preventing back/shoulder injuries

[PostpartumNurse'07]

Hey there,

First post :-). I am a brand new grad nurse in Canada and I have started working on postpartum at a tertiary care women's hospital in Vancouver.

Anyway, here is my question: how do you help women up from bed (e.g. to go to the BR for the first time)? I generally don't pull them up or anything, but the other day, this patient who didn't speak English, just suddenly grabbed my hand to steady herself while she got up from the toilet.

Later when I got home, my shoulder and upper back on that side were sore and aching.

I really want to prevent hurting myself, so I am thinking that the best thing to do is to just stand by and make sure they're mobilizing well, rather than actively pull/anchor them. But how safe is this for the patient? What do you guys do?

[PostpartumNurse'07]

anyone?

[rn/writer, RN]

I usually guide my patients (section patients especially) in ways to use the head bed rail for support, then have them push against the mattress to raise themselves to a sitting position. Make sure that the head of the bed is raised up and the knee gatch (which automatically rises when the head end is put up) is lowered. It's very difficult for women in pain to wiggle past that raised lower end.

As for people grabbing you, stand out of reach initially.

Whenever possible, talk out the procedure with your patient ahead of time. If someone should grab you while out of bed or start to fall, go with the flow rather than resist and tighten up. It's usually the sudden tensing that does the damage. You're better off sinking to the ground with a patient than letting her yank your arms, shoulders or neck.

I wish you well in your new position.

[PostpartumNurse'07]

I usually guide my patients (section patients especially) in ways to use the head bed rail for support, then have them push against the mattress to raise themselves to a sitting position. Make sure that the head of the bed is raised up and the knee gatch (which automatically rises when the head end is put up) is lowered. It's very difficult for women in pain to wiggle past that raised lower end.

As for people grabbing you, stand out of reach initially.

Whenever possible, talk out the procedure with your patient ahead of time. If someone should grab you while out of bed or start to fall, go with the flow rather than resist and tighten up. It's usually the sudden tensing that does the damage. You're better off sinking to the ground with a patient than letting her yank your arms, shoulders or neck.

I wish you well in your new position.

Thanks rn/writer. Just wondering: so do you hold their hands at all while you walk with them to the bathroom?

[rn/writer, RN]

Thanks rn/writer. Just wondering: so do you hold their hands at all while you walk with them to the bathroom?

Had to think about that for a minute. Actually, I don't. I extend my forearm for them to hold, and, in the case of section patients, let them use the PCA/IV stand to steady themselves.Or I might put my arm around their waist for support. But I try very hard not to be in a position where they can just grab at me. I also have them sit at the bedside and then stand in place for a few seconds before we take off. You usually know in the first thirty seconds if there are going to be problems.

Probably the most important thng I can tell you is to get help whenever you're in doubt. If you use another nurse to help you get them up that first time, it can save your anatomy. She doesn't have to stay the whole time the patient is out of bed, although most of my co-workers will straghten the bed and change the big cotton covering pads before they leave. We really try to help each other out so that there aren't injuries to patients or staff.

You're wise to think about good body mechanics and taking care of yourself. After all, you can't help anyone else if you're down and out.