Post-it Sunday 9/18/22- When the lift is just that good

The gown card reads ‘when the patient lift is so good it sets off the bed alarm’.

This actually happened last week and made me laugh.

This happened when I was being the second PACU nurse which I do as part of my new job role. If there isn’t another case, I stay in recovery with the patient and the primary PACU nurse, just in case there is a problem. Safety in numbers.

The patient had woken up and was in the PACU. Since they were being admitted to the hospital overnight, we placed them on a hospital bed after surgery, not a gurney. They had woken up a bit antsy and had squirmed their way down the bed.

As a result, their oxygen saturation wasn’t ideal. And they were uncomfortable. This is because they were so far down the bed that instead of bending at the waist when the head of the bed was raised, they were bending in the middle of their chest. This is uncomfortable. And some people even wiggle down further so that the bend is at their shoulders and neck. It isn’t ideal.

Well, this patient was bending uncomfortably in the middle of their chest. This does not allow for optimal lung expansion, and their oxygen saturation becomes compromised. Sometimes this can lead to air hunger, or the decreased oxygen saturation can affect their mentation. The best thing to do is to lift the patient bodily in bed so that they are no longer bending in the middle of their chest and their lungs have room to expand and contract and they can breathe better.

This particular patient, while not small, had wiggled their way down and was in the situation. The real PACU nurse and I decided to lift them in bed leading to better gas exchange and a more comfortable patient. The head of the bed was lowered and the PACU nurse and I lowered the top head rails and grasped the sides of the lifting sheet. We reassured the patient that the head of their bed would not be down long and instructed them to bend up their knees and push on the count of three.

One

Two

Three

The PACU nurse and I tightened our grasp, lifted the patient slightly, and pulled toward the head of the bed. This is all one motion. The patient pushed up at the same time.

And the patient got pulled up to the head of the bed.

Up went the side rails. Up went the head of the bed. Up went the knees of the bed as a speed bump to help them not slide down again. Covers were pulled taut again. A successful lift.

We were so successful that the bed alarm went off, thinking that the patient was trying to get out of bed. Even the though the patient had not left the bed.

A bed alarm is necessary, and it alarms when there is a pressure change on the mattress. This is a safety feature that notifies the staff on the unit that the patient was getting out of bed. We don’t want patients to get out of bed without permission. This can lead to a patient falling.

The patient had not left the bed, but the alarm was still going off. This lift was that smooth.

I had to make a note on a gown card, knowing that I would make it a Sunday Post-it post. When things work in healthcare, it can be a thing of beauty.