Taking good body mechanics too far?

JDZ344 · Jun 23, 2011

I suffered a muscular injury to my back in Jan. Still twinges sometimes. If there is an alternative, I ain't lifting. Next time it might not be "just" muscular.

Flo., BSN, RN · Jun 23, 2011

I don't allow pts to pull on me. They can push off the bed and I will assist them. If they can't do that then I get more staff.

Butterfliesnroses · Jun 23, 2011

I was a CNA for 6 years. I was warned by the older nurses aides not to lift soemone just bc I could or I would regret it years later. Guess what? 6 years later and I regret it. I'm 26 years old and I have a bad back. I also have a sciatic nerve that is pinched. I'm a nurse now and after a 12 hour shift I'm in pain. Save your back!

anotherone, BSN, RN · Jun 24, 2011

Everyone, I would like to hear your opinions on a situation that came up at work this past weekend:
I was taking care of a pt on a m/s floor who was admitted w pneumonia. She was getting ready to be d/c'd in 1-2 days, so, she wasn't too sick..
The pt was a L BKA of 2+ years and used a prosthesis. pt was ambulating w standby assist x1 to BSC to void over the night shift and the nurse had been answering her lights all night (just how it happened to work out, I wasn't refusing to answer her lights or anything like that, I was just already busy when they came on...) and so, the last time she called before the end of shift I answered her light and she needed to use BSC. I put her prosthesis on for her (which she probably could have done herself, but that's another thread...) and then she proceeded to ask me for my hand and to pull her out of bed. I told her that I would prefer for her to use the bedrail and she was completely offended. I told her that by pulling pts out of bed that I could injure my spine and that we're trained to always use good body mechanics to promote spine health. She freaked out and said something like "go get the nurse! she'll HELP me!"
In my opinion, I think I was right. I have seen too many nurses with bad backs, joints, etc, pushed out of nursing because of it and I have too many more years to work to have a bad back! Also, I try to promote independence whenever possible.
I told the nurse about the situation and she agreed that I was right but said she'd been pulling her out of bed all night and said she'd do it just to keep her happy.
What do you guys think about all that? Would any of you sacrifice your back in a situation like this to appease the pt?
Do you think it's no big deal just to give an old lady hand to get OOB even though it's not following proper body mechanics?
Maybe it's just me, but I wouldn't put myself in a situation where I could get injured at work... call me crazy!
I would love some of your opinions!

Timely thread for me because I was about to launch onto my own stories. This has happened MANY times the last few shifts I work and it highly disgusts me. People expect you to sacrifice your own life/well being for their laziness/ignorance. That's what it is. I try the whole ," reach for the bed rail" etc and pts demand to use my hand, shoulder. HELL NO. I can understand what that nurse did because after so much whining and how "pt complaints" are handeled at some places, some people just give in. I recently had a pt YELL at me because I refused to pull her up in bed on my own and needed to call for help. (she was about 300lbs which is me and the other person and more depending on the co-worker who helps... )....................I have had pts sit up in bed, dangle and get ready to stand. when i tell them to push down on the bed with their hands, they want to push or pull on my shoulders.

anotherone, BSN, RN · Jun 24, 2011

I would have probably pulled her up. However, I'm not saying it right or appropriate. I am a strong advocate for helping the patient maintain or gain some independence. So if I felt she was capable I would have tried to get her to attempt to do it herself. But more than not, reality sits in and I have too many patients and tasks to do that I find myself wanting to hurry the process up. In addition, I have an EMS background, where my partner was old enough to be my grandmother, so I have acquired some really bad lifting habits. As a result, I am twenty-two years old and I already have a sore back. So I need to start being more like you.

Exactly, you have other tasks and patients . Your co workers are too busy to help you, sometimes you need 3-4 people to help with some pts. If you go looking for help and have to wait 10-15mins to get all these people to come to one room to help, you are the bad nurse that took too long to reposition a pt or answer a call bell. ahhhhhhhh lol (that is NOT what I think, just what amny visitors or patients seem to think)

K+MgSO4, BSN · Jun 24, 2011

I know it is late in the day now but could you have spoken to occupational therapy or a physiotherapist and got a bed lever for her bed?

I was lucky enough to be involved in setting up my new ward and I got 6 of these from an outpatient supply dept that was closing down. they are fantastic!

wooh, BSN, RN · Jun 24, 2011

I always say I'm going to do better about safe back habits. Heck, I've had back surgery already! And for lifting, I'm usually good. But in peds, you'd better not wake the patient! So you don't raise the bed, or what I've been getting lately, I'm bending over for kids in a car seat on the floor. But it's impossible to get a bp if the kid wakes up when you're putting them somewhere safe to reach. The parent throws a fit if you wake them up. My back is sore at the end of the day, not because I'm lifting, but because I'm bending.

But we're nurses. Who cares about our quality of life? We should spend our lives in chronic pain so someone doesn't have to move their own lazy butt. So someone doesn't have to wait. So our employers don't have to pay for staffing that would allow us to move people safely AND get our other million tasks done in a shift.

suanna · Jun 24, 2011

"Body Mechanics" is/are largely a myth in the type of lifting involved in patient care. It was originaly designed for industrial/dock workers who were lifting static loads in boxes. If you could get your patient to climb into a box with a handle there may be some validity to using body mechanics. Most patients prefer not to go the box route.

There have been many studies showing a complete lack of effectiveness of body mechanics in preventing injury in the health care setting. The only thing body mechanics does is give your employer something negating to put in your file when you injure yourself at work. ie: failure to use proper body mechanics resulting in injury to back- in the future employee is to use proper body mechanics when lifting." It wouldn't keep you from being injured, but it keeps the employer from having to spend big $$$ on lifting assist devices and adequate staffing to provide for safe patient care for the patient and the worker.

suanna · Jun 24, 2011

My favorite part of health care body mechanics is when EVERYONE insists on taking the bed up to a higher position "so we can lift with out getting hurt" !!??? All that does is eliminate my ability to straighten my back and arms and lift with the bigger muscles in my thighs and pelvis. With the bed at belly height the only muscles I can lift with are my neck and shoulders- Why is this a good idea?

My next favorite is when we each hold a patient from the side by one arm- there are two of us aren't there? How could we get hurt? I'm not a big person- about 60kg 5'8" and I challange any two people to support me in a standing position by my arms from the side if I buckle my knees. It can't be done. It's a great way to hurt your back and ensure tyhat your patient cannot even break thier fall with thier arms when they fall. It almost ensures a head injury.

**canoehead, BSN, RN** · Jun 24, 2011

my favorite part of health care body mechanics is when everyone insists on taking the bed up to a higher position "so we can lift with out getting hurt" !!??? all that does is eliminate my ability to straighten my back and arms and lift with the bigger muscles in my thighs and pelvis. with the bed at belly height the only muscles i can lift with are my neck and shoulders- why is this a good idea? i think the point is that you don't need to bend over as far to do the lift. usually if the patient is bed bound you're going side to side too, not up and down.
my next favorite is when we each hold a patient from the side by one arm- there are two of us aren't there? how could we get hurt? i'm not a big person- about 60kg 5'8" and i challange any two people to support me in a standing position by my arms from the side if i buckle my knees. it can't be done. it's a great way to hurt your back and ensure tyhat your patient cannot even break thier fall with thier arms when they fall. it almost ensures a head injury.

you'll never hold someone up if they collapse, but you can direct their fall to a chair or bed, or ease them down to the floor with no injury.

Tait, MSN, RN · Jun 24, 2011

I would have helped her up, got her to the BSC, and then reminded her next time it was her turn. I generally (even pregnant) would offer a patient my hand in a specific way that allowed me to brace my feet and use my bicep, not my back, to help support them a bit.

Gait belts and moving equipment are fantastic, but when you come out of another room to find your patient has been calling for 10 minutes to go to the bathroom one just has to do the best they can. Yes I have a compressed L4L5 but it isn't from nursing and when I lost 30#'s it stopped hurting.

Tait

suanna · Jun 24, 2011

you'll never hold someone up if they collapse, but you can direct their fall to a chair or bed, or ease them down to the floor with no injury.

not from the side by holding on to thier arm. from that position all i'm going to do is pull thier arm out of the socket and hurt thier ability to help themselves. anything i try more than that and i'm going to hurt myself as much as them. the patient has the momentum and the leverage from that position. from the front or back i can support them from the trunk and guide them with my legs and trunk muscles. i can get a dead body up to a standing position without hurting myself if i can position myself face to face and secure the patients feet with my feet, thier knees with my knees, and hold thier pelvis stable with a good old "reach-around."

i would love for some nursing leadership body to explore "optimal patient mobility mechanics" with a fresh start- not just rewriting the old body mechanics good- body mechanics bad arguement. it would be a lot more useful than one more useless nursing theory or some fun new nursing diagnosis. i could wait on deciding if nursing is a profession or just a career/job if i could find a way to keep practicing nursing without ending up on disability.