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patient in a side lying position. This is done by the nurse placing one hand on

the client’s hips and one hand on the client’s shoulder. The nurse then

transfers their weight onto the back foot while at the same time rolling the

client towards them. The next step is the nurse places one arm underneath the

patient’s shoulders and one arm underneath the knees. The nurse then turns on

the balls of the feet while at the same time pulling the client’s legs down on

the floor.

The next move is transferring a client from the bed to a chair. Once the client

is sitting on the edge of the bed, the nurse can easily move the patient to a

chair. This procedure therefore follows on from the procedure of sitting a

client up in bed. This can be done by the use of a “transfer belt” (Kozier 1995

p.924). Before commencing the lift, the nurse must have the wheelchair ready

and parallel to the bed. The nurse must make sure the client’s feet are placed

flat on the floor with one foot slightly in front of the other. The nurse then

places the belt around the client’s waist. The nurse stands facing the client

with their arms around the client’s waist, holding onto the belt. The nurse

asks the patient to assist by transferring the weight onto the front foot on the

count of three, while at the same time, the nurse transfers their weight onto

the back foot, lifting the client up to a standing position. The nurse supports

the client until they are balanced when standing. The nurse and client, when

ready, pivot in the direction of the chair. The client then holds the arms of

the chair as a means of support and to assist when lowering into the chair. The

nurse then lowers the client into the chair, bending at the knees. The transfer

belt is then removed when the nurse has assessed that the client is comfortable

and secure in the chair. The nurse should also ensure the client has suffered

no ill-effects as a result of the move.

When the transfer belt is not available, Kozier (1995 p.925), recommends that

the nurse puts both hands at the sides of the patient’s chest and continue the

procedure in the same way.

When transferring the patient from the chair to the bed, the same procedure is

implemented but in reverse. However, the transfer is started, the nurse should

ensure that the bed is clean and dry. The client is then moved from the chair

to the bed and then assisted to a lying down position.

Manually lifting patients is effective, however, when able, the nurse should

lift or transfer with a mechanical lifter. These are especially effective in

reducing the risk of injury. This is supported by Seymour (1995 p.48) who says

that,

“more nurses are beginning to realise the equipment’s potential for protecting

both client and carer from injury.”

When using these devices, the nurse should tell the patient what is being done

and how it is being done. Mechanical lifters either have two slings, one sling

for underneath the shoulders and one for underneath the thighs or buttocks.

Other lifters have an all in one sling which extends from the client’s upper

back to lower thighs. The lifters substantially reduce the strain on the nurse

and the patient and are able to be used for all transfers. The nurse places the

sling underneath the patient and attaches the slings to the lifter with hooks,

and the nurse then controls the lifter for the desired action.

When using a mechanical lifter, some problems which may arise include the lifter

being broken or unavailable. The nurse should therefore be aware of how to

correctly manually lift the client in the event of this occurring. Another

problem with mechanical lifters, according to Scott, (1995 p.106) was that

mechanical devices were,

“often left because staff did not feel confident enough to use them.”

This highlights the fact that all staff need to be taught the correct way that

the lifters are used.

The problem with lifting patients physically, is that nurses are often required

to lift loads greater than they are physically able. This is due to,

“the likely mismatch between the size of a patient to be lifted and the physical

capabilities of the nurses on duty.” (Love 1995, p.38).

This can lead to potential injury for nurse and client.

Another problem with lifting patients manually, is that the correct lifting

procedure may not be carried out. This can lead to patient discomfort, as well

as long term back problems for the carer involved. One problem which may also

arise from incorrect lifting techniques is the development of pressure areas,

due to the patient being dragged and not lifted across the sheets. This

friction can lead to the patient developing reddened skin which may lead to skin

breakdown.

DISCUSSION

By the health care worker implementing the correct lifting techniques, the nurse

and the patient’s safety is not compromised in any way. Nurses should be

constantly aware of any new methods of lifting or transferring which arise, so

they are able to maximise the level of safety for themselves as well as for the

patients. By the nurse using the correct lifting techniques, and not dragging

the patient, the risk of the patient sustaining further injury, such as pressure

areas, is reduced. By communicating with the client, the nurse is also made

aware of any

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