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Toni Talks about PT Today

‘I Can't Help, My Back Hurts'

Published March 19, 2013 11:03 AM by Toni Patt
This morning there was a patient on the floor so the request went out for lifting help. Four people responded, including me, a PTA, a male CNA and the patient's nurse. The patient was a big man, weak and in a narrow space so it wasn't going to be easy. As we were positioning ourselves to lift him the nurse stepped away. She said she didn't lift because she had hurt her back and didn't want to be out of work again. The three of us got him into the chair none the worse for the experience.

When the nurse said she didn't lift because she hurt her back, I had to fight the urge to ask her what she was doing at work if she couldn't perform her duties. This is an SNF. Lifting is an everyday part of the job description. If she wasn't able to assist with moving patients, she wasn't performing a regular job duty. In this case, that meant three people were at greater risk of an injury because the necessary fourth person wouldn't assist.

I've lost count of the times I've heard that excuse from someone. Usually it's a nurse, not a CNA, who you would expect it from. Once in a while, PT techs have been unable to lift, but in my experience they try anyway. I don't think I've ever heard a PT or OT say they couldn't lift.

What is the problem with nursing? Is that something they're taught in school? There's always some friction between rehab and nursing about who is responsible for lifting. I worked in one hospital where PTs were considered a lifting service. Not only would nursing not help, they wouldn't stay in the room. Lifting heavy people is so much easier with more staff.

I don't doubt this nurse had a back problem. If she had a lifting restriction, she should have been on light duty or not been working. I don't understand how this is acceptable for one group of employees and not another. This wasn't an instance of being sore from a specific activity with recovery in a few days. This nurse stated she didn't lift at all.

I wonder what would happen if I did that. I don't think it would last very long. Even if no one questioned me, I wouldn't be able to work because my patients would stay in bed.

2 comments

We have a minimal lift policy which I agree with you that seems to be more favorable to nursing than PT.  As  middle aged PT I do rely on equipment.  In this case if your facility had friction reducing materials they could have been placed under the pt and used to help slide him to a larger space so that you could utilize the lift equipment to help him get up.  The equipment does work well and I am hoping PT's will start considering it as an adjunct to treatment options just like anything else.

Kelley March 19, 2013 8:12 PM

I was involved with research that dealt with work-related injuries in PTs and OTs.  When compared to Nursing, PTs and OTs were way behind in recognizing that lifting a patient might be bad.  Research has shown that PTs and OTs forego their own health when it comes to moving or lifting a patient.  They would "save" the patient, even if they were in pain or were injured, putting the needs of the patient before their own.

Some facilities now have a "no-lift" policy and use equipment to transfer patients from the floor to a bed or chair...  

Physical therapists should recognize that when transferring a patient who weighs over 100lbs, they are at risk of injuring themselves.  Fed Ex and UPS have regulations on how much they are allowed to lift, why is it so different for our profession?

Even if you interject that 'using proper bodymechanics' will protect your back or body from these transfers, the research has shown that even with proper body mechanics, there still is enough sheer force on the spine to create problems.

So I wouldn't get so down on the nursing staff, sure they didn't want to 'do their job' but I think the nurse was the smart one.

Paul March 19, 2013 1:12 PM
NJ

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