Transfer of ABD Sx pts from stretcher to bed?

[All4Seasons]

I have a personal 'policy' that I don't usually have my postop abdominal sx pts move themselves over from stretcher to bed if I've accompanied them to the floor. I think it's not only cruel,but it can easily stir up a whole lot of unnecessary pain in a previously decently comfortable postop belly -that's a lot of use of abdominal muscles as you can imagine. Some floor nurses disagree, "well,I'm getting them up to the BR anyway!" - two completely different circumstances imo. Now,I am protective of my back, and I don't like hauling all the "heavily laden" pts around either,so I always ask for the slider board/sheet and three-four people, if at all possible. I think it's the least we can do for our pts.

Of course,if it's a fit,young person post lap-appy whose been quite comfortable,maybe tap blocked + narcotic - they'll zip across - fine and dandy. But for those older,heavier, pts and bigger procedures....no way. Not all of my colleagues see it this way.

What's your practise?

P.S. I never have my PM/AICD/back sxs shimmy over either.

[canoehead, BSN, RN]

To get up out of bed if they lie on their side and push up with their arm they can minimize the use of abd muscles. I can't think of a way to go from stretcher to bed without straining the abs. I think you are doing them a favor if it's an open abd surgery. Possibly laparotomy patients are more capable, but a little extra TLC is OK too.

[PostOpPrincess, BSN, RN]

It depends.

If it is someone who is young and bigger, I will encourage them to move on their own, at their own pace. The movement itself reminds them to breathe--that is that it wakes them up and often I hear them cough or take in a deep breath and that opens up the little alveoli.

If they are older and more fragile, I will definitely move them.

I think it really depends on the patient.

For some reason, when they are able to move on their own, the fear of "breaking open" or not being a "normal person" again is somewhat alleviated.

[katkonk, BSN, RN]

I think it is a good idea to use the slider board on most "big surgery" patients. It minimizes the strain on the patient, and even more importantly, it decreases the wear and tear and possibility of injury to the nurse. (If you are injured, who is going to care for the patients?) I think a period of rest before straining is important to let healing begin at the cellular level and to minimize inflammation, in essence to let things "settle down" in there. If you have never seen a big bowel surgery where the patients intestines are taken out and sitting on top of their body and the skin is retracted, etc., then you cannot appreciate the level of surgical trauma that is inflicted upon the patient during surgery. I think every nurse that works with surgical patients on the floor should actually witness what goes on in the OR, then they may have some more empathy for post-op patients and their pain and fears of, as you said, "breaking open". Sliding boards are just ALWAYS a good idea. Bravo to you!!