# 178 Making light of work
"Clean and Jerk" is an Olympic weightlifting style. Jerking the patient from one bed to another is neither acceptable nor harmless. Poor lifting methods may injure both lifters and patient. Never have there been so many lifting aids available. Even with little or no equipment, the transfer to bed should be smooth, and scarcely perceptible by the patient.
In past years, an ambulance crew might transfer the patient with a pole and canvas stretcher, remove the poles from their sleeves and leave the canvas under the patient. Latterly, they might use a breakaway stretcher or a scoop stretcher; either gives a simpler transfer and is disassembled from the patient.
Hospital staff don't do as well as EMS teams, as staffing varies frequently each shift, and there is generally no group practice to be a team. With a higher proportion of female staff and mismatched heights and strength, the load is not well distributed. Most transfers being lateral, from beds alongside each other, the forward lean by staff is greatly damaging to backs. This causes a "get-it-over-and-done-with" mentality that fosters speed over quality. Few career-long bedside nurses escape having musculoskeletal issues.
Awake patients should be given a distracting task ("hold your elbows" or purse), and to "take a deep breath, and blow all the way out." At the end-expiration, the prepared team (with straight arms and straight backs, using their weight to shift the patient) glides the patient over. There is no muscular tension fighting them at end-expiration. With very difficult moves, it is worth a few moments time to rehearse the transfer.
A clinical leader should establish an ethos and expectation of smooth moves, always, in the department. Equipment should be provided in sufficient number, and maintained at hand, so that career-ending and patient-damaging short-cuts need not be taken. All providers and staff need to be trained, and expected to help. There are no degrees or certifications that exempt one from providing assistance. Slackers should be disciplined. Low-friction transfer sheets, mechanical lifts, air-hover devices are all available. A light-hearted team-felt joy in providing an imperceptible lift and transfer should be the order of every day's work.
Trimble, Tom. No "Dr. Benton's" Here, Please! From "Tips & Tricks" in Emergency Nursing World ! [http://ENW.org] © 1998-2016 Tom Trimble, RN.
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