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September 26, 2018

By: Roric P. Hawkins MBA, BSN, RN

Working-out or lifting patients

As I prepare for my evening workout at the gym today, it’s more than likely that I will use weights greater than 35 pounds when performing various exercises. I’m no stranger to the gym (even though I don’t go as much as I should anymore), so my previous training, coupled with years of experience, has taught me how to use good judgment as well as execute proper body mechanics in effort to avoid and reduce the risk of injuring myself. Repetition has allowed me to feel confident that I’ll achieve the benefits associated with working out with barbells and dumbbells without hurting myself in the process. Besides, having lifted weights for over 25 years, I have been fortunate to not ever have sustained a severe injury.

Many of us approach going to work every day with this same level of confidence. We know that most of our patients will certainly weigh more than 35 pounds. Because we have been formally trained and have many years of experience to rely on, we are confident in our abilities to execute good body mechanics to avoid injuring ourselves. Repetition has allowed us to feel confident in the idea that we know what we are doing because to date, we have yet to injure ourselves. However, I would be willing to bet that if you have worked as a caregiver at the bedside for 10 years or more, one (or both) of two things are true: you have sustained a minor injury or you know someone who has been significantly injured while handling patients.

There are some truths behind lifting weights versus lifting people that I believe are worthy of a quick discussion. I tend to believe the following three points are why caregivers are often injured at the bedside.

  1. When we think about the weights we use when working out at the gym, we can predetermine the weights (barbell or dumbbells) in pounds we are physically capable of handling. Because we understand our limitations, these are the weights that we will personally use, nothing more. Unlike going to work or clocking-in for a shift, what we will be required to physically handle or lift in the form of our patients, will all be based on what patients are assigned to us for that day. Regardless of the size or weight of the patient, we are expected to provide consistent consummate care regardless of our physical capabilities to do so.
  2. Unlike most patient care environments, our local fitness centers and weight rooms are highly organized, controlled environments with a variety of options based on our physical skill levels and abilities. Often, there are physical trainers readily available to demonstrate how to perform an exercise properly for the purposes of keeping us safe. Additionally, we are less likely to feel rushed into performing the exercise. In most in-patient, patient care settings, caregivers often work in confined, restricted spaces. The environment usually requires us to work from less than optimal positions. Caregivers often feel rushed being that there are usually three or four other patients assigned to our care. Patient-care settings are only controlled up to a certain point. That point is generally to the extent of the physical abilities of each individual patient, who we know are mostly unpredictable. You can never be 100% sure how much your patient can or cannot assist you in terms of physical mobility. Often, we don’t figure this out until midway through the lifting or assisting event.
  3. Weights, whether barbells or dumbbells, are fixed objects with even weight distribution. This is why performing proper body mechanics when lifting weights is highly effective. Unfortunately, proper body mechanics do not transition into patient care settings very well. Humans are not fixed objects, so core body mechanic lifting principles do little to prevent musculoskeletal injuries resulting from lifting people. Even with additional help or assistance, because human body weight is not evenly distributed, bringing another person doesn’t effectively divide the weight by two. Even if it did, a 300-pound patient divided between two caregivers leaving 150 pounds for each person would greatly exceed the limits of the amount of weight that most of us would dare to lift in a weight-room environment.

When thinking about how we approach preserving our safety when providing patient care, we must be careful not to assume that all lifting logic and techniques can be universally applied to all settings. As mentioned throughout this blog, the way we lift weights for our fitness and health and the way we lift patients within our profession for our livelihoods, lifting methods and processes for fitness cannot be similarly applied as an effective means for maintaining our work safety.

It’s not coincidental that according to the U.S. Bureau of Labor Statistics, nurses are the most injured professionals in the U.S. workforce. The reason is not because nurses who are injured lifting and handling patients are less than prudent caregivers. If we are to change these statistics for the better, we have to embrace the evidenced-based facts that the only way to overcome these injuries in our profession is through the use of mechanical patient-lifts.

Roric P. Hawkins is the founder and president of The RP Hawkins Group (www.therphawkinsgroup.com) and is the safe patient handling coordinator at Michael E. DeBakey VAMC in Houston, TX. The views expressed here are his own.

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