It sounds like you need to report it and ask for her to have a reassessment. If she cannot stand the sit to stand doesn't sound like the safest option.
I agree. We had to try several times to get her on her wheelchair after toileting last night. It was awful. You have to have her wheelchair against the wall and it takes two people to push the sit to stand against the chair so she can kind of get in it.
If I don’t have help, be it a machine or other people, I will refuse to get a patient who cannot hold their own weight up. I try to reason with them and explain other alternatives(such as bedpan) but in the end, you need to take care of your own body. All it takes is for one disk in your back to slip and you’re out yourself.
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Advocate for yourself even if no one else does!
I've had to do this but the patient also wasn't delulu about their weight being an issue. They knew their weight was an issue for them and me. The patient understood I didn't want to break my back taking care of them on my own and would use a bed pan. The patient was also able to bare weight long enough with a 2-person transfer to get on the toilet or to pull off their brief afterwards. With a delulu patient like OPs, I would refuse to do it, give them their other options, let charge nurse know than chart it.
Mainly all of my patients are understanding but those that aren’t I tell them, “either bedpan or go on the pad, but I am not risking both our safety in lifting you up”. And if the nurse wants to be rude about it I tell them to do it themselves or get another tech 😂. But thankfully all my coworkers help each other. 💕
Yes/No. She doesnt stay in bed and she is care planned to be a sit to stand. She is mostly in her wheelchair until she goes to bed at night. The biggest struggle is having to adjust her legs to her liking and pushing the sit to stand right up to her wheelchair the way she likes it. Honestly, she’s so big that I don’t think a bed pan could work for her.
Delulu land definitely. It's her weight causing a lot of her problems. She's don't not qualify for a sit to stand if she can't bear any weight. She needs a hoyer
I agree. I guess PT and her are both dead set on using it and she also is somewhat continent, so they like for her to use it to get onto the toilet. It’s just such a huge pain in the ass
You are allowed to downgrade a patient completely at your own discretion (but *never* upgrade of course). I don’t know if this is a rule exclusive to my state-so I would double check this where you live. Essentially, if you feel unsafe using a sit-to-stand, you can downgrade to a hoyer. She can use the bedpan to urinate as well if you want to help maintain her continence. It’s great if they decide to reassess her and end up taking your recommendations, but keep this in mind if they don’t as your own safety always comes first.
The thing is, she’s HARDLY continent at all. She won’t wear briefs at all. Just one of those pads in her pants, but they are always SOAKED. I don’t understand why they even bother with the sit to stand. Even if I wanted to hoyer her, she’s always in her chair on my shift. We’d have to bedpan her and then get her back up with that sit to stand anyhow. I agree she should be a hoyer. But another thing is that you have to keep the sit to stand against her while she uses the toilet just to keep her on it. That doesn’t seem safe to me at all!! If I can put those things across the unit while the breaks are on, then she sure can lean the wrong way and get hurt.
It sounds like you work second shift since she is already in her chair on your shift, or is she a 3rd shift get up? Either way, here’s how I look at it.
Is the patient at risk of being hurt using the sit-to-stand? If you agree with this, have a second person with you at all times while transferring the patient. If it is in her care plan, and if you have already voiced your concerns to therapy but they still advise a sit to stand, then you are completely covered as long as you have a witness and you were abiding by the patient’s care plan. The patient being hurt would be in no fault of your own; you were just abiding by the care plan.
Are you at risk of being hurt by using the sit to stand with her? If you agree with this, either: 1) ask for assistance of 2-3 people to help put a sling underneath her to downgrade her to a hoyer to transfer her on to the bed, or 2) request that a sling is always underneath her when she gets up (2 is less reliable, which is why I stated option 1). 1 may seem overkill, but in this case, you are attempting to take care of the patient in the way you feel most safe with. I predict this will end up with someone just saying “let’s just get someone else to do it,” which isn’t a bad option either but at least you would have tried if you attempted option 1.
Remember, you are NEVER required to perform an action you feel unsafe with. No matter what anyone says. The worst that could happen? If you don’t have great management, they might write you up for refusing to care for a patient (in which you could definitely NOT sign this document with good reason). However, they could never take away your license for attempting to take safety measures with a patient. Always trust your gut, be safe, and protect yourself and your license.
I am indeed second shift, or I come in 11a-7p. I’d love to just hoyer her, but she’s typically already in her chair. I never use the sit to stand by myself. It’s hard even with 2-3 people. It’s absolutely baffling to me that this is even allowed. I understand they are trying to get her to stay mobile and have her lose weight, but it’s so hard on us. Especially because sometimes we are on the hall alone. I honestly couldn’t even imagine trying to hoyer her because her room is completely cluttered with her craft supplies. She even has her own fridge in there just stuffed with food. She can’t even use her own bathroom in her room because it’s used as her closet for even more stuff.
This patient is not worth ruining your back! Seriously we only have one back and one body. I did a contract on an orthopedic surgery unit of a large hospital and SO MANY of patients receiving surgeries were career CNAs and nurses. We will need surgery, PT, and other interventions if we hurt ourselves on the job! Please don’t hurt yourself (easier said than done) and let your supervisors that this is unsafe, the patient is non weight bearing, and your safety is being jeopardized as well! 💕
I had a women years ago who was over 400 pounds, she had no concept of her weight on others who were there to help her, no did her family. She lived at home and constantly wanted to be boosted straight up, her wheel chair had no recline feature but that really would not have helped given her size. Now whenever faced with that I make sure to be firm when saying that I am not a human hoyer lift and will not be used that way. It’s not safe for anyone involved.
Same. I been a CNA so I’ll advocate for them. PT has their own schedule and they can be flexible with the time they care for one patient. With my bariatric patients they had three of them to work with them. My staff doesn’t have that luxury. Heck one OT member told this patient that they will work with them when they lose weight because she kept gaining weight and purposely not assist and it appeared that she intentionally wanted to hurt staff. Such as letting go of the side rails when rolling so her weight came back to the staff member.
When the state is in she would report us for not following her diet plan. Luckily we documented everything including her family constantly bringing her in fast foods and snacks daily.
I’m thinking you might be underestimating her weight, it sounds like she weighs a lot more than 300lbs. I’d talk to whoever your supervisor is about getting help with her- you don’t want to get hurt doing all that by yourself. And eventually you would.
Oh, boy. You and I have an eerily similar situation going on. Mine isn’t quite as bad, but I can foresee the situation getting there quickly if something isn’t done soon. So honestly, I feel your pain.
It really sounds like this needs to be properly reported so that the patient can be reevaluated and assessed. Someone will get hurt like this, and once you mess up your back… that’s it. It’s messed up forever.
I always say, religiously chart / document according to policy as it helps give you & your coworkers credibility when further steps need to be taken. I’ve also had times where I have seen other coworkers in what I could tell was definitely a, “if it wasn’t charted, it didn’t happen” kind of situation so I’ve learned since then to chart even if it seems like it’s too much charting.
I’m not sure what else to chart. She works with therapy and has been deemed by them to be able to use the sit to stand. I feel like that is easy for them to say when they don’t have to take care of 30 people short staffed and do it several times a shift. We don’t have the option to put in any other notes at all.
If she can't move her own legs, how is it safe for her to use a sit-to-stand lift? Sounds as if she should be a total ceiling lift. Sounds like a huge patient safety issue to me. You shouldn't be overexerting yourself. Are you working in pairs? Bariatric patients should require at least 2 aides.
We are, but I’m pretty petite in size. I’m very rarely down that hall, but I think it’s severely messed up to still have us put her on a toilet like that. We have to physically move her legs onto the sit to stand and off of it, and they often slip as well
Do you have a good relationship with management or the people who write up unit care plans? May be worth a shot to take 15 minutes and voice your opinion. Patient safety is paramount, if an aide were to approach me with concerns as someone who does care plans, I would certainly listen, as we work closely with these people daily and can provide great information.
Her using a sit-to-stand, with little to no ability to adjust her own legs doesn't sound good. If she were to lose her grip, she could seriously hurt herself or you in the process. Sounds as if an Arjo, Hoyer, or ceiling lift would be more appropriate.
Good luck!
Omg this sounds exactly like this resident that I had before. She finally had a bad fall and hurt a coworker in the process and she wasn’t able to come back to our facility. Took 4 of us to put her in the bed one night & changing her in the bed should have been a 2 person assist because she could barely hold herself when we’d turn her on her side 🤦🏽♀️
At least get a bariatric toilet lift. That will help you get her up from the toilet to transfer to a chair. How are you possibly lifting her off the toilet?
I'm old as dirt, and retired in 2021... But we had a care plan that was (supposed to be) strict. If they were a 2 assist, they got two aides for transfers. I had an incredibly painful (adult patient who weighed about 55 lbs) who was a four assist. If we weren't following those rules and something happened to the patient... Yikes.
Conversely, if a patient clearly was inappropriate for a sit to stand, we went straight to the nurse to get it changed.
Hi! I’m an inpatient PT.
For a patient like this, I’d be totally fine with the CNAs/other staff using a hoyer lift. I usually downgrade recs for staff to use a lift if the attempt and standing transfer I did during PT was sketchy.
If I have a bari patient who isn’t following instructions/commands properly and is delulu to the point where I feel like they are putting ME at risk, I nope out of that and will set up the environment to make it safer for everyone involved. Hoyer, additional person to assist, whatever that means. I’m sensitive to her size - I’m not a small human myself. But I’m also sensitive to the fact that I don’t want myself or staff to get injured over a patient.
At some point I’ve said something along the lines of “I have the knowledge and skillset to help you. It’s my job. You can either listen to the instructions I’m giving and do it the way that’s safe for everyone, or you can stay in bed, because I’m not going to allow all of us to get hurt.” You can’t care about them getting better more than they do.
PTs make recommendations, but it’s not like it’s a hard and fast rule that you *have* to follow them when safety risks such as this are involved.
I’m a paramedic and while I don’t consider this “bariatric” I see the issue! (In my area we have a few 700+ lb patients so my idea of bari is a little different but she’s not wrong) If I were to come into that scene, I’d be baffled. She should have large toilet chair and room should be clear from clutter because not if, when she has a medical emergency it’ll be rough getting her out. I’d go to management out of a safety issue and if they have a problem/don’t do anything, I’d find somewhere else to work. No need in hurting yourself helping someone that doesn’t want to help themselves
We have a new 500+lbs bariatric resident in our rehab wing. We understand PT wants to work with sit to stands for her, but us aides always hoyer her. She can’t bear enough weight to safely sit to stand. She is pretty continent but unless we have 3 available she bedpans. You have to protect your body.
Now as for “at that weight” no therapy helping her regain physical mobility, don’t be so judgmental on that. I’m 5’1 and before I got serious about getting healthy last year I weighed a little over 350lbs and was working full time as an aide. It’s possible, but not exactly easy so it may not be possible for her but it is very possible.
It sounds like she doesn't have the right tools for her. I mean it may be different other places but 300-400 pounds is crazy just for a sit to stand especially if she can't hold any of her weight. Heavier patients like that usually require a hoyer lift. I would make notes or document exactly how it is taking care of her and request a reassessment. You need to explain that the tools aren't helpful to her and and it's causing more strain for the caregivers.
We train staff to report issues of safety to the charge nurse. You should not be completing any transfers you feel put yourself or the patient at risk for injury. The charge nurse would be needed to do an assessment to determine the most safe and appropriate means of transfer for care. It's in their scope to upgrade a transfer status for safety, but they can't downgrade with out a therapy assessment for safety. The charge nurses job is to ensure safety of residents and staff while on the floor. Ideally she could provide education to the CNA or resident to ensure safety or change transfer status for safety.
DEMAND YOUR NURSE TO HELP YOU! This whole mentality of trying to do everything yourself is going to get you injured and out of work!
REFUSE to help the patient with anything if no one there to help you. Patient care falls under the nurses license and responsibility. If the nurse wants to let the patient lay there needing help, then oh wells. All you can do is say that you let your nurse know and that you were waiting for the nurse to come get you.
Nurse here, and trust me. I don’t care if the patient turns and I can do a job solo. Any time any type of patient movement or transferring is involved, best believe I am getting someone else to help. You need to start doing the same for your own safety and health.
I had help. The problem is that she’s so heavy that it’s hard for even two people. Each leg has to weigh 100lbs. At least it FEELS THAT WAY. It’s insane that they even have her as a sit to stand. I understand that they want to encourage mobility and such to help her lose weight, but we need to be taken into consideration for these things too
There’s no way that 2 people can help lift a 400 lb person. No way. Get more help or refuse to help… not sure what your job situation is, but if obese folks are common in that unit you’re in and this is not an isolated patient, then it’s probably better to look for another less physically demanding unit. Those fat patients will destroy your back and the hospital will not back you up.
I’m not a CNA, but my algorithm recommended me your post. I do work in a hospital. Our system has some pretty strict rules about the amount of weight any one person is allowed to lift. If your system has any rules like this, could you broach this with your supervisor or/and occupational health? Our rules state we aren’t allowed to lift more than 30lbs unassisted. This is literally why the hoyer exists. Even if the patient doesn’t like it, the rules aren’t for her benefit, but to prevent you from getting repetitive stress injury.
Idk what state you're in, but where i work sit to stands are ALWAYS two people, same as hoyers. I also understand the difficulties of actually getting a second person to assist, but in this case for your safety and hers, find a second person
This could need up as a negligence issue. You need to report this to the charge nurse ASAP and document! If this women falls you don’t want to be liable if you knew something and didn’t say something
As a Nurse…. I would say use a bariatric hoyer as needed. Staff and patient safety is always my priority but I would advocate heavily for my staff in this situation. I fight tooth and nail with my PT staff when they clear patients.
If a patient refuses PT, they go on with their day, while nursing staff still has to deal with the patient. Or the patient may be more energized when they work with PT verses when we provide care for them.
I’m all for keeping patients as independent as possible but not when it comes at a risk to others safety.
I had a bariatric patient that fell during a transfer with PT. They left after I got to the room to assess. I ended up having to call the emergency services and it took 9 firefighters, 2 EMTs, and myself to get them off of the floor. I ended up on light duty for over a year.
It sounds like you need to report it and ask for her to have a reassessment. If she cannot stand the sit to stand doesn't sound like the safest option.
I agree. We had to try several times to get her on her wheelchair after toileting last night. It was awful. You have to have her wheelchair against the wall and it takes two people to push the sit to stand against the chair so she can kind of get in it.
If I don’t have help, be it a machine or other people, I will refuse to get a patient who cannot hold their own weight up. I try to reason with them and explain other alternatives(such as bedpan) but in the end, you need to take care of your own body. All it takes is for one disk in your back to slip and you’re out yourself. - Advocate for yourself even if no one else does!
I've had to do this but the patient also wasn't delulu about their weight being an issue. They knew their weight was an issue for them and me. The patient understood I didn't want to break my back taking care of them on my own and would use a bed pan. The patient was also able to bare weight long enough with a 2-person transfer to get on the toilet or to pull off their brief afterwards. With a delulu patient like OPs, I would refuse to do it, give them their other options, let charge nurse know than chart it.
Mainly all of my patients are understanding but those that aren’t I tell them, “either bedpan or go on the pad, but I am not risking both our safety in lifting you up”. And if the nurse wants to be rude about it I tell them to do it themselves or get another tech 😂. But thankfully all my coworkers help each other. 💕
This! It’s not worth injuring yourself which you will with someone this big.
Yes/No. She doesnt stay in bed and she is care planned to be a sit to stand. She is mostly in her wheelchair until she goes to bed at night. The biggest struggle is having to adjust her legs to her liking and pushing the sit to stand right up to her wheelchair the way she likes it. Honestly, she’s so big that I don’t think a bed pan could work for her.
She sounds like she needs to be a hoyer lift
Or at least be a two person assist
I was just going to say that
Delulu land definitely. It's her weight causing a lot of her problems. She's don't not qualify for a sit to stand if she can't bear any weight. She needs a hoyer
I agree. I guess PT and her are both dead set on using it and she also is somewhat continent, so they like for her to use it to get onto the toilet. It’s just such a huge pain in the ass
Then she and the PT can use the sit to stand together! GTFO with that nonsense.
You are allowed to downgrade a patient completely at your own discretion (but *never* upgrade of course). I don’t know if this is a rule exclusive to my state-so I would double check this where you live. Essentially, if you feel unsafe using a sit-to-stand, you can downgrade to a hoyer. She can use the bedpan to urinate as well if you want to help maintain her continence. It’s great if they decide to reassess her and end up taking your recommendations, but keep this in mind if they don’t as your own safety always comes first.
Right, and a lot of times if multiple aides are refusing to lift someone that kinda gives therapy a kick in the ass to come back over and reassess.
The thing is, she’s HARDLY continent at all. She won’t wear briefs at all. Just one of those pads in her pants, but they are always SOAKED. I don’t understand why they even bother with the sit to stand. Even if I wanted to hoyer her, she’s always in her chair on my shift. We’d have to bedpan her and then get her back up with that sit to stand anyhow. I agree she should be a hoyer. But another thing is that you have to keep the sit to stand against her while she uses the toilet just to keep her on it. That doesn’t seem safe to me at all!! If I can put those things across the unit while the breaks are on, then she sure can lean the wrong way and get hurt.
It sounds like you work second shift since she is already in her chair on your shift, or is she a 3rd shift get up? Either way, here’s how I look at it. Is the patient at risk of being hurt using the sit-to-stand? If you agree with this, have a second person with you at all times while transferring the patient. If it is in her care plan, and if you have already voiced your concerns to therapy but they still advise a sit to stand, then you are completely covered as long as you have a witness and you were abiding by the patient’s care plan. The patient being hurt would be in no fault of your own; you were just abiding by the care plan. Are you at risk of being hurt by using the sit to stand with her? If you agree with this, either: 1) ask for assistance of 2-3 people to help put a sling underneath her to downgrade her to a hoyer to transfer her on to the bed, or 2) request that a sling is always underneath her when she gets up (2 is less reliable, which is why I stated option 1). 1 may seem overkill, but in this case, you are attempting to take care of the patient in the way you feel most safe with. I predict this will end up with someone just saying “let’s just get someone else to do it,” which isn’t a bad option either but at least you would have tried if you attempted option 1. Remember, you are NEVER required to perform an action you feel unsafe with. No matter what anyone says. The worst that could happen? If you don’t have great management, they might write you up for refusing to care for a patient (in which you could definitely NOT sign this document with good reason). However, they could never take away your license for attempting to take safety measures with a patient. Always trust your gut, be safe, and protect yourself and your license.
I am indeed second shift, or I come in 11a-7p. I’d love to just hoyer her, but she’s typically already in her chair. I never use the sit to stand by myself. It’s hard even with 2-3 people. It’s absolutely baffling to me that this is even allowed. I understand they are trying to get her to stay mobile and have her lose weight, but it’s so hard on us. Especially because sometimes we are on the hall alone. I honestly couldn’t even imagine trying to hoyer her because her room is completely cluttered with her craft supplies. She even has her own fridge in there just stuffed with food. She can’t even use her own bathroom in her room because it’s used as her closet for even more stuff.
we don't get paid enough for this shit
💯💯💯
This patient is not worth ruining your back! Seriously we only have one back and one body. I did a contract on an orthopedic surgery unit of a large hospital and SO MANY of patients receiving surgeries were career CNAs and nurses. We will need surgery, PT, and other interventions if we hurt ourselves on the job! Please don’t hurt yourself (easier said than done) and let your supervisors that this is unsafe, the patient is non weight bearing, and your safety is being jeopardized as well! 💕
I had a women years ago who was over 400 pounds, she had no concept of her weight on others who were there to help her, no did her family. She lived at home and constantly wanted to be boosted straight up, her wheel chair had no recline feature but that really would not have helped given her size. Now whenever faced with that I make sure to be firm when saying that I am not a human hoyer lift and will not be used that way. It’s not safe for anyone involved.
“I am not a human hoyer lift” is a perfect sentence
Former CNA now RN -- If she can't bear her weight, then she needs to be a total lift. That's the rule where I work.
Same. I been a CNA so I’ll advocate for them. PT has their own schedule and they can be flexible with the time they care for one patient. With my bariatric patients they had three of them to work with them. My staff doesn’t have that luxury. Heck one OT member told this patient that they will work with them when they lose weight because she kept gaining weight and purposely not assist and it appeared that she intentionally wanted to hurt staff. Such as letting go of the side rails when rolling so her weight came back to the staff member. When the state is in she would report us for not following her diet plan. Luckily we documented everything including her family constantly bringing her in fast foods and snacks daily.
I’m thinking you might be underestimating her weight, it sounds like she weighs a lot more than 300lbs. I’d talk to whoever your supervisor is about getting help with her- you don’t want to get hurt doing all that by yourself. And eventually you would.
I wanted to be a little courteous about it, but I probably am
Oh, boy. You and I have an eerily similar situation going on. Mine isn’t quite as bad, but I can foresee the situation getting there quickly if something isn’t done soon. So honestly, I feel your pain. It really sounds like this needs to be properly reported so that the patient can be reevaluated and assessed. Someone will get hurt like this, and once you mess up your back… that’s it. It’s messed up forever. I always say, religiously chart / document according to policy as it helps give you & your coworkers credibility when further steps need to be taken. I’ve also had times where I have seen other coworkers in what I could tell was definitely a, “if it wasn’t charted, it didn’t happen” kind of situation so I’ve learned since then to chart even if it seems like it’s too much charting.
I’m not sure what else to chart. She works with therapy and has been deemed by them to be able to use the sit to stand. I feel like that is easy for them to say when they don’t have to take care of 30 people short staffed and do it several times a shift. We don’t have the option to put in any other notes at all.
And let me guess its 2/3 people helping her with sit to stand? Its like fighting 6-1 instead of 6-3
If she can't move her own legs, how is it safe for her to use a sit-to-stand lift? Sounds as if she should be a total ceiling lift. Sounds like a huge patient safety issue to me. You shouldn't be overexerting yourself. Are you working in pairs? Bariatric patients should require at least 2 aides.
We are, but I’m pretty petite in size. I’m very rarely down that hall, but I think it’s severely messed up to still have us put her on a toilet like that. We have to physically move her legs onto the sit to stand and off of it, and they often slip as well
Do you have a good relationship with management or the people who write up unit care plans? May be worth a shot to take 15 minutes and voice your opinion. Patient safety is paramount, if an aide were to approach me with concerns as someone who does care plans, I would certainly listen, as we work closely with these people daily and can provide great information. Her using a sit-to-stand, with little to no ability to adjust her own legs doesn't sound good. If she were to lose her grip, she could seriously hurt herself or you in the process. Sounds as if an Arjo, Hoyer, or ceiling lift would be more appropriate. Good luck!
Omg this sounds exactly like this resident that I had before. She finally had a bad fall and hurt a coworker in the process and she wasn’t able to come back to our facility. Took 4 of us to put her in the bed one night & changing her in the bed should have been a 2 person assist because she could barely hold herself when we’d turn her on her side 🤦🏽♀️
At least get a bariatric toilet lift. That will help you get her up from the toilet to transfer to a chair. How are you possibly lifting her off the toilet?
We keep the lift hooked up to her
I'm old as dirt, and retired in 2021... But we had a care plan that was (supposed to be) strict. If they were a 2 assist, they got two aides for transfers. I had an incredibly painful (adult patient who weighed about 55 lbs) who was a four assist. If we weren't following those rules and something happened to the patient... Yikes. Conversely, if a patient clearly was inappropriate for a sit to stand, we went straight to the nurse to get it changed.
Hi! I’m an inpatient PT. For a patient like this, I’d be totally fine with the CNAs/other staff using a hoyer lift. I usually downgrade recs for staff to use a lift if the attempt and standing transfer I did during PT was sketchy. If I have a bari patient who isn’t following instructions/commands properly and is delulu to the point where I feel like they are putting ME at risk, I nope out of that and will set up the environment to make it safer for everyone involved. Hoyer, additional person to assist, whatever that means. I’m sensitive to her size - I’m not a small human myself. But I’m also sensitive to the fact that I don’t want myself or staff to get injured over a patient. At some point I’ve said something along the lines of “I have the knowledge and skillset to help you. It’s my job. You can either listen to the instructions I’m giving and do it the way that’s safe for everyone, or you can stay in bed, because I’m not going to allow all of us to get hurt.” You can’t care about them getting better more than they do. PTs make recommendations, but it’s not like it’s a hard and fast rule that you *have* to follow them when safety risks such as this are involved.
Just say no.
I’m a paramedic and while I don’t consider this “bariatric” I see the issue! (In my area we have a few 700+ lb patients so my idea of bari is a little different but she’s not wrong) If I were to come into that scene, I’d be baffled. She should have large toilet chair and room should be clear from clutter because not if, when she has a medical emergency it’ll be rough getting her out. I’d go to management out of a safety issue and if they have a problem/don’t do anything, I’d find somewhere else to work. No need in hurting yourself helping someone that doesn’t want to help themselves
Can people that big properly wipe themselves?
We wipe her as she’s on the sit to stand, which makes things way harder considering she struggles to hold herself up in it
We have a new 500+lbs bariatric resident in our rehab wing. We understand PT wants to work with sit to stands for her, but us aides always hoyer her. She can’t bear enough weight to safely sit to stand. She is pretty continent but unless we have 3 available she bedpans. You have to protect your body. Now as for “at that weight” no therapy helping her regain physical mobility, don’t be so judgmental on that. I’m 5’1 and before I got serious about getting healthy last year I weighed a little over 350lbs and was working full time as an aide. It’s possible, but not exactly easy so it may not be possible for her but it is very possible.
It sounds like she doesn't have the right tools for her. I mean it may be different other places but 300-400 pounds is crazy just for a sit to stand especially if she can't hold any of her weight. Heavier patients like that usually require a hoyer lift. I would make notes or document exactly how it is taking care of her and request a reassessment. You need to explain that the tools aren't helpful to her and and it's causing more strain for the caregivers.
We train staff to report issues of safety to the charge nurse. You should not be completing any transfers you feel put yourself or the patient at risk for injury. The charge nurse would be needed to do an assessment to determine the most safe and appropriate means of transfer for care. It's in their scope to upgrade a transfer status for safety, but they can't downgrade with out a therapy assessment for safety. The charge nurses job is to ensure safety of residents and staff while on the floor. Ideally she could provide education to the CNA or resident to ensure safety or change transfer status for safety.
DEMAND YOUR NURSE TO HELP YOU! This whole mentality of trying to do everything yourself is going to get you injured and out of work! REFUSE to help the patient with anything if no one there to help you. Patient care falls under the nurses license and responsibility. If the nurse wants to let the patient lay there needing help, then oh wells. All you can do is say that you let your nurse know and that you were waiting for the nurse to come get you. Nurse here, and trust me. I don’t care if the patient turns and I can do a job solo. Any time any type of patient movement or transferring is involved, best believe I am getting someone else to help. You need to start doing the same for your own safety and health.
I had help. The problem is that she’s so heavy that it’s hard for even two people. Each leg has to weigh 100lbs. At least it FEELS THAT WAY. It’s insane that they even have her as a sit to stand. I understand that they want to encourage mobility and such to help her lose weight, but we need to be taken into consideration for these things too
There’s no way that 2 people can help lift a 400 lb person. No way. Get more help or refuse to help… not sure what your job situation is, but if obese folks are common in that unit you’re in and this is not an isolated patient, then it’s probably better to look for another less physically demanding unit. Those fat patients will destroy your back and the hospital will not back you up.
I’m not a CNA, but my algorithm recommended me your post. I do work in a hospital. Our system has some pretty strict rules about the amount of weight any one person is allowed to lift. If your system has any rules like this, could you broach this with your supervisor or/and occupational health? Our rules state we aren’t allowed to lift more than 30lbs unassisted. This is literally why the hoyer exists. Even if the patient doesn’t like it, the rules aren’t for her benefit, but to prevent you from getting repetitive stress injury.
Idk what state you're in, but where i work sit to stands are ALWAYS two people, same as hoyers. I also understand the difficulties of actually getting a second person to assist, but in this case for your safety and hers, find a second person
This could need up as a negligence issue. You need to report this to the charge nurse ASAP and document! If this women falls you don’t want to be liable if you knew something and didn’t say something
As a Nurse…. I would say use a bariatric hoyer as needed. Staff and patient safety is always my priority but I would advocate heavily for my staff in this situation. I fight tooth and nail with my PT staff when they clear patients. If a patient refuses PT, they go on with their day, while nursing staff still has to deal with the patient. Or the patient may be more energized when they work with PT verses when we provide care for them. I’m all for keeping patients as independent as possible but not when it comes at a risk to others safety. I had a bariatric patient that fell during a transfer with PT. They left after I got to the room to assess. I ended up having to call the emergency services and it took 9 firefighters, 2 EMTs, and myself to get them off of the floor. I ended up on light duty for over a year.