Nursing home nurses/moving pt's

okiemedic

BLS Healthcare Provider Instructor
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What is the deal with nurses and CNA's at nursing homes? Do they get their certs off cracker jack boxes?

I've been working wheelchair a few times the last couple weeks. When I have a patient that is semi ambulatory. I always ask them. What do you feel comfortable doing when moving from a wheelchair to a bed..Then I allow them to direct me. That gives them a little more self confidence and it gives them trust in me........

Whenever I see a nurse or CNA do it. They grab a belt or the back of the patients pants and yanks them to the bed. Nine times out of ten the patient always complains of pain...

I was picking up a patient last week in Plano that was going to a Dr appointment...I asked the patient and the daughter of the patient...What is the best way to move her? CNA walks in..grabs a belt and starts to yank her out of bed...The daughter immediately starts yelling at her...saying...I know how to do this!! You'll put her on the floor!....If you drop my mother i'll put you on the floor!!!

The CNA storms out of the room and the daughter puts her in the wheelchair...

So what is the deal? Is this lack of training or just no common sense?
 

Shishkabob

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Which Plano home? The one across from HCA Plano?

If so... I know exactly what you mean.



If I have a patient who is in no danger from walking, I ask if they feel comfortable walking. I'm not going to hurt myself when someone is fully capable of moving themselves.
 
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okiemedic

BLS Healthcare Provider Instructor
54
3
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Which Plano home? The one across from HCA Plano?

If so... I know exactly what you mean.



If I have a patient who is in no danger from walking, I ask if they feel comfortable walking. I'm not going to hurt myself when someone is fully capable of moving themselves.

:lol:

I wanted that daughter to knock that nurse out.(I'd be lying if i said i haven't wanted too)..Less Paper work for me....
 

adamjh3

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We took a 450lb patient to a SNF once, we got there, got the move all set up and situated, the only step left was the actual move. My partner and I were both pretty big guys, but we're not going to throw our backs out moving that much weight.

I go down to the Nurse's station there's two GIANT Samoan dudes in scrubs there, I ask them if they wouldn't mind helping us move our patient. One dude says sure, we'll send someone down.

About five minutes later, in walks this tiny CNA standing at about 5'2 and 110 pounds.

Thanks for the help, guys... :glare:
 

b2dragun

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I refuse to move a pt without all the help I feel I need...IFT not 911. When I am doing 911 I try but do what is needed. When it comes to IFT, I will ask for 8 people if I have to. This is a job/career, not my life. I need my body for both my job and my life. I usually don't have too much trouble, when I do I go to the nurse station and stand there until I get people actually walking with me.

I don't get bonus points or paid extra if I show that I am strong. I use every advantage I have; slide board, help, ramps, winch.
 
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Shishkabob

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Shoot, even in 911, if the patient isn't actively dying, I'm sitting on scene till I get help to move them, be it 10 minutes or over an hour.
 

b2dragun

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Shoot, even in 911, if the patient isn't actively dying, I'm sitting on scene till I get help to move them, be it 10 minutes or over an hour.

I agree, unless they really really need transport. I am also lucky in that I am in a dual response system, so every 911 call has 4-10 people on scene...sometimes more depending where we are. I am usually strong enough to lift my pt's but that doesn't mean I want to, I would much rather make this a career as opposed to a stepping stone to teaching or dispatch because of an injury.
 

Sasha

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Shoot, even in 911, if the patient isn't actively dying, I'm sitting on scene till I get help to move them, be it 10 minutes or over an hour.

Even if they are dying are they worth permanently hurting yourself?

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b2dragun

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I guess I'm lucky, for me IFT=Bariatric (or damn close) and 911=less then 250lbs(most of the time). Not that I want to lift 250 if I don't have to. Then again with a bariatric I get a big bed with push bars, ramps and a winch. So all in all bariatric pt's are the easiest...just press a button and winch them into the back.
 

Sasha

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250 is tiny.
 

Tigger

Dodges Pucks
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I guess I'm lucky, for me IFT=Bariatric (or damn close) and 911=less then 250lbs(most of the time). Not that I want to lift 250 if I don't have to. Then again with a bariatric I get a big bed with push bars, ramps and a winch. So all in all bariatric pt's are the easiest...just press a button and winch them into the back.

I wish all our 911 patients would be nice enough to not weigh more than 250 pounds! My partner and I will take someone to about 400 pounds, but after that they just don't fit on our stretcher so well. With the baratric stretcher comes more hands, so anything over 400 pounds almost becomes easier.
 

Sasha

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Heck certain short 300lbers don't fit on the regular stretcher. It's all how they carry the weight.
 

b2dragun

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250 is tiny.

I'm a big 200 and use to be 270, so 250 isn't small but it isn't huge. Like I said though...I don't do it without help if I can. Plus, moving a pt isn't just about weight. Height, width, muscle mass vs fat, surface, ambulatory status all play a huge role too. I have had a 250lb Bariatric and I have had 400lb "normal" pt(granted he was 6'8" and a lineman).
 
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okiemedic

BLS Healthcare Provider Instructor
54
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We don't have any Bariatric units in service. I could be wrong, I think our MICU unit has a lift. But, I've never seen that thing in service...

I've had a 600 pound patient once. Had to lift her from a dialysis chair to the stretcher...Once we got to the nursing home we used a lift. Had to utilize two Ambulance units for that one call..

I just don't understand how an individual would allow themselves to get that big....
 

Sasha

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We don't have any Bariatric units in service. I could be wrong, I think our MICU unit has a lift. But, I've never seen that thing in service...

I've had a 600 pound patient once. Had to lift her from a dialysis chair to the stretcher...Once we got to the nursing home we used a lift. Had to utilize two Ambulance units for that one call..

I just don't understand how an individual would allow themselves to get that big....
Mental illness or physical illness.

A tip, i never lift over the arm rest for dialysis patients. Line the top of the stretcher with the bottom of the chair so all you have to do is slide them down ward instead of taking them up and over.

I disagree about height/muscle mass etc.400lbs is 400lbs if they are 6'8" or 4'11", body builder or human blob. Your back doesnt care why theyre heavy just that they are.


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Tigger

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Heck certain short 300lbers don't fit on the regular stretcher. It's all how they carry the weight.

Please tell dispatch this! Maybe then they'll stop asking if we really need the wide stretcher since she weighs only 350.
 

JPINFV

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Please tell dispatch this! Maybe then they'll stop asking if we really need the wide stretcher since she weighs only 350.
Just start singing over the radio, "They're a little tea pot short and squat."
 
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