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Toni Talks about PT Today

Safety in Numbers?

Published October 25, 2011 3:10 PM by Toni Patt

There seems to be a common misconception among non-PT people such as nursing. For some reason, they believe the more people you have for a transfer, the safer the transfer will be. I don't know where this idea came from. I suspect its roots lie in a lack of understanding of body mechanics and transfer techniques. The truth is, it's safer to have one or two people who know what they're doing.

Nursing schools must not teach transfer techniques. That, or they must teach nursing students how to transfer as a group. It never fails. A difficult transfer that I can do by myself will take an average of three nurses to complete in my absence. There is nothing like seeing a group of people grabbing on to someone while lifting to send chills down my spine.

It's always safer to get in close to the patient when transferring. The more people involved, the harder this will become. This also means whatever group strength might be available is dissipated by the increased reach. I'm able to transfer people twice my size by myself. I've seen two nurses who are twice my size unable to transfer one person who is my size. Naturally they get more people.

The only people I have trouble transferring are those more than eight inches taller than I am. I simply lack adequate level arms to move them. I end up getting a second person who is tall enough to manage the patient. It's all in controlling the center of gravity.

The more people involved, the more likely it is to get into each other's way. People trip over each other. Hands slide off because the grip wasn't great to begin with. Because everyone is grabbing on, no one can get in front and block knees or stabilize the trunk. All it takes is for one person to slip or lose a grip and the patient will go down. The situation becomes more complicated because now the patient has to be gotten off the floor.

I had that very situation a few years ago when I worked in an LTAC. Five or six nurses tried to transfer a 500-plus pound patient. She ended up on the floor. That's when they called me. It took four of us, none of whom were the original nurses, five minutes to get her off the floor and back into bed. We used the bariatric sling lift, which was parked in the hall outside the door to her room. All I had to do was supervise getting the sling under her and strategically position people to guide her to the bed. The lift did the rest.

2 comments

Toni,

Excellent topic.  More is not always better.

The PT and nursing schools mentioned by Erik are to be commended, not only for the cross training but for the early indoctrination into a team mentality.

I didn't learn my best transfer techniques in school.  I learned them on one of my student affiliations:  Cardinal Hill Hospital, a spinal cord injury rehab facility.  Makes sense that therapists who spend their days with patients who have little to no use of their legs and/or arms would know the best transfer techniques.  My CI was incredible, and like Toni, I learned how to transfer patients 2+ times my weight.  

Janey Goude October 25, 2011 9:15 PM

When I was in PT school, once we had finished learning transfers ourselves, the local first year nursing students came to campus and we taught them proper techniques.  In return, later they taught us about hospital rooms, equipment, etc.  Seemed to be a very good cross discipline opportunity to avoid the issues that you mention.

Erik Waterland, PT - DPT, Out patient October 25, 2011 3:59 PM

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