Saturday, November 1, 2008

protect your backs

A few days ago my supervisor and I went to see a patient who was day 2 post TKR. She is on a clinical pathway and therefore the aim for day 2 is to walk a few steps and start her knee exercises. However she was in too much pain on day 1 to stand so this was her first time getting OOB. This patient however is quite stubborn and impulsive and also weighs 170kg. After getting the doctors in to convince her to at least try standing up, she did so very reluctantly. However after a few seconds standing up she tried to sit back on the bed without telling us. As a result she nearly missed the bed and we had to really try hard to stop her falling. She's quite a short lady with little legs and therefore couldnt push off the ground to get back on the bed so we had to sort of 'pull/lift' her back on the bed. I was behind her and in charge of her trunk and as a result got quite a sore back. I think it's a tricky situation because obviously you cant let a patient fall and she was in severe pain and trying to get back into bed straight away, however you always have to make sure you protect yourself as well, especially your back. In hindsight we probably should have anticipated her having difficulty getting back into bed and asked the nurse to be around in case we needed a third pair of hands to help just to make sure everyone involved stayed safe.

3 comments:

Jess said...

This kind if situation really highlights the fact that no matter how much you try to do things in a way that is going to protect your back, unanticipated circumstances can make things go pear-shaped. I'm sure we've all been guilty of some bad body mechanics at some point in our training, it's just unfortunate that this kind of lose-lose situation put your back at risk!

Afroman said...

these circumstances are difficult. all we can do is be more prepared and predict when you need more assistance.

Anonymous said...

I have also been in a situtation when transfering a patient and i've tweaked my back. We all know about back protection however sometimes it takes the experience to really cement how important it is. I have since been more concious about good positioning for my back. And it can happen at anytime so good reactions, preparation and a backup plan are necessary.