Describe how a CNA can assist in the rehabilitation process for a patient recovering from a fracture, focusing on the importance of proper body mechanics and encouraging active participation.
A Certified Nursing Assistant (CNA) plays a crucial role in assisting with the rehabilitation process for a patient recovering from a fracture. This support involves not only providing physical assistance but also encouraging active patient participation while always prioritizing proper body mechanics to ensure the safety of both the patient and the CNA. The rehabilitation process is designed to restore function, strength, mobility, and independence after the injury, and the CNA's support is an integral component of this process.
Firstly, assist with mobility as directed by the physical therapist or physician. This may include helping the patient with ambulation, transfers, or range-of-motion exercises. If the patient is using assistive devices such as crutches, a walker, or a cane, ensure they are using them correctly and safely. Provide guidance and support as needed, but allow the patient to participate actively in the process. For example, if a patient is learning to walk with a walker after a leg fracture, guide them on how to use the walker safely, making sure they are putting minimal weight on the affected leg if that is what is indicated in their orders. Provide clear, step-by-step instructions and offer encouragement and support throughout the process. Never force a patient to perform an activity that is too difficult or painful for them.
When assisting with transfers, such as moving a patient from the bed to a chair, or from a chair to the toilet, prioritize proper body mechanics to prevent injuries to both yourself and the patient. Keep your back straight, bend at your knees, and use your leg muscles rather than your back muscles to lift and support the patient. Use assistive devices, such as a gait belt, slide boards, or mechanical lifts, whenever necessary and ensure you are trained to use them. For example, when transferring a patient from the bed to a chair, position yourself close to the patient, use a gait belt to support the patient, bend at the knees, and lift with your legs, not your back. Always communicate with the patient, and count to three, to synchronize the transfer, and make it easier and safer.
Assist patients with range-of-motion exercises as prescribed by the physical therapist. These exercises help to prevent stiffness and contractures. The range of motion exercises may be active, where the patient performs the exercises themselves, or they may be passive, where the CNA assists the patient through the exercises. Perform the exercises slowly and gently, paying attention to the patient's comfort and avoiding overexertion. Encourage the patient to participate in the exercises as much as they are able. For example, if the physical therapist has assigned passive exercises for the patient, gently move the patient's joints, ensuring they do not have any pain, and only move the joints within the limits of comfort. If active exercises have been assigned, encourage the patient to do them on their own, or guide them through the exercises, offering encouragement.
Encourage the patient to participate actively in all aspects of their care. Encourage them to perform activities of daily living independently, as much as they are able to do so. Offer support and encouragement, but do not take over completely, unless it is necessary to ensure their safety. Allow patients to perform tasks by themselves, even if they can only do so slowly, or partially. For example, if the patient is able to brush their own teeth, allow them to do so, only offering support if it is needed. Always promote patient independence, and provide positive reinforcement.
Be aware of the patient’s pain level, and ensure that pain is well controlled. If they have pain with activities, communicate with the nurse or physical therapist so appropriate pain medication, or pain management techniques can be implemented. Ensure that the patient is always as comfortable as possible, and that they are not over-exerting themselves. If the patient is reporting pain, or appears to be having difficulty with their activities, you must stop the activity immediately. For example, if a patient is experiencing pain during a range of motion exercise, stop immediately and report this to the nurse and the physical therapist. Do not continue the activity if the patient is experiencing pain.
Always provide positive reinforcement and encourage the patient throughout their rehabilitation journey. Acknowledge their progress and effort, no matter how small, and provide reassurance and encouragement. Use encouraging words such as "You are doing great!", or "I see how much you are improving", or "I know this is difficult, but you are doing a great job!" This can help boost their confidence and motivation to continue the rehabilitation process. A positive and supportive attitude from the CNA can contribute to the patients success.
Be an active member of the healthcare team and communicate with other staff, including the nurses, physical therapist, and physician regarding the patient’s progress and any concerns you may have. Document the patient’s activities, their responses, and their progress. Note if they were cooperative or refused to participate in some activities. Use objective terminology, and be as detailed and accurate as possible. For example, if you notice a change in the patient’s ability to ambulate, or perform range of motion, report this to the nurse and physical therapist immediately. If a patient is refusing to participate in certain activities, communicate this as well, so that the team can help the patient.
Ensure the environment is safe to prevent falls and further injuries, and to facilitate the rehabilitation process. Remove any clutter, obstacles, or loose rugs from the patient’s room or any other area where they may be walking or moving around. Be sure the area is well lit, and that the patient is wearing proper footwear, such as non-skid socks, or supportive shoes. Be sure all equipment is in good working condition, and properly positioned and stored. For example, make sure the hallways and the patient's room are free of any clutter, and that the patient is always wearing proper supportive footwear when they are out of bed.
In summary, a CNA assists in the rehabilitation process for a patient recovering from a fracture by providing support with mobility and transfers, assisting with range-of-motion exercises, encouraging active patient participation, prioritizing proper body mechanics, providing positive reinforcement, documenting and reporting on progress, and ensuring a safe environment. By utilizing all of these skills, the CNA becomes a crucial partner in helping patients regain their mobility and achieve optimal recovery and independence after a fracture.