Why lift foot of bed up to lift pts in bed?

[Googlenurse, ASN, BSN, RN]

Is the new thing? I've noticed several CNA and nurses lift the foot of the bed to the highest possible(while the head stays flat) and then lift them in bed?  

I do not understand why. That makes the majority of the patient's weight go to the center and makes it harder actually to lift them up with the turning sheet and cotton chux. Also,the feet seem to get stuck. The nurses claimed it makes the patients slide up easier,but they are not supposed to slide up anyway. We are supposed to lift them up to prevent shearing. 

[JKL33]

1 hour ago, Googlenurse said:

We are supposed to lift them up to prevent shearing. 

Speaking of "supposed to"--what does your job description say about your lifting requirements? Likely something like 50-75 pounds. That means 4 (yes FOUR)--or at the very least 3--staff members to lift a pt that weighs a mere 200 lbs. One or two nurses do not magically make a people-moving machine. Just no.

What kind of tools do you have available? Something more than just a regular draw sheet I hope.

[Googlenurse, ASN, BSN, RN]

No, that is it. A draw sheet. Most of the patients are comatose. Most are over 200 pounds.

 

We don’t have plastic blue patreon sheets. 

 

The CNA and I usually lift up the patients in bed ourselves. But I noticed the cnas would elevate the foot of the bed( reverse high Fowler’s) and we then lift the patients up. Our lift policy is max 75 pounds alone. We don’t have the staff to help lift these patients. 

[CrunchRN, ADN, RN]

Maybe they are hoping gravity will help?

 

[kbrn2002, ADN, RN]

That's not a new thing. I worked in LTC for 25 years and we did that for all 25 years I was there.  Raising the foot of the bed or better yet  for a very large resident putting the bed in Trendelenburg if the bed will do that allows gravity to do it's thing and assist with boosting the patient up to the head of the bed. It actually helps quite a bit. Another little trick is after you get that resident boosted keep the foot of the bed slightly elevated to slow down the inevitable sliding back down. 

While we were all aware that a resident should be lifted up and then toward the head of the bed that's just not always feasible in the LTC setting. Most buildings are older so a ceiling lift is usually not an option and finding adequate staff to lift that resident is truly impossible. Especially on a night shift that already runs bare bones staffing even if they are not short staffed so we had to make do with the staff we had. Yeah, I don't miss the days of repositioning these residents every 2 hours.

[Googlenurse, ASN, BSN, RN]

IDK, but lifting the foot of the bed seems to push all the weight up in the middle, which makes it harder to lift them up IMO. Plus, their feet actually still drag on the bed

[Kitiger, RN]

I do private duty home care. 

To scoot a patient to the top of the bed, I use a satin-type sheet on top of the fitted sheet - with the slipperiest side up - with a draw sheet over that. The draw sheet is positioned under the patient from shoulders to the feet.

To scoot the patient up, I position my arms between the draw sheet and the satin sheet, under the patient's shoulders and buttocks, and scoot the patient & draw sheet up toward the head of the bed. Be careful that you don't let the patient's head hit the headboard!

I don't have to lift the patient up off of the bed to move him - he will slide easily. And shearing is not possible, since the patient does not move on the draw sheet; the draw sheet moves on the satin sheet.

[barcode120x, RN, NP]

I was a lift tech (aka mobility tech) for 2 years prior to doing nursing. Aside from proper body mechanics and bringing extra people for help, lifting the foot of the bed was a key thing taught to aid in pulling patients up. Of course, you do need the proper equipment (bedsheet and a chuck of some sorts under the patient). Obviously if you just have ANY bedsheet and just the patient's bare skin or clothes on their back touching the bedsheet, literally nothing will happen, and as the OP side the patient will be stuck in the middle especially if it's a heavier set patient.  And trust me, after my years of service as a lift tech and a bedside nurse, I know what it feels like to attempt to pull a patient up with nothing but bedsheet under the patient and sometimes nothing at all....

I duno, I feel like this is just common sense knowledge to know as a nurse/CNA.

[Kitiger, RN]

12 hours ago, barcode120x said:

I was a lift tech (aka mobility tech) for 2 years prior to doing nursing. Aside from proper body mechanics and bringing extra people for help, lifting the foot of the bed was a key thing taught to aid in pulling patients up. Of course, you do need the proper equipment (bedsheet and a chuck of some sorts under the patient). Obviously if you just have ANY bedsheet and just the patient's bare skin or clothes on their back touching the bedsheet, literally nothing will happen, and as the OP side the patient will be stuck in the middle especially if it's a heavier set patient.  And trust me, after my years of service as a lift tech and a bedside nurse, I know what it feels like to attempt to pull a patient up with nothing but bedsheet under the patient and sometimes nothing at all....

I duno, I feel like this is just common sense knowledge to know as a nurse/CNA.

Yes. I also lift the foot of the bed.

[Googlenurse, ASN, BSN, RN]

On 12/28/2022 at 3:04 AM, barcode120x said:

I was a lift tech (aka mobility tech) for 2 years prior to doing nursing. Aside from proper body mechanics and bringing extra people for help, lifting the foot of the bed was a key thing taught to aid in pulling patients up. Of course, you do need the proper equipment (bedsheet and a chuck of some sorts under the patient). Obviously if you just have ANY bedsheet and just the patient's bare skin or clothes on their back touching the bedsheet, literally nothing will happen, and as the OP side the patient will be stuck in the middle especially if it's a heavier set patient.  And trust me, after my years of service as a lift tech and a bedside nurse, I know what it feels like to attempt to pull a patient up with nothing but bedsheet under the patient and sometimes nothing at all....

I duno, I feel like this is just common sense knowledge to know as a nurse/CNA.

I never just use a bedsheet. We use a chux pad. No facility I’ve worked in before have I seen the CNA or nurse lift the foot of the bed first before pulling up. I still don’t see how it prevents shearing of the skin, and furthermore I still believe it makes the pt harder to pull up in bed because it makes all of the weight go to the abdomen. Thus making it harder to actually push up in bed. 
 

I wasn’t taught to do this in nursing school either, but that was 20 years ago. I looked on YouTube and didn’t see anyone lift a pt like this either. I also didn’t see any evidence based articles about it. So you could have kept your little smart comment to yourself

 

[BunnyBunnyBSNRN, ASN, BSN]

7 hours ago, Googlenurse said:

I wasn’t taught to do this in nursing school either, but that was 20 years ago. I looked on YouTube and didn’t see anyone lift a pt like this either. I also didn’t see any evidence based articles about it. So you could have kept your little smart comment to yourself

 

And we wonder why "nurses eat their young" is still a saying....

[2B a Nurse, ADN, BSN, MSN, PhD, RN]

Not really a new idea but a little different than what I was familiar with. We would place the patient in Trendelenburg. This allows gravity to work with you rather than against you.