Week 5 # 1 - the bariatric patient

Today we were referred a 180 kg patient that had a total knee replacement last week, but because of his size hasn't been able to be mobilised properly, but he had no choice but to get out of bed because he needed to go have a lung function test, as he is on BiPAP at night as he gets sleep apnoea, just one of the co-morbidities he has aslong with diabetes and his shotty knees, which could all be controlled if he just lost weight, and if he did that then he might not have needed the knee surgery!!!! Anyway he was very unmotivated to do anything and wanted all of the 3 nurses and us 2 physio it needed to move him, to do it all for him, but that didnt happen! We had to find a special bariatric pulpit frame for him, and use that. After a lot of encouragement we moved him in his bed and managed (using excellent manual handling skills) to get him sitting up on the edge of the bed. It then took all of us to help him to stand, and know i realise how important it is for the leader to know what they are doing and what they want everyone else to do, because if we were to move this patient we all needed to work together and at the same time so everyone was carrying their share of the weight. Once we got him up standing he was relatively good, all though he wanted us to move his legs for him when we walked. This was when my supervisor realised he is probably just really lazy and became very firm with him and just told him what to do and said she wasn't going to help him! Watching this was handy for the nursing staff as well as they were able to watch how to t/f them, and the best way to get him to do stuff. Tomorrow when we treat him i think we will achieve much more if we state that we aren't going to help him and he needs to do it all himself! Its just very frustrating becuase he isnt motivated and he says that all he wants to do when he gets home is go and ly in bed all day....WHATS THE POINT! Later that arvo we saw him moving around in his bed with ease!! lazy bones....