(Names and identifying details have been changed to protect the privacy of individuals). “A Hoyer Lift is a transfer device composed of a soft, reinforced sling and a small, portable crane that works like an auto mechanic’s engine hoist. In fact, when R.R. Stratton applied for a U.S. patent (#2706120) for the first one in 1955, the patent application specifically referred to it as ‘an automotive engine hoist.’” ***
A hoyer lift with a six hundred pound woman in it tipped over, trapping a nurse aide against the wall at a nursing home. How did this happen? I had transferred Mary, the six hundred pound woman, from the couch to the bed many times without incident. The first step was counterintuitive. We had to move the couch with Mary in it. The couch probably weighed around two hundred pounds on its own. Together with the resident, that’s eight hundred pounds of weight. Surely one can’t push nearly half a ton across the floor, right? But we could. I could even move it a few inches by myself. And with two people, there we were, sliding eight hundred pounds several feet on the linoleum. Moving the couch against the wall made room for the hoyer lift, a human-sized, crane-like machine that we would use to hoist Mary into the air. The contraption reminded me of a toy claw machine at a chain restaurant or a supermarket -- only, in this case, instead of scooping up a fluffy, green alien, we were ensnaring an obese resident. If we positioned the device correctly, facing the window, all we had to do was rotate it and drop Mary in the bed. Since we were clever, she’d already be positioned the right way, with her head at the pillow and feet at the bottom of the bed. If we did it backwards, we’d have to spin Mary midair, jeopardizing the whole effort. The spinning would make the hoyer wobble and wobbling could take it down. I pushed it slow. I pushed it straight. When I had to turn, I did it with great care, aware that any shift in her weight could topple the lift. If done properly, the entire process took about five minutes. If not, it could take up to fifteen or twenty, and cause lots of stress for both the resident and the staff. So, how did the lift tip over and trap an aide? They said there were five people in the room: four aides and one nurse. We usually only needed three. There was really no reason for five people to be in the room in the first place. One or two of them would only get in the way. I assumed there was lots of talking, almost like a transfer party. Mary said the aides were goofing off and dancing around. It’s hard to imagine someone dancing while operating a hoyer lift. What were they doing? Twerking to a music video? I pictured a girl shaking her ass while Mary shook in the sling. “I like fun as much as the next person does,” Mary said. “But there’s a time for horseplay and a time for work and when I’m swinging around in the air, it’s not time to play.” I confronted one of the aides with this information. “We were not playing around,” she said. She looked serious. She looked upset by the thought of it. I believed her, I think. Maybe the truth was somewhere in between. Maybe they weren’t goofing off per se, but maybe they weren’t as focused as they should have been. Something must have happened. The next day, everybody in the building was talking about it: “A six hundred pound woman like a wrecking ball, knocking an aide into the wall.” “Can you imagine?” “Who was there?” “Did they get into trouble?” “What’s going to happen now?” “Can we get Mary out of bed again?” They said Mary’s body sandwiched the aide by the bathroom door. I put myself in that moment. I’m claustrophobic and I probably would have panicked. It reminded me of the time I was at a Penn State football game and they had closed the gates temporarily due to a rain delay. I couldn’t see the end of the crowd in front of or behind me. I had nowhere to go. I couldn’t move. My nose almost touched a lady’s ear. I was shoulder to shoulder with a big man with a big, red beard. I could smell him. It felt like a nightmare. Deep breaths. I took deep breaths and closed my eyes. I thought of those Radiohead lyrics inspired by something Michael Stipe once said to Thom Yorke about fame. Yorke had asked Stipe what he does to deal with the pressures of celebrity. He responded, “I think, ‘I’m not here. This isn’t happening.’” Did she feel like that? She, too, was trapped by a body. They said she was only caught for a few seconds before they were able to pull her out and safely lower Mary to the ground. Two other aides were injured as well. One had a sprained wrist and the other, a twisted ankle. They filed it as an “incident.” There was lots of paperwork. The aides received cards from the insurance company for any doctor visits. I wasn’t aware of any changes in protocol or of any write-ups. I don’t know the conclusion of the investigation. All I know is that the situation is burned in my brain: a six hundred pound woman swinging in the air, the aides chatting and laughing. What are they laughing at? Whether it happened or not, the girl shaking her ass is there. Even though it was 2019, I pictured Miley Cyrus’s “Wrecking Ball” video on the TV. There she swings, naked, breaking through the wall as Mary swings one more time, a little too much, and the big crane, originally invented to hoist an engine out of a car, crashes down. “If you were there, it wouldn’t have happened,” Mary said. “You guys know what you’re doing.” Maybe she was right. Maybe not. Despite my best efforts, sometimes I am easily distracted. Maybe I, too, would have been distracted by the shaking ass. Maybe there was no shaking ass. Maybe Mary simply heard some laughter and in the trauma of the moment, her mind exploded that into a party, into goofing off, into a whole scene that didn’t exist. An aide might have merely said something funny. That could’ve been the whole of the shenanigans. Mary did tend to exaggerate. And she liked to get people in trouble. It made her feel powerful, important. “I have the authority to have you stripped of your badge.” She liked that. But laughter and the collapse of the lift were enough to set her mind off and running. Mine, too.
*** EMS Providers Should Consider the Benefits of Lifts, Thom Dick, published in JEMS, the Journal of Emergency Medical Services.