Lifts & Transfers

Keeping your back healthy is very important. We all know this. And yet, at every long term care facility I have worked at, I have seen aides cheat the systems and policies and rules when it comes to LIFTING. Aides will lift heavy residents by themselves; they will also refuse to use mechanical lifts designed to save our backs.

Mechanical Lift Cheating
Most aides will cite time as a major factor when it comes to using the mechanical lifts (ML). Time involved with seeking assistance, as most facilities require two people attend a ML transfer; and time involved with setting the resident up for the transfer. The placement of the lift pad, attaching it to the machine, operating the machine…the positioning of the resident into the wheelchair or bed; removal of pad…the process takes about 4 to 5 minutes. Whereas a two person lift takes about a minute at most.

I’ve asked aides how they manage to perform these lifts, on really heavy or otherwise unsafe residents. They tell me they feel confident with their strength and ability to do the lifts. They are sneaky about it too: Many an aide will go to the trouble of getting the ML and bringing it to the room. But it just sits there, unused. The only time they will use the machine is for the extremely overweight resident, or for a resident who is with it and KNOWS they are not to be lifted/transfered by staff. Even with this, the resident sometimes insists upon being lifted as it is faster. And some residents will badger the unsure aides into lifting them.

Staff Assisted Lifts/Transfers
As for two person “human lifts”, aides will not bother getting help. They do the transfers alone, placing themselves and their residents at risk. Again, the aides have a level of confidence in themselves to do this. The aides don’t consider that these movements might hurt the resident, might be rough or terrifying. And they don’t seem to understand that a few months of doing this will result in soreness and back, shoulder and knee pain. I know aides who’ve been doing this work for years who have bad backs, who are forever complaining about being in pain…who gimp and limp around all shift…who speak of being on different pain meds all the time…it’s no wonder!

Once a facility has enough aides who prefer to transfer residents the wrong ways, it’s very difficult for newer aides to turn this around. The newer aides feel compelled to work on their own. They have asked for help but have gotten nasty looks, rolled eyes and heavy “sighs”, along with comments such as “I do this by myself!” To the defense of the old timers, they probably got stuck one time too many waiting for someone to come help them. In the nursing home environment, time is everything. Once you get behind, you cannot catch up unless you cheat. And that means cheating residents out of the care they deserve.

Fixing the Problem
How to fix this? Should management be concerned? Is management even aware of these practices occurring? Good questions and only each facility can answer. Of course the leadership should be concerned. After all, the worker comp costs are in direct line with staff compliance on lifting policies.

Should punitive steps be taken towards non compliant staff? Speaking as an aide, I say YES. Because the non compliant aide is a virus- and viruses spread. In my experience, aides who are non compliant in this area are non compliant in many areas.

Having said that, I also believe facilities should have a hard look at their policies and promotion of teamwork vs. being task and time driven. If more value is placed upon the timing, then facilities are just asking for the aides to do whatever they can to survive- up to and including cheating. If value is placed upon teamwork and healthy body mechanics, the aides relax a little and are much more apt to be compliant.

If you’re an aide who does cheat, remember you only have one back. Remember too, your shoulders and knees will only put up with so much of these bad lifting habits. It will catch up with you. If it’s in the residents’ care plans that they are to be transfered via a ML or with two staff, you are breaking rules and could lose your certification over this. Especially if you document the transfers were performed as care planned: You’re participating in fraud if you sign it off as done. And if you get hurt, how will you explain it? Worker comp claims are often denied when they find out (and they do investigate) you did an illegal lift.

Is it worth being out of work with an injury, with no pay coming in? Consider your reputation as well…you will probably be fired for not following policy and this will follow you in your future employment opportunities. And remember this: You’re teaching the next generation of CNA’s some pretty poor work ethics- and worse, you’re planting the seeds of a painful future for another person (the new aide)…and keeping this cycle alive and well.

New aides can set the standard, as can aides with more experience who decide to change their attitudes on these things. Do it right! Save your body. And think of the resident’s safety! Use the proper lifting guild lines for each resident…if a ML is called for, USE IT. Get your resident all ready for the transfer BEFORE getting help- remember your co workers time is valuable. Don’t waste it. Work efficiently and with purpose. Make teamwork as simple as possible.