lot of abd surgery which is one of the worst for people helping themselves since every motion really does hurt a lot and could even be potentially risky.
Also, love the bed pan comment - so true! Random side thought, does anyone have a bariatric bed pan at their hospital?