The AHA does support voluntary efforts to adopt lifts, and generally is behind recommendations to include them in new builds. But another reason for its reluctance to get rid of manual lifting entirely, is that not all old hospitals can easily fit in ceiling-mounted lifting systems, Luggiero said.

Many of the hospitals in the United States were constructed in the 1950s and 1960s, the so-called Hill-Burton era, when after the passage of the Hospital Survey and Construction Act, proposed by Sens. Lister Hill and Harold Burton (thus, the Hill-Burton Act), the federal government helped pay to remodel and build hospitals, Luggiero says. These hospitals have physical limitations.

"We cannot support retrofitting these devices into every hospital, because structurally, the walls, the ceilings, it cannot be done in some areas," she says. "When you take that ceiling apart, you've got the lighting, the sprinkler system, oxygen tubes. All of those elements have to be considered when you're doing a renovation."
What's more, she says, many of these old hospitals pack two to four beds to a room, so patients needing a lift to go to the bathroom might have to be carried over another patient's bed.

"So there's a privacy issue there, and that often gets overlooked."

Resistance from nurses
But not all the resistance is from hospitals. Nurses, too, are often reluctant to abandon a tradition that expected strong nurses for whom lifting patients was routine and workplace injuries part of the job.

"It's kind of been accepted that it's part of the job for a long time," the ANA's Hughes says. "The training schools in the 1900s talked a lot about physical strengths of the nurses."

"Nursing schools for the longest time taught use of proper mechanics," she adds. "If you bend your knee, lift from your leg, that type of education, and that's fine if you're lifting a static load, a box with handles. They're really not to be used for patient handling."

To combat this resistance, the American Nurses Association ran a project with NIOSH, and the Tampa VA James Haley Center in Florida, getting 26 schools of nursing involved. They put "no lift" and safe handling principles in a test curriculum, and also got item riders on a nursing exam.

While Hughes says nursing students took to the new safe handling principles, tradition isn't the only sticking point. There's also time. Nearly everyone we spoke with admitted that for small adjustments, these machines can take more time than normal manual lifting.

"That's one of the push-backs we get from nurses," Kristeller says.

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