Originally Posted by Sneakymom
Pain free days are a good thing.
I have to admit- this is the one thing that REALLY scares me about becoming an RN. And I'm not exactly starting out as a "young" person, by the time I graduate I'm going to be pushing 45.
Do you have any tips (other than lifting correctly- I'm practicing that NOW when I lift stuff) so that I don't throw my back out in my first year of nursing (or worse yet doing it during clinicals?)
Patients can generally do more for themselves than they let on, even when they first come back to the ward from the operating room.
I try and make my patients do as much as they can for themselves and I'll assist them with what they can't do.
For example, last Friday I picked up an evening shift on CVT. One of my patients rang and wanted use to give him a boost up in the bed because he had slid down and his head was too low from the top. The nurse that was with me grabbed the sheet under him and was getting ready to boost him up. I told her to wait a minute.
I asked him how he got into bed. He admitted he had done it himself and he had been high enough up at that time, but he's slid down. I asked him who was going to boost him up when he went home. He said "I will be." So with that, I uncovered him, he stood up and moved up higher in the bed and got himself back into bed all by himself. 2 nurses backs saved that time.
Tonight we have a patient that is very heavy care. A very sick lady, but even she can help herself when encouraged. One nurse and I were in a rush with other things and this lady needed a boost up. So we took the "easy" route and boosted her up. OMG! She was complete dead weight. It took us 2 attempts and all our strength to move her up in the bed.
The next time she called, I tipped the bed so it was slanted head down and feet up. Then I had her bend her knees and hold her that when I said "3" she needed to dig her heels into the bed and push with her legs to help us. That worked way better.
When we get someone back from the OR, if the are able to use their arms (IE: didn't have breast surgery or open chest surgery), we have the raise their arms and grab hold of the side railings above their head and help to use those along with their bent knees and feet to help boost themselves in the bed.
Another tip is to get them up and have them stand at the side of the bed and march their legs up and down just to increase circulation. Then have them move a few steps high up toward the head. They need to be sitting on top of where the bed bends at the head. Then they lean their upper body sideways towards the head of the bed and lift first one leg and then the other into the bed.
I rarely "boost" people up in bed anymore when I've assessed the person to be able to assist with it themselves. Having them help themselves also gives them some exercise and helps keep their muscles strong, which is a good thing when in a hospital. The activity also gets them breathing a bit heavier which keeps their lungs expanded.
For every 24 hours you spend laying in a bed, you lose 20% of your muscle mass, and that is accumulative. So if you started with 100% muscle mass, in 24 hours you have lost 20% of that and are left with 80%. If you spend another 24 hours in bed, you loose 20% of that 80% that you had left, so you've lost another 16%, and so forth.
So that explains why the longer someone stays in bed, the more tired they are and the more they want to stay in bed. Plus the body gets accustomed to wanting to stay in a laying down position and has a hard time when it's suddenly put to the test of having to sit, stand or walk.
If you do have to actually boost someone who can't help you. Make sure the bed is at a good height for you. Put down the railings on your side of the bed. Put your knee up on the bed to give yourself leverage. For me when I'm on the left side of the bed and I'm going to be helping boost the person towards my right, I put my right knee on the bed and position myself so that I'm not using my back, but instead I'm using my legs and entire body to help move the person up. If you don't have that knee on the bed, you tend to end up using your back and shoulders.
Nursing school does teach you proper body mechanics to lift. But where you go to work their health and safety department will also go through proper body mechanics...or they should. Where I work did. But I learned way more from working with Health Care Aides. Their jobs are lots of lifting and they can teach you lots.
When I was on CVT and was getting my patients to help boost themselves, even a man who had a stroke, the nurses couldn't believe how easy it was and how less taxing it was on our backs.