Angel Transfers

Dear All,

I am currently completeing a neuro inpatient clinic on an acute ward. One thing we've had to learn to do thus far is an 'Angel' transfer. For those of you that are unaware - it is a maximal dependent transfer - with students 1 at the front of the patient and one behind controlling the pelvis. It can go to say that the person at the front has a bit more work to do. Anyway, the idea is that you take the patient's weight with them leaning on you, ensure that you've got their weight, and you kind of rock forwards and to the direction you are going in, then unaware to the patient, you transfer them. Nursing staff do not do this transfer due to the 'no lift' policy and this transfer is classified as a lift.

We have been seeing a patient who had a large L MCA infarct on the 6/1/07, and was allowed up on Wednesday. Thursday we took the pt to the gym and were shown the transfer. Our supervisor wanted us to perform it ourselves getting the pt from the plinth back into her chair, and almost unfortunately I was the student in front. This pt would weigh approx 100kg......my weight: approx 55kg. I was quietly anxious regarding transfering such a large pt in this style, however completed the transfer with minimal difficulty, however I felt as though I put in maximal effort.

Then on Friday, I had to transfer the pt from her bed (complete with Nimbus mattress) to her wheelchair. By the end of the week I also had quite considerable DOMS in both my ULs and LLs, not to mention trunk, abs....ok everywhere - I'm the sorest I've ever been, so I was a little anxious to say the least. The pt's room was full of pepole and I didn't want to have to spend a lot of time doing the transfer, and needless to say - the transfer didn't go as well....I almost overshot the wheelchair and pushed my weight too far backwards....so although the pt ended up in her chair....I nearly ended up on the floor! I was quite embarrassed to say the least, and have learnt my lesson in that - when preparing for the transfer to TAKE YOUR TIME and not go until you are really sure you've got the pt exactly where you need them. I was also really worried that the pt had lost confidence with me.....so when we got down to the gym, despite being asked by my supervisor if I would like her to do the transfer, I did another 2 - with no hiccups. BUT I am still quite sore to say the least. So....I have restored my pt's confidence in me (I hope) and my confidence in myself....however I'm wondering when and how you decide that a pt is either too big for your body size and therefore it's unsafe for you to manually transfer them whilst they are completely dependent? I have also been thinking about the culture of physiotherapists....we seem to have this belief that we can manually transfer anyone, no-one is too big for us if we have the correct technique - but is that really true?? What about all of the 'workplace safety policies' - do they not apply to us? AND, if you do decide NOT to manually transfer a pt - do you look incompetent or like you have a lack of confidence to your supervisors?

Mads