Please don't expect CNAs to

Schmoo1022 · Nov 20, 2009

I'm sorry you have to go through this. The sad thing is if something happened to you or the patient YOU would be screwed for not transferring properly. It is sad that everyone is short staffed, sometimes residents have to wait.

ctmed · Nov 20, 2009

I'm sorry you have to go through this. The sad thing is if something happened to you or the patient YOU would be screwed for not transferring properly. It is sad that everyone is short staffed, sometimes residents have to wait.

Agreed. ^^THIS^^

If I am incapable of lifting someone or transfering someone safely, that patient stays where they are at until I have the help I need to do it. Non-teamwork work environments be darned. However, eventually, help does appear if you are insistant. Patient will have to wait. Bottom line, no comprimises.

Most of these places DO NOT give CNAs give you insurance if you mess yourself up anyways. Plus, I doubt any sane DON is going to fire any CNA for asking for help due to safety. (But then again, I have met some pretty insane DONs)

nursemike, ASN, RN · Nov 20, 2009

In my previous job, I spent a lot of my time getting people from bed to wheelchair, bed to cart, bed to chair, and vice versa. The heaviest transfer I ever did alone was 550 lbs. That's roughly comparable to the ratio of caregiver-to-patient mass as the 90-some pound physical therapist to me, when she taught me how to do it. (I did assess the pt, who only needed modest stabilization--he bore his own weight, and we were only pivoting to a bedside commode.)

With pts

My point is not that the OP is wrong. Honestly, for a total lift, if two are required, 4 is probably better. You can transfer a lot more gently if you aren't straining. A 200lb pt divided by 2 is 100lbs. each. I'm a guy, and not small. I used to carry 80lbs up a ladder, on my shoulder. I can lift 100 lbs. But often, in the positions we have to work, it isn't an easy lift. If four of us lift 50lbs each, we can actually lift, rather than slide, and nobody has to strain. I'll also get help to put a 100lb pt on a bedpan, so I can turn them while someone else places the pan. (100 lb pts are usually females, so I take the modest side.)

But I also see the other side of the picture. Aide needs to bathe a 250lb patient, so the nurse has to help, or 2 aides work together. Some are smart enough to get help for the part they need help with, some expect you there the whole time, to get it done more quickly. That can be okay, but there are plenty of times I don't have time to help was the front of a supine patient or hang out during oral care. Nor do I really have time to put people on and off bedpans, by myself, because the aides are busy doing baths together. Some jobs that are easier with two can be done by one, and others actually require two (or more).

It isn't fair to accuse the OP of things I've seen with the aides I work with, and truth be told, the aides I work with are generally very good. But there are times when even the best of them aren't seeing the whole picture. I have overheard aides responding to the clerk over a call light, "Let the nurse do some work, for a change." Do I hurry when they need assistance? Well, crap, yes I do, because you can't put the patients at risk. But if--and I emphasize, if, the OP takes that disrespectful attitude toward nurses, I, for one, would find it hard to feel sympathetic, because I do use my brain, quite a lot.

PostOpPrincess, BSN, RN · Nov 20, 2009

Nurses, get off your ***** and help her.

ktwlpn, LPN · Nov 20, 2009

Sheesh-doesn't your facility have a lifting policy and equipment on the unit? I have worked with many staff members whom would rather lift a way- too- heavy- patient then bother to go get the proper equipment and staff. As for nursing staff that don't want to "touch" a patient-I see this crap in LTC all of the time. BUT Please don't interrupt me during my med pass from hell to help you because you don't want to work WITH your partner because she is not in your clique. My team is almost always willing to lend a hand and often do so-sadly it is usually not right where all of the cna's can see so some just assume we don't. And no matter how much we do it's never enough for some. And they also assume that because we may be sitting at the desk we aren't working. Day shift is responsible for the monthly recaps,restorative notes,the docs all do their rounds on days and we write a big comprehensive note each visit and we do all of the annual,quarterly and significant change assessments(keyed to the MDS) We have to follow up on the previous 2 shifts and take care of anything that they felt could wait-we have to order and put away all supplies,we follow up with meds (tracking them down if missing) and follow up with incident reports.We often eat on the run or sneak in and and of the med room for lunch.And after busting our butts I'll hear a cna say something like "Oh yeah when the state comes they'll all be on the floor" My ADON and my DON both back us up-we CAN do the cna's job but they can't do ours. The facility is NOT going to pay me over time because I could not manage my time and get my stuff done because I was jumping up and down all day lifting,toileting,etc.

GucciRN22 · Nov 20, 2009

that this is even a problem is stupid! if i don't expect myself to do a task that requires 2+ people, then why on earth would i expect someone else to do it?!? i guess some people don't think before designating tasks....

koi310 · Nov 21, 2009

Sheesh-doesn't your facility have a lifting policy and equipment on the unit? I have worked with many staff members whom would rather lift a way- too- heavy- patient then bother to go get the proper equipment and staff. As for nursing staff that don't want to "touch" a patient-I see this crap in LTC all of the time. BUT Please don't interrupt me during my med pass from hell to help you because you don't want to work WITH your partner because she is not in your clique. My team is almost always willing to lend a hand and often do so-sadly it is usually not right where all of the cna's can see so some just assume we don't. And no matter how much we do it's never enough for some. And they also assume that because we may be sitting at the desk we aren't working. Day shift is responsible for the monthly recaps,restorative notes,the docs all do their rounds on days and we write a big comprehensive note each visit and we do all of the annual,quarterly and significant change assessments(keyed to the MDS) We have to follow up on the previous 2 shifts and take care of anything that they felt could wait-we have to order and put away all supplies,we follow up with meds (tracking them down if missing) and follow up with incident reports.We often eat on the run or sneak in and and of the med room for lunch.And after busting our butts I'll hear a cna say something like "Oh yeah when the state comes they'll all be on the floor" My ADON and my DON both back us up-we CAN do the cna's job but they can't do ours. The facility is NOT going to pay me over time because I could not manage my time and get my stuff done because I was jumping up and down all day lifting,toileting,etc.

Lift policies (and enforcement) really depend on the facility/unit as does the availability of lifts. There are private (ie. no medicare/medicaid) ARCH homes that can double as SNFs/hospice, even though they are set up like care homes for ambulatory residents, not SNFs. In those situations, you probably won't see a hoyer because staff might not have to use it extensively, and management would thus consider it 'underutilized'. A hoyer IS necessary,however, for those residents that eventually require a fully-assisted lift during their stay at a facility.

~Mi Vida Loca~RN, ASN, RN · Nov 21, 2009

This semester when I started clinicals in the nursing home the facility had us attend this 2 hour training on lifting and stuff. Gait belts the whole 9. In school they were pounding this into our head as well. So my first day of clinical they had us follow a CNA for the day to practice the basic tasks we learned in nursing lab. So I was put with this hefty cna man. Hefty as in probably more muscle bulk probably about 5'9 (I am like 5'3 1/2) anyway, so I notice he isn't using the gait belts at all and I asked him about it and he admitted he probably should be using one. I asked in a way that wouldn't be scolding or anything like that, I just told him I wanted to make sure if only certain criteria called for one because I had no experience with them.

So anyway, later in the day he got a lot more comfortable in telling me things to do instead of me assisting him, but I needed to learn so it was all good. So he asked me to wheel this one Pt to her room and get her into bed and change her so I say ok. She is about 250 lbs I would say. Well the CNA sheet said she was gait belt assist. So I get the gait belt on her and go to help her out of her wheel chair and into bed. She refused to get up. She said she wanted into bed and stuff but she said she couldn't stand that she was to tired. I tried a few times to get her to help me get her into bed but she wasn't budging.

Obviously without her help I can't assist her with a gait belt. So I go to the CNA and told him I would need help and he was like you just have to assist and I explained to him that she wasn't willing to get up at all. So he was like, well just get in a stance like your giving her a hug and lift her up and put her into bed.

Ummmmmm negative sir. I told him that wasn't going to happen, that one the manager at the center was very clear we were NOT to do that and said if we were caught not using gait belts or lifting in that manner that we would be banned from the clinical site. He told me not to worry about it and no one would know, I said no. Shoot I already have back issues that I will hopefully be starting Physical Therapy on soon. He got so mad that I wouldn't do it. He went in and got her under her arms and roughly lifted her and put her in bed and turned and was like, "do you think you can at least handle turning her on your own to change her" I told him I would take care of it because I wasn't going to have him take his frustrations with me out on her again and I managed changing her and convinced her to help me with rolling herself on her side.

I told my Clinical Instructor about the whole thing in post conference.

I know it can be frustrating for some to help a fellow co worker when you might be busy and stuff but seriously, I have no doubt some of these same nurses, or CNA's or what not would want help themselves if the roles were reversed.

To the OP good for you for standing up for yourself. I know in my clinicals us nursing students were at the bottom of the totem poll and some felt that we were their to be their personal slaves I guess they weren't prepared for a group like mine, we were fully prepared to stand up for ourselves and advocate for ourselves and our patients on our first day!