Transferring A Patient

All CNA duties are in a RNs scope of practice, they have just been delegated to them. So we will be transfering patiens as RNs. I hurt my back a little earlier in the semester, transfering a pt, and my clinical instructor got mad at me. She said that back injuries were one of the top reasons that nurses stop nursing, and she was not going to have any NS get hurt on her watch!!! We had to make sure that we were doing everything correctly body mechanics-wise and get help when you need it. I want to be able to be a nurse for a long time!!!

How are you transferring them? Are they able to put any weight on their legs? Do you have a gait belt? I did the CNA course this past spring...and while transferring is never easy - I felt okay about doing it. I think you were very smart to say that you weren't comfortable doing it at that time!! Better to speak up than to hurt yourself and the patient! And make sure you ask for help if you don't think you can do something on your own! Better safe than sorry, right?

In response to you possibly hurting your back - make sure you don't lift "from your back." Try to keep your back as straight as you can when you lift. Bend your legs and use your leg muscles to help. If you have a resident that's full coherent, make sure you let them know when you're going to lift - so they can be prepared too. If you're needing to lift them up higher in the bed (with another person helping, if possible)... have the resident cross their arms over their chest if possible and also have their legs bent with their feet on the bed (so they can help push if they're able to). And use a sheet underneath them...rolled all the way till it's right up next to their sides with your hands holding over the sheet (not under) when you lift (does that make sense??). When you transfer from one chair to another, have the chairs at a bit of an angle from each other if you can. Put a gait belt around the resident and hold on with your hands going under the belt (not like holding the sheet with hands over). If they can't hold much weight on their legs, then put your feet toe to toe with their's...so that it braces them as you stand them up. Help scoot them a little forward if you can...and count to three before you stand up. (make sure you're bent at the knees and not with your back!!) Pull them up and out of the chair and pivot them right into the other chair. Here's some tricks for getting them out of bed (I'm going to pretent you're on the patient's left side): sit the bed up a little and place your left arm under their left arm and your right arm around to support their back (kind of like a big hug!) and help them sit up and scoot to the edge of the bed. Lower the bed so their feet are on the floor or as close as possible. (Don't forget the non-skid socks or shoes!) Make sure you're constantly supporting them (or have one hand always on their shoulder) in case they get woozy. Put the gait belt around them and do the same thing as with the chairs. Have the wheelchair (or whatever) next to the bed at a slight angle. Be toe to toe. Count to three and get a little rocking type motion going. (Have them place their hands on the bed and push if they can.) Pull them to a standing position (You're going to be in really close contact with them - don't be afraid of that).... and then pivot them or step around slowly if they can stand a little. Make sure their legs are up against the wheelchair and help them gently sit down.

I hope this helps (though it's probably what you've learned already). It just takes practice! You'll get there!! Just make sure you have what you need ready and within reach.. and make sure to ask for help if you think you might need it! Good luck!!! :)

Thank you for the tips.

For specifics: this resident is over 6 ft tall (possibly well over - his legs were bent with his head touching the top of his bed and his feet against the bottom) and he is combative. He has contractures, but can move his (permanently) bent legs and his arms around quite a bit (he takes his legs and kicks them over the railings enough that he can touch my shoulder while I'm standing next to the bed. He is extremely thin, has advanced alzheimers and does not speak or do much other than want to hold your hand, and try to kick/hit you depending on the moment. He's just very awkward, not helping, and not understanding comforting words or directions.

I honestly know that I am not in good enough shape to lift patients on a daily basis, so if that is a necessary part of the job I am in rough shape. I just cannot do it alone. I had thought there was a way to do it with two people, but it always seems one gets the majority of the weight. I guess I'll just continue to read on transferrs and maybe something will click.