December 11, 2018 Celeste Monforton, DrPH, MPH 0Comment

Do you want a 16 year old student using a mechanical lift to move your injured mother from her bed at a rehab hospital? What about a 17-year old intern using a power lift at a nursing home to move your cancer-stricken father?

Not a good idea, says nearly 80 percent of U.S. adults in a national survey.

Hart Research Associates asked 1,004 adults about a Trump administration proposal that would reverse long-standing safety protections for 16- and 17-year old workers. Currently, workers under age 18 are not permitted to operate power-driven hoisting equipment by themselves. Such equipment is used in medical care, nursing, long-term care, and assisted living facilities to lift and transport a patient or resident, such as from a bed to a chair or a chair to a showering room. To ensure the patient and the operators are not injured, skilled and experienced health care providers should be the individuals using power-driven patient lifts.

The National Employment Law Project contracted with the public opinion research firm to ask the following question:

“Nursing homes use power-driven mechanical lifts to help move patients who cannot lift themselves. Currently, federal child labor rules say that mechanical lifts may not be operated by employees under the age of 18 unless they are assisted and supervised by a trained adult employee at least 18 years of age.

The Trump administration has proposed eliminating this rule. Do you favor keeping the current rule that requires supervision and assistance by a trained adult employee, or do you favor eliminating the rule so that nursing homes can have employees under age 18 operate mechanical lifts without supervision to move nursing home patients?”

The results are in:

  • 78 percent oppose changing to rule, including 54 percent who “strongly oppose” it.
  • Based on the political party affiliation of the respondents, 87 percent of Democrats, 69 percent of Republicans, and 77 percent of Independents opposed it.

The Trump administration asserts that revoking the safety protection would increase employment opportunities for 16- and 17-year olds. In proposing the change, however, the Labor Department (DOL) fails to provide any evidence that the prohibition for youth on using power-driven hoisting equipment is a barrier to employment in healthcare facilities.

I’ve read through some of the 175 comments submitted to DOL about its proposal. Those who support the change argue it’s needed because of labor shortages in the nursing care industry. They don’t come out and plainly say it, but they want 16- and 17-year olds to be able to operate power-driven patient lifts by themselves–not with supervision.

The current guidelines allow 16- and 17-year old workers who are in a nurse’s aide training program (e.g., CNA) to assist an adult worker (i.e., someone 18 years or older) with power-driven lifting equipment. The commenters don’t acknowledge this option.

The commenters also seem unfamiliar with the Food and Drug Administration’s (FDA) guidelines for using these lifts. (The FDA is responsible for reviewing and approving medical devices — and patient lifts are medical devices.) Those guidelines states that most lifts require at least two caregivers to safely operate.

And this proposal does not just have implications for the safety of young workers.  It will put patients at risk of injury and trauma.

One commenter wrote:

“I am an experienced caregiver of patients afflicted with dementia. … I have no idea whose idea this was, but they know absolutely nothing about direct care of this extremely vulnerable population of patients. Care of these individuals requires extreme attention to detail, ability to project and predict problems, patience uncommon in youthful workers, and emotional maturity beyond the norm. I am highly offended that the only objections seem to be centered around worker safety and not the safety and care of the patients.”

I agree that DOL’s proposal has serious implications for the safety of patients. That combined with the concern for young workers should be sufficient for the Trump administration to ditch this bad idea.

 

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