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Question about proper body mechanics and communication?

by Marie
(Boston, MA)

I was so happy to find this site. I was fortunate to find several weekend hours caring for a woman in a facility. I am not a healthcare professional, but help her with dressing, hygiene, etc.

Nurses work at the facility, but as she is an "independent resident" they are only there to administer medicine. I've been directed by my own boss not to bother the nurses at all, unless there is an emergency.

She was recently discharged from hospital but refused the physical therapy the doctors recommended.

This is my problem: The patient complains frequently of pain. The worst is when she is trying to sit up in bed. I have mentioned to my boss that an adjustable bed would be wonderful for her but as far as I know there are no plans for one.

The best I can do as far as helping her to sit up is to gradually prop her up with pillows. I'm not thin but the patient weighs about forty pounds more than I do and this is doing a terrible job on my own back. It would be very helpful if someone could advise me on the correct way to help a person sit up without hurting myself.

I know she was supposed to have a physical therapy evaluation this week but apparently is refusing to do the exercises.
The client and her husband are very nice people and the hours are great but I hate to think of the condition of my own back and neck after another weekend unless I learn how to move the patient properly. Thanks so much for any advice!

Marie,
I am an old(seasoned)rehabilitation nurse. Your concerns about your back are legitimate. Proper body mechanics is important for you and your patient.
There are several approaches you can take to this dilemma. Your boss really has an unrealistic expectation of not utilizing the staff.

As a nurse that has worked in many facilities as an agency nurse, I know the importance of making the staff your friends/teammates. You are the eyes and ears to the facility on the status of the patient. Waiting for an emergency is too late.

You are being proactive and your boss should embrace your initiative.

You may want to consider discussing the adjustable bed with your boss and ask to pass that information onto the case manager or social worker in the facility.

During a the physical therapy evaluation, the therapist can assess for that type of bed. Medicare may pay for the bed.

I would also discuss with the patient and her husband how beneficial a bed would be for her. She will be able to change her position and become comfortable by herself.
With the present situation, both the patient and the staff are at risk for injury.(Hey, the last thing your boss wants if a worker's compensation claim for a back injury).

Here are other issues that you must be concerned about:pulling her can cause muscle pulls to both of you. Your patients skin is prone to breaking down and pulling on her could cause a skin tear that can develop in to a pressure sore.

You may want to write a note about a possible bed and ask the nurse to tape on the front of her chart for the PT to see before the eval.

You may also request that the therapist provide training to all staff providing care for the staff providing hands on care.
Marie, in your post you said you are not a health care professional. Please understand that you are at the very heart and soul of caregiving.

One of the saddest things that occurred in nursing is that the professional nurses no longer get an opportunity to do the hands on care.

That is the most important time to get to know the patient, assess the patient and educate them on their own care and health condition. You now have the responsibility to pass that information onto the right individuals to prevent a crisis.

Feel free to post any time Marie. Thank you for bringing this to the forefront. Many others are in the same situation as you.

Diane Carbo RN

Be proud of what you do. I salute your efforts and your caring.

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