When you’re assisting a patient who is in a wheelchair, you sometimes go through doors. Sure, some doors open automatically or have the handicap accessibility button to open them, but if you work where I work, sometimes this button is broken.
Oftentimes, hospital doors can be very heavy and also automatically close very quickly. These doors have tried to kill me more often than not when I am with my patient who is in a wheelchair. This can get even trickier when you have additional equipment such as walkers and oxygen tanks.
After much trial and error, I have come up with a pretty efficient way to open a door and go through it myself while pushing a patient in a wheelchair (including larger tilt-in-space and bariatric ones).
Things to keep in mind
- Be careful of ramps when working with a patient. Do not step away and let go without setting the brakes if there is a risk they may slide down the ramp. This is kind of obvious, but worth mentioning.
- Be careful of your feet and lower legs. Wheelchair wheels, casters, and other parts like to give your lower extremities abrasions and contusions.
- Be careful of someone else opening the door on you and/or your patient as you walk up to the door, even if it is made of glass and see-through. People, especially children don’t really pay attention.
- Communicate with your patient what you plan to do and if they need or will not need to assist you.
- Think of ways your patient may assist, e.g., holding the O2 tank between their legs and having it rest on a leg rest.
- Figure out which way the door swings when it opens. You will need to stand out of its way.
- Push your patient up to the door just out of the way that the door opens. For example, if the door swings open to the right when it opens, position your patient’s W/C and stand on the left of the door frame. Naturally, when you push a patient in the wheelchair, the only way you can do anything functionally is beside or behind you, not in front (because the wheelchair is in the way). You will need to turn the wheelchair sideways or even backward-facing temporarily up to the door. This looks silly, but it works.
- With one hand, open the door as wide as you can to allow both you and your patient through.
- Use your leg as a doorstop. In this example, I would use my right leg as it is closest to the door.
- Simultaneously pull your patient from backward or sideways facing to front-facing and push the wheelchair over the door threshold. At this point, your legs will be in a wide stance, you’ll almost need to kind of lunge as you reach and move the wheelchair towards the door.
- When the wheelchair is halfway through the door, you can move your leg that is acting as a doorstop into a more natural gait.
- At this point, the door will try to close on you and your patient. Tell your patient they will not need to assist or they may get injured. If the door tries to close on you, it will often be stopped by the wheelchair wheel. Or, you can use your free hand to hold the door and the other hand to push the wheelchair – however, I often find it difficult to push a wheelchair with just one handlebar as the physics and force is uneven.
- If it is difficult to go over the doorway threshold, use your leg as a doorstop again and simultaneously tilt the wheelchair back if it has anti-tippers installed. Otherwise, just give it some ‘umph’. Tip: your patient may also assist with wheelchair propulsion at this point if you hold the door for them so that the door does not close on their upper extremity.
- Proceed completely through the doorway and allow the door to close by itself. Otherwise, close it manually once your patient is fully inside.
To open single and double doors from the inside, you do something very similar. Another technique is to turn the wheelchair backward facing the door and use your body, e.g, your bottom, to open the door, go through first yourself, then simultaneously pull the wheelchair backward through the doorway until you both clear it.
Hope this makes sense. Unfortunately, I don’t have a wheelchair to demo this and don’t have time to film it at work without risking HIPAA. Maybe I’ll record a video with my baby stroller one day.
If any wheelchair users have any tips on how to independently open doors that close automatically (in situations when automatic door openers do not work), please send me an e-mail of how you do it. I would love to hear your tricks.