Tuesday, May 29, 2007

Slither

We are called to a nursing home for a lift assist. I have never done a straight lift assist in a nursing home before, so I am a little puzzled. Isn't this something that nursing homes are supposed to do themselves?

The short, squat nurse demands to know why we have brought in our stretcher, monitor, house bag, oxygen and long board. "We don't need the stuff. We just need you to help pick him up. You don't need all that."

"We always bring it," I say.

"Suit yourself. Follow me."

On the way, we walk by a hoyer lift, which I take as a bad sign. It doesn't appear broken.

"He slipped and can't get up," the nurse says pointing in the room. "The guys here don't know how to lift."

My preceptee enters the room first and I hear a voice say, "A girl, they send a little girl?"

I enter the room next. There on the floor is a human blob. Jabba the Hut. I have a hard time making out the flat flabby legs from the flab that emanates from al sides of the patient. He sits upright, his head like the cooked yellow yolk of an egg, with his fat all the white surrounding it.

"Two of you," he says, "Just two of you?"

My other two partners come in the room, nearly running into each other as they stop suddenly at the sight of the patient.

"You guys don't look very big," he says. "You're going to need an army to lift me -- me -- the fat guy -- the humiliated fat guy."

"We should be able to do it," I say.

I have picked up big patients before, patients even heavier than this one, who I am guessing is 500 pounds tops. I have a great method. I slide a board under them, lay them down, and strap them to the board. I have two people -- preferably strong firefighters or cops on each side of the board near the head, facing each other, holding the board under the patient's arms. I have my partner stand in front. I take the end of the board, squat down and lift up, as the two responders pull up on their sides of the board. My partner in the front is there just to help balance the patient as we use the leverage of the board to get the patient to a standing position, from which the patient can either walk or we can slide a giant wheelchair underneath them.

The problem here is the patient's mishapen legs make it impossible for him to stand, so that method is out. Adding to the problem, the patient has numerous open wounds on his legs.

I announce my plan -- get the patient on the board, and then try to lift the board up enough to get the head of the board on the bed, and then we can lift the other end of the board from the feet and swing the patient around onto the bed.

But then the nurse starts telling me how she would do it.

I just look at her until she quiets. "You called us?" I said.

"Yes," she says.

"That's right," I say, "And we have it under control, thank you."

I think I imperceptibly nod toward the door for her to leave.

In the meantime, my partner has radioed dispatch for some first responders to come help, and before I know it the radio is full of units coming out to help. "We need more strength here," my partner said. I don't know if it is the desire to help or curiosity that is bringing them, but it seems everyone wants to come help.

"We'll at least get her on the board and then wait for them to help lift," I say.

It takes awhile, but we get the board under the patient, with much moaning and groaning from the patient, who seems to protest at any touch of his skin. The constant "owws" bring the nurse back into the room. "Why don't you wait for the others to come?" she says. "You've got to be careful with his legs."

This time I definately nod toward the door. "We're just putting him on the board. We've got it."

While the board is too wide to disappear in the patient's bottom crack, the thought does come to my mind. There is more of the patient on either side of the board than there is on the board. We need to link two nine foot straps together to properly secure a strap around the patient's middle.

Our support arrives -- more it seems than can fit into the room. I pick three to help. I have two on each side, one at the feet and I have the head. The patient sits upright on the board. "Don't drop me. I don't want to be dropped."

"We never drop anyone on days that end in 'Y'," one of my partners says.

"That's reassuring," the patient says.

"It'll be okay, trust me," my preceptee says. She had been doing a fine job easing the patient's mind. I think my annoyance with the nurse has scared the patient.

I stay away from my normal routine of 'We won't drop you, not after what happened to the last guy. The last guy? Oh, that's right, we're not supposed to talk about that -- the lawyers, you know.'

"Just don't reach out," I say.

I bend down in the squat position, and start to lift, driving my legs up. Something is wrong. The patient wavers and reaches out frantically. I can feel the board starting to split. "Abort!" I say quickly, and we set the patient down before the board can disintegrate.

"Do you want me to call the fire department?" the nurse says from the door. "That's who we asked for."

I ignore her. She leaves again.

"You're going to have to lay down," I tell the patient. "I know it might be hard for you to breathe, but we need to distribute the weight across the board, and not have it all in the center. And you can't reach out."

"You're going to drop me. I know you're going to drop me. You've never had anyone as fat as me."

I keep my mouth shut.

I reposition everyone. I share the end with another strong EMT. We lift on my count. Up we go and over onto the bed. The force takes me off my feet and onto the bed. I feel the patient slither over me. I at least have some of the board between us and I can pivot it enough to keep from being crushed.

"I squished him," the man says. "Oh, god, this is embarrassing. Is he all right? I squished him."

"I'm fine," I say, my eyes saying to my partners, "Help me out here."

I make it back to my feet. People look at me with astonishment as if I have come out of a collapsed coal mine after they thought there could be no survivors.

"I'm okay, I'm okay," I say.

On the way out, the seated nurse says, "thanks for coming."

I give a little wave and keep on going, headed for the merciful exit.