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Joseph Handy
medicine forum beginner
Joined: 25 Jun 2006
Posts: 2
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 Posted: Sun Jun 25, 2006 4:39 pm Post subject:
transferring the non-weight bearing patient
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I have a question regarding transferring the non-weight bearing patient. If
a patient is non weight bearing to one foot what is the proper means of
transfering him from bed to chair?
Thanks
JH |
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Starlight
medicine forum Guru Wannabe
Joined: 30 Apr 2005
Posts: 186
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| Posted: Sun Jun 25, 2006 4:52 pm Post subject:
Re: transferring the non-weight bearing patient
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On Sun, 25 Jun 2006 12:39:48 -0400, "Joseph Handy"
<claypot@localnet.com> posted:
| Quote: | I have a question regarding transferring the non-weight bearing patient. If
a patient is non weight bearing to one foot what is the proper means of
transfering him from bed to chair?
Thanks
JH
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Non-weight bearing to one foot means he can use the other foot? Are
you referring to a wheelchair, or a chair across the room? |
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Mortimer Schnerd, RN
medicine forum Guru Wannabe
Joined: 09 May 2005
Posts: 208
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| Posted: Mon Jun 26, 2006 8:59 am Post subject:
Re: transferring the non-weight bearing patient
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Joseph Handy wrote:
| Quote: | I have a question regarding transferring the non-weight bearing patient. If
a patient is non weight bearing to one foot what is the proper means of
transfering him from bed to chair?
|
It varies with the situation. A young stout fellow could get up one his strong
leg and kind of hop to the chair with someone there to balance him. Somebody
who's balance is more suspect ideally would be stood up at the bedside with a
walker to help support him while he once again put all his weight on his strong
leg alternating with taking all the weight with his arms while he takes a step.
People with no upper body strength usually require more direct intervention:
you stand directly in front of them and block their feet with yours. They
should reach up with their hands draped over your shoulders (not around your
neck) while you have them lean forward from the edge of the bed. Your knees go
against their knees. You reach around them and together you stand them up...
with any luck they'll take some weight on their strong leg but they don't
always. You swing as a unit and pivot to the side so their legs bump up against
the chair, then you let them down.
I probably didn't describe the max lift well but what you really need is to have
a physical therapist demonstrate it.
FWIW, when I had an acetabular fracture I used to walk on one foot with no
walker... no help of any kind. I'd pivot between the ball and the heel of my
good foot. I could go backwards or I could turn in one diraction. Maneuvering
in the other direction involved a 270 degree turn in the wrong direction until
I was headed where I needed to go. All things were possible.... but I was a
relatively young stout guy with an independent streak and excellent balance. I
never fell, I never put more than touchdown weight on my right leg, and i never
needed help getting to the bathroom down the hall in the middle of the night. I
don't teach this technique to patients because while I trusted my balance, I
don't trust theirs.
--
Mortimer Schnerd, RN
mschnerd@carolina.rr.com.REMOVE |
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satin90250
medicine forum beginner
Joined: 24 Feb 2006
Posts: 8
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| Posted: Mon Jun 26, 2006 10:23 am Post subject:
Re: transferring the non-weight bearing patient
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You have all missed the boat. The PROPER way to solve this nursing
problem is with a GAIT or TRANSFER belt around the patient. Transfer
toward the strong side.
Consult a Physical Therapist for more details about a "stand-pivot
transfer".
jaj
On Mon, 26 Jun 2006 08:59:30 GMT, "Mortimer Schnerd, RN"
<mortschnerd@carolina.rr.com.REMOVE> wrote:
| Quote: | Joseph Handy wrote:
I have a question regarding transferring the non-weight bearing patient. If
a patient is non weight bearing to one foot what is the proper means of
transfering him from bed to chair?
It varies with the situation. A young stout fellow could get up one his strong
leg and kind of hop to the chair with someone there to balance him. Somebody
who's balance is more suspect ideally would be stood up at the bedside with a
walker to help support him while he once again put all his weight on his strong
leg alternating with taking all the weight with his arms while he takes a step.
People with no upper body strength usually require more direct intervention:
you stand directly in front of them and block their feet with yours. They
should reach up with their hands draped over your shoulders (not around your
neck) while you have them lean forward from the edge of the bed. Your knees go
against their knees. You reach around them and together you stand them up...
with any luck they'll take some weight on their strong leg but they don't
always. You swing as a unit and pivot to the side so their legs bump up against
the chair, then you let them down.
I probably didn't describe the max lift well but what you really need is to have
a physical therapist demonstrate it.
FWIW, when I had an acetabular fracture I used to walk on one foot with no
walker... no help of any kind. I'd pivot between the ball and the heel of my
good foot. I could go backwards or I could turn in one diraction. Maneuvering
in the other direction involved a 270 degree turn in the wrong direction until
I was headed where I needed to go. All things were possible.... but I was a
relatively young stout guy with an independent streak and excellent balance. I
never fell, I never put more than touchdown weight on my right leg, and i never
needed help getting to the bathroom down the hall in the middle of the night. I
don't teach this technique to patients because while I trusted my balance, I
don't trust theirs. |
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Starlight
medicine forum Guru Wannabe
Joined: 30 Apr 2005
Posts: 186
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| Posted: Mon Jun 26, 2006 12:27 pm Post subject:
Re: transferring the non-weight bearing patient
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On Mon, 26 Jun 2006 06:23:27 -0400, none@none.net posted:
| Quote: | You have all missed the boat. The PROPER way to solve this nursing
problem is with a GAIT or TRANSFER belt around the patient. Transfer
toward the strong side.
Consult a Physical Therapist for more details about a "stand-pivot
transfer".
|
I asked two questions for clarification. How is that "missing the
boat". So if the patient is 80 years old, do you put the gait belt
on and drag them to the chair? The OP asked HOW to transfer;
posting "transfer toward the strong side" doesn't answer the question. |
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Mortimer Schnerd, RN
medicine forum Guru Wannabe
Joined: 09 May 2005
Posts: 208
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| Posted: Mon Jun 26, 2006 2:51 pm Post subject:
Re: transferring the non-weight bearing patient
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none@none.net wrote:
| Quote: | You have all missed the boat. The PROPER way to solve this nursing
problem is with a GAIT or TRANSFER belt around the patient. Transfer
toward the strong side.
|
Oh, yeah... that piece of equipment that every PT carries and to which no RN has
access... at least on any unit I've ever worked. But yes, it definitely makes
it much easier. But do you know the easiest way to transfer a patient?
Tell the NA to do it.
--
Mortimer Schnerd, RN
mschnerd@carolina.rr.com.REMOVE |
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Norminn
medicine forum Guru Wannabe
Joined: 05 May 2005
Posts: 157
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| Posted: Mon Jun 26, 2006 8:53 pm Post subject:
Re: transferring the non-weight bearing patient
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none@none.net wrote:
| Quote: | You have all missed the boat. The PROPER way to solve this nursing
problem is with a GAIT or TRANSFER belt around the patient. Transfer
toward the strong side.
Consult a Physical Therapist for more details about a "stand-pivot
transfer".
jaj
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If it is a nursing problem, we don't call the PT  )
Gait belts were not yet invented when I learned to stand-pivot patients
from bed to chair. PT's did real physical therapy then. Never hurt a
patient or myself in moving them about. |
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Joseph Handy
medicine forum beginner
Joined: 25 Jun 2006
Posts: 2
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| Posted: Tue Jun 27, 2006 1:22 am Post subject:
Re: transferring the non-weight bearing patient
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Thanks for the responses.
Allow me to clarify the question by providing more details.
The patient in question was approximately 80y/o with a hx of dm and
parkinson's disease. He was admitted with a non healing wound to his left
foot which no longer had any toes. He had been immobile and on bedrest for
at least five weeks prior to my having him as a patient.
When getting him oob to a barco what would be the proper placement of the
barco. The way I did it was sit him up on (his) left side of the bed, with
the barco at the foot of the bed, facing the head of the bed. I used
another person to assist with the transfer. Both of us stood in front of
him to prevent him from falling.
While this did safely get him from the bed to the chair, it also caused his
wound to bleed a small amount, just enough to soak through the dressing.
This was the method that had been used previously by other staff and the
bleeding wound was a chronic problem following transefers.
Was this the best way of doing it? Could the bleeding have been prevented?
"Norminn" <norminn@earthlink.net> wrote in message
news:ePXng.12871$o4.5702@newsread2.news.pas.earthlink.net...
| Quote: | none@none.net wrote:
You have all missed the boat. The PROPER way to solve this nursing
problem is with a GAIT or TRANSFER belt around the patient. Transfer
toward the strong side.
Consult a Physical Therapist for more details about a "stand-pivot
transfer".
jaj
If it is a nursing problem, we don't call the PT )
Gait belts were not yet invented when I learned to stand-pivot patients
from bed to chair. PT's did real physical therapy then. Never hurt a
patient or myself in moving them about. |
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Mortimer Schnerd, RN
medicine forum Guru Wannabe
Joined: 09 May 2005
Posts: 208
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| Posted: Tue Jun 27, 2006 1:50 am Post subject:
Re: transferring the non-weight bearing patient
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Joseph Handy wrote:
| Quote: | When getting him oob to a barco what would be the proper placement of the
barco. The way I did it was sit him up on (his) left side of the bed, with
the barco at the foot of the bed, facing the head of the bed. I used
another person to assist with the transfer. Both of us stood in front of
him to prevent him from falling.
|
Not to come across as a complete moron, but what's a barco? Don't they make
uniforms?
Are you referring to some sort of lift? (Like a Hoyer?) Or a recliner?
(Barclay?)
--
Mortimer Schnerd, RN
mschnerd@carolina.rr.com.REMOVE |
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Starlight
medicine forum Guru Wannabe
Joined: 30 Apr 2005
Posts: 186
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| Posted: Tue Jun 27, 2006 2:29 am Post subject:
Re: transferring the non-weight bearing patient
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On Mon, 26 Jun 2006 21:22:37 -0400, "Joseph Handy"
<claypot@localnet.com> posted:
| Quote: | Thanks for the responses.
Allow me to clarify the question by providing more details.
The patient in question was approximately 80y/o with a hx of dm and
parkinson's disease. He was admitted with a non healing wound to his left
foot which no longer had any toes. He had been immobile and on bedrest for
at least five weeks prior to my having him as a patient.
When getting him oob to a barco what would be the proper placement of the
barco. The way I did it was sit him up on (his) left side of the bed, with
the barco at the foot of the bed, facing the head of the bed. I used
another person to assist with the transfer. Both of us stood in front of
him to prevent him from falling.
While this did safely get him from the bed to the chair, it also caused his
wound to bleed a small amount, just enough to soak through the dressing.
This was the method that had been used previously by other staff and the
bleeding wound was a chronic problem following transefers.
Was this the best way of doing it? Could the bleeding have been prevented?
|
How about a transfer board? Place the side of the chair next to his
bed, slide him onto the chair, using a gait belt and the board.
Or, place the chair next to his bed, side of the chair along the side
of the bed, have him put his arms on your shoulders or upper arms, you
grab the gait belt to stand him up on his good foot, pivot him into
the chair.
If he has a non-healing wound because of the transfers, use a Hoyer
lift. All these methods can be done with one person.
Becky |
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Norminn
medicine forum Guru Wannabe
Joined: 05 May 2005
Posts: 157
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| Posted: Tue Jun 27, 2006 11:03 am Post subject:
Re: transferring the non-weight bearing patient
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clipped
| Quote: |
Was this the best way of doing it? Could the bleeding have been prevented?
A good sign - first time in 5 weeks anyone decided to promote improving |
the poor guy's circulation. Did he leave any toes under the sheet, or
bring all with him? |
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