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It isn't obvious to me why, if your client is happy to use the Hoyer at all, the client wouldn't be better off being transferred to a commode for toileting. Safer, less stressful and less hurried, I'd have thought, no?

Is the problem that you're not comfortable using the hoyer, or that you don't like the idea of setting a bed pan under someone who's still in mid-transfer, or that you don't like the idea of keeping someone suspended in the sling for too long?

It's unconventional, but there's nothing obviously unsafe. How long is the client expecting to be suspended in the sling? That might be an issue.

But if you don't have authorisation to use the Hoyer, or not outside strict guidelines, then just don't do it. Seek advice from your supervisor or agency on how the client's wishes can be met.
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Sweetnurse Oct 2019
Thank you for your response
I am completely comfortable using the hoyer I have been a CNA for 20yrs+ and I have never been in this situation before
The client wants me to hoist her up in the hoyer over the bed and place the commode bucket under her for BM
The reason I don’t want to do it is because she just had her hemorrhoids banded about a month ago
I informed her and her family that I know that this is not proper use of the hoyer and she should not be straining and this is also a dignity issue
To me it doesn’t matter how long she wants to be up there however there are patient rights
so I requested that she sign a liability waiver
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I have used a Hoyer for my husband, and I can say that maneuvering it over a bedpan and trying to keep it still while the person used it would be pretty difficult. You’d have to hold the sling and the person in place. There is a “toileting sling” with a hole in the back. But, if you went to the trouble of getting them into the sling, why not just get them to the toilet in a wheelchair and use the sling to get them on the toilet? Using a bedpan on its own and just slipping it under the person would be much easier.
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Sweetnurse Oct 2019
Thank you for your response
I agree the bed pan is the safest
The client is claiming the hoyer and commode bucket is the easiest for her because it comes out easier for her.
Your correct the toilet sling is for transfer to commode or toilet or to the wheelchair or shower
It is total misuse of the machinery
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Oo crumbs - the haemorrhoid treatment a month ago - was she sent home with any information about how to handle toileting, and for how long she needed to take extra care? I think I'd get advice from her doctor and relay that advice to her. If she's using the pressure on her buttocks from the sling as a kind of lever (!) to help her pass a motion, isn't that a slightly alarming thought?

What's she got against transferring to a commode, so that at least her weight rests partly on her feet for most of the time?
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Sweetnurse Oct 2019
Thank you
Family of course did not tell the doctor about the hoyer use
The main after care instruction was keep bowels soft
I do not do her meds !
yes she is using the sling to make her crapshoot in the commode bucket
The complaint with the commode is it hurts her back
I’ve have been looking for a more comfortable commode
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If she wants to do it and you are ok with it, get at least a letter from her doctor stating that it won't be harmful to her recent surgery and that this method of toileting is medically ok. The release of liability is a good idea too.

Honestly, I can't imagine how this is comfortable for someone to use the commode mid air. I have never had to use a hoyer that way.

If you work for an agency, let them get all the proper documentation in place first.
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