I just received a letter from an occupational health and safety liaison nurse:
As an ex ED/ICU nurse in both NSW and Victoria,( and devoted reader) I have now found myself seconded as the No-Lift co-ordinator of our hospital nursing staff, 3 campuses (campi?), I would like to have dialogue with others in this field as I am finding several areas difficult to crack ( ED still believing their superpowers can elevate!),
any suggestions??!
- Quasimodo
Actually, most ED nurses like to keep their range of superpowers pretty close to their chest lest they fall into the wrong hands. Elevation, extrication, disimpaction, levitation, its all in a days work.
But as a nurse who sustained a painful back injury a while back, the importance of your quest cannot be over emphasized. One second I was bending over to quickly lift a defibrillator off the floor, and the next 2,419,200 seconds I found myself in a world severe pain, totally unable to perform even the simplest of nursing tasks.
Thankfully with a little physiotherapy and some restorative down-time, my back slowly healed. But I was pretty shaken up by it all.
I consider myself a fairly fit sort of bloke, impervious to the back injuries I had seen befall my colleagues. But once you do loose the mobility and flexibility of your spine, you very quickly realize what an incredibly physical and dynamic profession we inhabit. Nursing is most definitely a verb.
And it doesn’t just have to be a single handed attempt at hauling that gargantuan flubberatric patient back into bed, an accumulation of I’m far too busy to go and get the lifter micro-injuries, will sooner or later catch up with you.
Once your back is properly buggered, you can pretty much kiss your bedside nursing career goodbye. So learning to care for your back and to lift patients safely is a big deal.
Most hospitals now have strict no-lift policies, providing training and equipment such as slide sheets, lifting aids, electronic beds and and patient transport devices to take the strain off our backs.
In fact, learning how to correctly use a set of slide sheets will not only revolutionize your nursing strength, and dramatically extend your nursing used by date, but it will also reduce the incidence of patient pressure areas that result from the shearing forces, and friction inflicted when dragging patients around the bed.
The hard part is disciplining ourselves to use them habitually, breaking down that most ingrained culture of nurse as martyr. “My back is not important right now, what is important is hauling this lady off the bed and onto a commode.”
So, I would love to hear your own stories of lifting, hauling, catching, and pushing catastrophes.
And if you work in a similar role as a No-lift coordinator, and might like to help out Quasimodo (not her real name), drop me a line and I will put you both in touch.
hey just reading some of your comments and i am amazed im from australia and we have strict no lift policy here, we have alot of equipment for moving and transporting pts. suprised that alot of you dont have access to all safety equipment. there are still alot of things wrong with our health system over here but not as bad as i have read. sympathies. one question about mechanical lifters i am in the process of doing my EN degree, what are some hazards when nursing use them??? appreciate the help thanks
my mother has left side weakness and could lift herself with the grab handle in the bathroom and assist of a aide, it kept her mobile and gave her a little independance within two years of the no lift policy , my mother is so contracted and has no circulation in her left ,if recirculation surgery dosent work the next step is to amptee her leg from the knee down why hasnt anyone looked at the negative side of this policy do residents not have a mobile policy
I read about the benefits of the no lift policy to the workers, but what about the impact on the patients?
Hi,
I moved from the Uk 2 years ago to canada and I am trying to set in place slider sheets .We have soaker pads that people use to lift patients on,these are ergonomically unfriendly and useless!!!!! I would anyone who has any relevant info to perhaps send me some would that be possible please cheers cathy
We have moved away from ‘no-lift’ as there really is no such thing. The program which our hospital uses is called BackSmart; using slide sheets, pat-slides, body mechanics and getting patient to do a lot of the work. It can take a bit of time to setup, however I find that patients can often move themselves afterwards or with minimal support by the nurses.
Hi,
I’m from Taiwan, and my company is trying to presuade the “No-Lift Policy” in my country.
Would you please tell me that Does there have any logo can represent “No-Lift Polocy”.
or any legal associate?
Thanks^^
Hi. I am from the U.S. I am doing some research as the ‘no lift’ policy is scarce here, but noted in recent articles i’ve read. Can you tell me where the ‘no lift policy started? Was it in England? How long ago? Do you have any articles/links that you could share with me to tell me if this is current practice in Au.?
Thanks!
Hi I am a registered nurse in South Africa ,and we are in the dark ages as we do not have any policies related to maual handling of patients,and with the HIV epidemic here we have alot of thin frail patients who are hurt when handled by staff ,I am hoping to start selling slide sheets here to try improve the situation for nurses and patients but I am looking for an instruction sheet ,with pictures if possible ,that I would be able to use ,can anyone help me ?
thanks
Wendy
Just make sure you use the correct grip on a slide sheet. Otherwise finger and wrist injuries can occur.
Andrea – I cannot think of any negatives to using slide sheets – once you understand how they work and practice a few times you will wonder how you ever got by without them .
They work by making it very easy to slide a patient – one warning though – initialy you have too be carefull because the patient can move very fast and go further than you want them to .
You have to be careful near the edge of a bed as it is possible that a patient could slide off without much effort . Practice first to get the idea .
And never place one on the floor as it would be like stepping onto a greased or icy surface .
Different brands of slide sheets have different degrees of slippery ness . Buy one and ty it – they are cheap . They are easy to use and if you need instruction I can try and help online . I have used them for years and instruct on there use at my facility . If you can’t get a commercial one it is possible to make your own that work just as well . I can advise .
I work as an RN on a med surg floor here in the USA and my mom works as a moving and handling trainer in the UK and she is constantly asking me why we boost up our patients using an incontinence pad and we do not use slide sheets. I have never even heard of one before and wonder why out of the 6 hospitals I have worked in none of them use them. Is there any negatives to using them?
Susan , is there an OH&S committee in your facility ? Management is very unlikely to take note of one staff member . Talk to other staff and see if others are concerned about the risks you all face .
A group can be formed that is not ‘ official ‘ . If necessary you can meet semi- formaly for coffee at some ones house to discuss issues . Most importantly -’ information is power ‘- obtain a copy of the current legislation like the OHS Act 2000 for instance . Read it and mark anything you think is relevant with a yellow highliter pen . The law prescribes actions your management must take to protect your safety ! And there can be severe penalties if they don’t .
I don’t know what State your in so I can’t give more precise info . Another good source of help is what ever union covers your work place . If you are a member they will help with info and even negotiations .
You asked if you have the right to refuse to to lift manualy – ( in my opinion ) yes you do – if you have a serious belief that you may be injured . In fact you may have a legal obligation to ‘ work safely ‘ . Depending on your relevant State or Territory legislation . It would be best to be a member of your relevant Union and check out your specific situation with them – that way you would have ‘ back up ‘ if your management gets tough .
There are many alternatives to using hoists or manualy lifting – some examples – if the toilet is too small you can possibly use a hoist in the bedroom from either a chair or bed onto a mobile commode chair and then roll the commode chair over the toilet . And reverse the process afterwards .
If the resident is in bed and you have a mobile bath then the resident can be slid from the bed to the mobile bath – taken to a bath room – bathed or showered and returned .
A lot depends on the specific mobility of the individual resident – how much can they assist ? do they have severe dementia or can they understand and follow simple instructions .
Could the resident stand if they were not in a low chair ? Are they stable if they could stand ?
Has the resident lost the ability to transfer themself because the staff have been lifting them ?
It can be pointed out to management that injuries have a cost – possible fines under the Act , loss of experienced staff and replacing injured staff , increases to insurance premiums due to claims , potential litigation for an injury to a resident ( or staff ) .
The biggest problem is ignorance – staff lift because it’s simple ( a no brainer ) and managements have an equal lack of skills and have no idea what else to do !
Do you have slide sheets ? Do you use a wall bar stand technique ? Do you know how to move a resident up a bed without lifting them ?
I work in a care home. The owners are reluctant to make wet rooms and large assisted bathrooms and toilets to accomodate hoists. The only option open to the staff is manual lifting of very heavy residents. I hurt my back lifting one lady, which I now refuse to lift manually until the lifting pokicies have been reviewed.
Is it my right to refuse to manually lift until I can use the method of my choice, which would, in this resident’s case be a standing hoist?
As the No lift pokicy was introduced in 1992, nurses and carers shouod not be injuring their backs in the 21st century!!
Here’s some of my experiences PRE No Lift .
I entered a residents room just in time to see two nurses supporting a woman under each shoulder and proceeding towards the bathroom . The particular resident had dementia and was only very marginaly weight bearing . On looking down to see if she was walking I was amazed to see that her feet were about 6 cm OFF the floor ! When I queried the actions of the nurses they replied that they were under ( strict ) instructions to ‘ walk ‘ the resident to maintain mobility ! When I pointed out that her feet were not on the ground and she wasn’t walking both nurses agreed but said they were under ‘ strict instructions ‘ !
I have seen two nurses struggling along a corridor with one supporting a large severely dementing male who was on an angle of approximately 45 degrees with one nurse staggering under the weight of the top half and the other nurse desperately tugging on the other arm at full stretch as they proceeded along the corridor . Think about that 45 degrees for a moment .
I have worked with a large number of nurses that have been severely injured – with two being permanently crippled due to shoulder injuries received during manual handling .
Thanks Rachel – maybe another option could have been to lower the bed a bit and then put something like pillows , folded blankets even clothes etc on the bed and then raise it release the resident – lower the bed and roll to remove the extra packing .
We made sure it got repaired – but I never heard what caused it to seize up like that. Yeah we had the bed up as high as it could go too.
To Rachel — You did not say what the cause of the malfunction was ? I hope the Lifter was checked out thoroughly and or the manufacturer was alerted .
I presume the bed could not be raised UP to the the resident / patient . Mechanical Lifters are not without risk ( I have known of one to be tipped over sideways ! with a resident in it – fortunately it tipped onto the bed . ) . I have seen a nurses back injured while trying to manouver a Lifter on a sloping floor in a bathroom – she was working alone and tried to control the lifter when it rolled sideways – hence two nurses to use a lifter should be the requirement .
A ‘ No Lift ‘ policy does not guarrantee safety – but it vastly reduces the chances of injury .
Scariest lifting incident I’ve had happened about 3 years ago when I was working in a nursing home while I was at uni doing my RN’s degree. Me and another staff member were putting one of the residents into bed for the night with the mechanical lifter. Got the resident over the bed, grabbed the remote to lower the resident down – lifter wouldn’t budge. We changed the lifter’s battery, pressed the emergency release button – nothing. We ended up having to get up on the bed, unhook the lifter harness and lower the resident down onto the bed ourselves. Thank god it happended while over the bed and not somewhere else (ie bathroom).
I have been ICU nursing for 15 years now. The lifting technique that reigns in my mind? “The cradle lift”: patient’s hands down our backs as we bend forward and hurl ourselves into the pillows. Digusting and unsafe! I did heaps of these in the UK where I trained in the early 90′s.