Turning a Patient in Bed

WHAT YOU SHOULD KNOW

WHAT YOU SHOULD DO

Preparations

• Keep the following handy: 2 extra pillows, 2 to 3 towels, and a board about 3 feet long by 2 feet wide. Before starting, tell the patient exactly what you plan to do.

General Guidelines

• To protect the patient's spine, roll him like a log. If you cannot roll his whole body at once, roll the upper body, then the legs.
• To prevent injury to your own back, spread your feet at least 3 feet apart when lifting. Bend forward from the hips, with knees bent and back straight, and straighten your knees as you lift.
• Whenever possible, pull or push, rather than lift, and ask the patient to help you by using his feet and arms.

Turning a Patient from His Back to His Side

• Spread your feet and bend your knees. Put one arm under the patient's hips and the other under his upper back. With your back straight and knees bent, pull the person toward you.
• Put your arms under the patient's legs and align them with the upper body. Your objective is to roll the patient so that he is facing AWAY from you. To do this, put one hand under the hip closest to you and the other hand under the shoulder closest to you. Gently push to lift the hip and shoulder off the bed until the patient is resting on the hip and shoulder farthest from you.
• Put both of your arms under the patient's waist and hips. Pull the hips toward you so the buttocks stick out a little. Bend his knees a little and straighten his head to align it with his neck and spine.
• To keep the patient in this position, put a pillow snugly against his back, bend his top leg at the hip and knee to form an "L" shape, and put a pillow under the top leg to hold it in place. Also give him a pillow to hold between his arms, and put a folded towel under his bottom knee to keep the ankle off the bed.

Turning a Patient from His Side to His Back

• Remove all pillows and towels from the patient's back, legs, and arms, leaving only the pillow under his head.
• Standing behind the patient, put one hand on his shoulder and the other on his hip, then gently pull him over onto his back. If this brings him too close to the edge of the bed, move him to the middle as follows: Stand on the side of the bed farthest from the patient. Spread your feet, bend your knees, and put one arm under his hips and the other under his shoulders. With back straight and knees bent, pull the patient toward you. Finish by putting your arms under the patient's legs and aligning them with his upper body.

Rolling a Patient from His Stomach to His Back

• Remove any pillows or towels from under the legs, hips, or chest. Pull the patient to the edge of the bed as follows: Spread your feet, bend your knees, and put one arm under his shoulders and the other under his hips. Then, with your back straight and knees bent, pull the patient toward you. Place the patient's arms in a straight line along his sides. Turn his head toward the edge of the bed.
• Go to the opposite side of the bed. Your objective is to roll the patient towards you with his face AWAY from you. With your knees bent, lean over the patient and put one hand on the side of the shoulder farthest from you and the other on the side of the hip farthest from you. With both palms down, gently pull the patient's farther side up and toward you until he is resting on the side nearest you.
• Complete the maneuver by following the instructions above for turning a patient from his side to his back.
• While the patient is on his back, keep a flat, firm pillow under his head. His neck should be straight and in line with his spine. Place a thin, folded towel or blanket under his calves. This will lift his heels off the bed so they won't get sore. Bend both arms to an "L" shape and rest his hands on his hips.
• Cover a 3 foot long by 2 foot wide board with a soft towel or pillowcase. Put the board at the foot of the bed and rest the patient's feet on it. His toes should be pointing upward, and his feet should form a right angle (L-shape) with the legs. (The angle can be slightly wider, if necessary.) This will prevent the condition called "foot drop."

Turning a Patient from His Back to His Stomach

• Keep two thin, folded towels within your reach. First turn the patient from his back to his side, following the directions above. The patient should then be resting on his side, facing away from you, on the side of the bed closest to you.
• Stay behind the patient to make sure he doesn't roll off the bed. Place one towel on the bed where the patient's chest will come to rest. Place another in the area that will be under his hips. The towels will help to prevent the skin over the hip and chest bones from getting sore.
• Gently roll the patient onto his stomach. If there isn't enough room on the bed, proceed as follows: Put your arms under the patient's upper body and hips, gently pull him towards you, then roll him onto his stomach. Finish by putting your arms under his legs and aligning them with his upper body.
• Once the patient is on his stomach, turn his head to one side so that his nose and mouth are unobstructed and he can breathe easily. Place his head in line with his spine, not too far back or forward. Put a flat pillow or folded towel under his head.
• Position the patient's hands on either side of his head. His arms should extend perpendicularly from his shoulders, with the elbows bent 90 degrees to form an "L." Put a rolled towel under his ankles to keep his toes and feet off the bed. Make sure the folded towels are positioned smoothly under his chest and hips. Wrinkles can cause skin sores.

Call Your Doctor If...

• The patient's skin develops red patches or sores.

Seek Care Immediately If...

• The person falls out of bed. Do NOT try to move him by yourself. Call 911 or 0 (operator) if necessary.