Today when I went to see Alma, she was near death and unable to move far in bed. This was an expected development and I had asked her family a week prior to rent a hospital bed. However, they declined, saying, "A hospital bed is too clinical looking."
So here I was, in stocking feet, crouched at the head of a sagging, lumpy, queen-sized bed. My 300-pound patient had slipped down toward the foot of the bed, her feet dangling off the edge, and her family asked if I would help them boost her up before she slipped off the bed completely.
I shifted my legs and feet, struggling to find a safe position from which to work. The thought of Jan, a coworker, popped into my head. She was still recovering from back surgery following a work-related injury.
"Well, let's get going!" exclaimed two voices in unison. Alma's daughters stood on my right and left, gripping the draw sheet.
"Let's find another way to do this", I said. "I'm concerned about all of us hurting our backs."
We found eight neighbors to help us carefully move Alma in bed. I made sure that no one had a history of back or limb injury and then taught everyone about proper body mechanics. With each of us working in unison the job was done safely and easily.
I sat down and made a list of friends and neighbors willing to help move Alma and strongly encouraged her family to rent a hospital bed as soon as possible. FIGURE
Back in the car, I shook my head in disbelief that I had come so close to making such a poor decision. Because autonomy and independence are hallmarks of home care nurses, we sometimes forget to ask for help when needed. A healthy back is essential for nurses, caregivers, and patients alike; therefore, it is important to address this issue regularly. If you use good principles of body mechanics with common sense and a commitment to safety, you, your patients, and their caregivers will be a lot healthier.
Back-Saving Tips
1. During any initial home visit, and periodically thereafter, teach and demonstrate proper body mechanics to all caregivers and patients.
2. Encourage the use of devices made for safely moving impaired individuals (e.g., hospital beds, shower chairs, commode chairs, walkers, canes, wheelchairs, slide boards, draw sheets, ramps, lift chairs, etc.).
3. Anticipate future need of assistive devices and have them in place before risk of injury occurs.
4. Never twist and lift at the same time.
5. Remember that moving a patient requires planning and leverage, not brute strength.
6. Ask for help when needed. Always teach helpers proper body mechanics before moving the patient.
7. Invite caregivers to assist in moving the patient when you visit even if you are capable of doing it alone. This is a good teaching opportunity and also provides a respite for your back.
8. Body position is important: Keep feet shoulder-width apart, bend knees with thigh muscles firm, and point feet in the direction you plan to move the patient to avoid twisting your back during movement.