clinical areas. And worse still discredited lifting techniques, including the 'underarm'
lift, continue.
The NMC Code of Professional Conduct requires that nurses act to ".. .promote and
protect the interests and dignity of patients and clients ..." (NMC 2004b clause 2.2). To
avoid being found guilty of professional misconduct a nurse must therefore be sure that
the procedures and practices she or he undertakes are compatible with current best
practice. That is, practices which a body of contemporary professionals would consider
to be consistent with practice based on the best current and generally available evidence.
This does not need to be evidence at the cutting edge (as it were) but it does need to be
practice based on valid conclusions drawn from the best currently and generally
available evidence; conclusions, furthermore, that it would be reasonable for any
competent practitioner to recognise as valid. This together with the professional
requirement for a registered nurse to maintain her or his professional competence and
the moral requirement to protect patients from harm makes it necessary for each
practitioner to identify and abandon any unsafe practices.
Measured thus a nurse who continues to lift rather than manually handle is failing to
practice in a way that is consistent with current best evidence-based practice. While it is
important to retain an open-mind in so far as it is possible that new evidence may
become available to show that current manual handling techniques are not best practice
it is folly to suggest that (under normal circumstances) the current evidence implies
anything other than nurses should manually handle rather than lift.
Closed-mindedness would seem to be a major factor in nurses’ continuing to lift in spite
of overwhelming evidence demonstrating the potential for harm. This can be
categorised as a type 1 risk of harm (the sort of risk that can be substantially reduced by
one’s own actions, see Chapter 2) and yet the failure by many to take preventative and
protective action continues. Those who lift know they should not and the most common
reason cited is a lack of time. There are indeed local obstacles to safe manual handling
including: a lack of easily available equipment; equipment that is perceived as
complicated and time consuming to use; insufficient training in the proper use of
equipment particularly where training does not keep up with changes in personnel, and
so on. But these obstacles only remain as obstacles in the face of resistance to changes
in practice. It suggests that nurses who continue to lift when there is such a weight of
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