Tuesday, July 30, 2019

Bed Scale Blues

It's easier to push a stalled '57 Chevy than a bed scale!
I made the mistake of reading some of my old posts and some of them resemble a distant ping from a satellite knocked out of orbit. Tales from a far away planet where bedside care was the only currency that mattered and what little money there was flowed away from nurse's pockets. It sounds paradoxical, but the more interface I have with "modern" healthcare, the more I miss the old days.

Oh well, Nero's circus must go on so here's my take on vintage behemoths that were part Hoyer lift, part ironing board, and finally part piano mover's dolly with enough free weights to open a gym. Bed scales were the hospital version of battleships, difficult to change direction when in motion, fraught with danger and best left alone.

The illustration above shows an intrepid  young nurse in transit for her mission; to weigh a bedridden patient. The ironing board part of the scale is hinged so it's vertical when in storage or moving  struggling down the hall. It's visible on the right side of the scale just inside the counterweights. After an arduous journey to the bedside, the ironing board like platform was tilted to a horizontal position. The patient is pulled, pushed, or glided onto the awaiting platform. You know, that old count to three and grunt routine.

The platform is elevated like a not so magic carpet by way of a hydraulic Hoyer lift like pump. Now for the fun part -  where the rubber meets the road. The patient is suspended inches above the bed while the nurse turns her attention to balancing the counterweights. A potential  hazard included becoming distracted by the precarious position of the patient and dropping a 20# weight on your foot. Clinic nursing  shoes did not have a safety toe so that's really going to leave a dandy bruise, if you are lucky. The not so fortunate will see the ortho clinic with compound fractures of the metatarsal bones.

One of the great nursing debates involved the question of including peripherals (How about that? I managed to hijack a term from the computer industry.) like Foley bags or surgical drains in the bedside  weight. The free spirit nurse simply tossed the Foley bag or drain apparatus into the mix and included it in the final weight. Dangling Foleys and drains were always at risk for unintended extrication during the transfer or elevation process so I usually left them be and subtracted a pound for the tare at the conclusion of the procedure.

One of my most colorful nursing instructors, Miss Bruiser had a favorite saying, "Work smarter; not harder." Every nurse hated bed scales with a passion and looked for a smarter procedure when it came to patient's weights. In nursing research there are methods for assuring interrater reliability so that results are consistent. Nurses weighing bedridden patients took a lesson from carnival weight guessing hucksters and followed suit. Before the bed scale weight was determined, the nurse took a guess at the patient's weight. When her guestimate came within 5 lbs. or so she became a certified patient weight confabulator. Leave that massive bedside scale in the clean utility room and bring in the certified nurse weigh approximator. These nurse's were also trained experts at clairvoyant counting patient's  respirations.

8 comments:

  1. Yep ~ I hated those things with a passion, too!

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    1. They were, indeed, bad news. The most hated feature as far as I'm concerned was the inertia they collected as you wheeled them along. It was too tough to stop and too easy to plow into someone or something. I treasured the weight guessing nurses who were worth their weight in bed scales.

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  2. I have missed your erudite observations.

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    1. I've been having some daunting problems with old deficits from my demyelinating encephalomyelitis episode decades ago. Before my neuro problems presented, I lived for my job and didn't think about much beyond the tiled temple. That all changed very quickly. Encephalomyelitis was the first problem I encountered that could not be altered by hard work or the force of my will.

      When I was told to seek care in a nursing home, my first response was, "That's not necessary because I'm going back to work." I found an old return to duty statement, altered it a bit and I was back in the nursing business. I lasted all of two months before my disability retirement was mandatory and out of my hands. Luckily, I was too sick to go through that what the heck should I do now dilemma. It took a few years but I gradually recovered to the point where my remaining problems were spasms and cognitive deficits with short term memory problems. I'll start my foolishness with blogging again soon.

      Thanks for missing me and I'm going to have to look that erudite word up.

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  3. I've got a neuropathy of unknown aetiology OFRN so I read your comment above with interest. It hit out of the blue in my forties and I left nursing to work with medical students, but eventually it became so bad I was pensioned off in my mid-fifties. I'd give anything to still be able to do even part-time nursing but any kind of strenuous work sends me into paroxysms of pain...

    It's a bummer but I'm glad you recovered so well and yes do keep up the blogging!

    I am moving soon, leaving the sub-tropics for an area of four seasons and cold snowy winters. Weirdly my condition is worse in humid weather I've discovered. So I'm headed back west of the Blue Mountains in Oz in the next few weeks - but I'll still be following your posts! Cheers from Sue

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    1. Thanks for being such a loyal reader, Sue, you even manage to peruse my comments. I have always lived in a region with 4 discrete seasons. Change is always nice.

      I hope your neuropathy has been stable. I was fortunate that my encephalitis stopped progressing so that, at least, I had a fighting chance.

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    2. It's beautiful here in the warm zone OFRN but yes I've been missing four distinct seasons - I'm just back from getting myself a little place in my old home town and the snow all over the hills was georgeous. I always loved the trees changing in the Autumn too...

      Take care of yourself - as Bette Davis famously said, getting older is not for sissies! Things start to go wrong ... Sue.

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  4. Santamedical Adult Deluxe Aneroid Sphygmomanometer - Professional Blood Pressure Monitor with Adult Black Cuff and Carrying case (Light Black)

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