Using a mechanical lift PRN

[Yrztree]

I'm currently getting trained to be an NA at my facility. We were learning to lift people, and a few people whom I feel should be on a lift are ONLY PRN for it. My instructer agreed about the first resident and was going to get them to change her to only a lift. However, on another resident who is paralyzed on one side it seems like and obese, she didn't agree. She said PRN is fine and we have to use our judgement to see if she's able to stand that day or not. When my instructor and another NA lifted her to show us, her feet were dragging and it seemed like they were about to drop her. This woman CANNOT move on her body to either side on her own, even to roll in bed. They said sometimes she can bear a little weight on one leg.

Does anyone feel it's safe to let NAs make a judgement call on if a person needs two people to lift or a lift each time they transfer? I feel like this is a lawsuit waiting to happen. I don't understand why a lift would ever be PRN, especially because even the most alert residents can overestimate their capabilities that day.

Any advice or thoughts?

[mindofmidwifery, ADN]

If you are using your best judgment and believe that the person you are transferring needs a two person or mechanical lift, do it. Let the nurse know either before or after but you don't want to be liable when that patient falls just because her care plan says 1 person assist.

[hookyarnandblanket]

It could go either way, depending on the facility. When I worked LTC, if you started using a lift, either sit-to-stand or Hoyer/sling, you then had to use it that way every time. There was no option for PRN.

The hospital where I now work allows for PRN lift use. We have two in-house permanent patients on whom we can use either sit-to-stand or Hoyer/sling depending on the day and/or shift. We usually don't consult with the RNs about it since it is a standing PRN order; however, if it is a skilled or acute patient, we clear it with the RN first before changing transfer when there is no order.

[Yrztree]

These people were both 2 person assists or PRN hoyer and can't really help with transfer. I'll take your advice. It just seemed odd to me to have a hoyer as PRN.

[hookyarnandblanket]

It can seem odd at first. The two long term care patients we have who use both a sit to stand and the Hoyer use them first thing in the morning due to arthritis, and the sit to stand the rest of the shift to help with flexibility and foot drop. 2nd shift will use the Hoyer strictly because by the end of the day, both patients are tired and don't do well with the sit to stand at that point.

Really it boils down to what is best for the patient and staff.