A Family Member Offering to Help With a Transfer
You are a CNA on a rehabilitation unit. Mrs. Patel, age 74, had a right total knee replacement 4 days ago. She is 5 feet 2 inches and weighs 210 lb. She is ordered to bear weight as tolerated with a walker and a gait belt. At 14:00 she needs to go from the bed to the commode. Her son, who is visiting, says, "I'm strong, I'll just lift her under the arms, we do it at home all the time." He steps toward the bed and reaches for her. Mrs. Patel says, "It's fine, he's done it before." The bed is at hip height and the commode is 4 feet away.
1. What do you say and do in the next minute, and why?
Read the worked answer
Stop the lift before it starts, politely and firmly.
- Say it plainly: "Please let me do this part - lifting under the arms can hurt her shoulder and her new knee, and it's not safe for your back either." Give a reason, not just a rule.
- Explain the specific risk. Lifting a 210 lb adult by the arms puts stress through the shoulder girdle and gives no control of the operative knee. It also puts the son at risk of a back injury. The gait belt and the walker are the correct equipment.
- Redirect him to a useful role. He can steady the walker, hold the door, or stand on her other side if the nurse agrees. That keeps him involved without making him the lifting device.
- Do the transfer correctly. Bed at hip height, non-skid footwear, gait belt snug, walker positioned, and a pivot with her instructions to stand and reach. If she cannot manage it, get a second staff member or a mechanical lift per the care plan.
- Do not let "we do it at home" override the plan. Home habits are often exactly how injuries happen.
2. The son becomes annoyed and says, "You're not a nurse, why should I listen to you?" How do you respond, and what do you do if he insists?
Read the worked answer
Stay calm and anchor your answer in the care plan and the resident's safety, not in a status contest.
- Acknowledge and explain scope: "I'm her CNA. Safe transfers are part of my training and her care plan, and I'm responsible for how she gets up while she's here."
- Offer the escalation path: "If you'd like, I can get the nurse to explain the transfer plan." This respects his concern and puts the licensed nurse in the conversation.
- If he still insists: do not physically struggle with him or with the resident. Pause the transfer, keep Mrs. Patel seated safely, and get the charge nurse. A contested transfer is a fall waiting to happen.
- Document the event - the request, your explanation, and the nurse's involvement - and report it.
- The principle: the resident's safety and the care plan outrank a family member's preference, and the CNA's authority comes from training and the plan, not from the title.