By Janice Homola, ARM, Coverys Senior Risk Consultant
There is a classic tale where a brave but lowly young man secretly falls in love with a beautiful princess. One day, the king discovers this clandestine romance. To administer justice for this perceived folly, the angry king puts the young man to the ultimate test in that kingdom: a choice between two doors in the king’s arena. Behind one sits a beautiful young maiden in wedding attire. Behind the other prowls a savage, hungry tiger. Opening one door brings the young man great joy and happiness, and opening the other, a violent end.
Sometimes, it seems, our caregivers are faced with a similar — though much more subtle — set of two doors when they need to move their patients. The caregiver’s dilemma is this: lift the patient manually to help them regain strength and sustain a possible injury to the caregiver, or use an “immobilizing” full lift with a seated sling, and personally stay on the road to health and happiness.
Recently, I had the opportunity to hear the true story of Rebecca*, an injured employee who spent some time in a rehabilitation facility. She had lost the use of her legs due to an illness, and was in the process of regaining her mobility and strength. Early on, she could not weight bear almost any of her 150 pounds of weight, so her caregivers wanted to place her in a lift.
“If you put me in that thing,” Rebecca adamantly declared,” I will never walk again. You will not put me in that lift, ever!”
Today, Rebecca is walking, albeit with the assistance of a walker and a bit of a wobbly step. And what of the nurses who cared for her, those nurses who manually lifted all of Rebecca’s 150 pounds of weight, over and over? What if one had ended up with a debilitating back injury while helping Rebecca? Is it right to unnecessarily sacrifice the potential health of one person for that of another?
Certainly, there was a time when the only way to get a patient up and moving meant using our caregiver’s backs to carry the brunt of the weight. Ambulating was done by holding onto a gait belt, even for high fall risk patients. If a patient started to fall, nurses were instructed to go against every human instinct to catch them, hope the patient doesn’t grab onto them for support, and “guide” the patient to the floor. This is a scenario fraught with risk for all involved.
Now, however, it is possible to create an environment where caregivers are not faced with the choice Rebecca’s caregivers had to make. Today, there are choices that will allow the patient to safely weight bear and at the same time, the caregiver will be safe. Once such safe choice is to ambulate a patient with the use of a walking jacket or walking sling attached to a full lift. Use of these slings will allow a patient to weight bear as much as their ability will allow, and at the same time, hold them upright so that their balance is more naturally centered. If the patient fell, the patient remains safe, and so does the caregiver. There are also similar walking slings designed for ceiling lifts. As an added bonus, this type of equipment may be used in mobility assessments, so the caregiver’s backs no longer need bear the weight to determine a patient’s weight bearing capacity; the equipment can.
Sit-to-stand devices can also be used to some extent to safely allow a patient to weight bear. Third, another less commonly known technique to help a patient bear weight but not overexert the caregiver is to use, in relatively stable patients only, the bed itself to stand up or sit down a patient.
This works especially well with “fast beds,” those that raise or lower in 20 seconds. Basically, a patient is leaned and steadied against a raised bed, and when it is lowered, they will automatically sit. The reverse will happen if a patient is sitting at the edge of a lowered bed with their center of gravity close to the front, and the bed is raised. The patient automatically stands!
Kudos to those who have reached a higher level of quality care, where, when it comes to lifting, it is understood that the safety of the caregiver is intertwined with the safety of the patient! These are the folks that are finding and applying new solutions that protect both the health of the patient and the caregiver.
*The caregiver’s name and some facts are altered slightly.
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This post is a work product of Coverys’ Workers’ Compensation Services. This information is intended to provide general guidelines for educational purposes. It is not intended and should not be construed as legal or medical advice. Please consult with your loss prevention consultant/professional with respect to the use or development of your own safety management program.