Do you do ROM on your residents?

Nursing Students CNA/MA

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Specializes in LTC.

PT does ROM with the rehabbers during their classes, but none of the CNAs do it with the residents or patients where I work. I saw a nurse do it on a resident's arm once, and then a couple months later a different nurse asked me to do it on the same resident's arm. Aside from that I haven't seen or heard anything about it, although it was one of the major skills in my CNA classes. I also didn't see any of it going on in the place where I did my clinicals.

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We don't do ROM either. Usually the RNA's at our facility will take care of that. But you do bring up a good point.

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Specializes in CV Surgical, ICU.

I do when I can find the time, but I make it a point to do it at least 5 days a week, even if I have to stay a little late and do it at the end of my shift. It's truly important, as an example.. I had a lady who had taken a stroke, and I would range her affected arm (her leg was too painful for me to range, she would cry) daily. I had ranged her to the point where after a while the arm was nice and loose and seemed to cause her much less discomfort when dressing her. They took her off of my assignment and gave her to another aide. I showed him what I had been doing, and told him how important it was. Couple of months or so later I had taken her on a day we were short.. When attempting to dress her, I could barely even move her arm it was as if it was frozen in place. And I'm certain he wasn't ranging her because I reminded him and he asked me to show him how to do it again!

So it's really important whenever you have a spare moment!

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Specializes in LTC.

I think if I did it I would get in trouble though, because it's not in any of our books.

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Specializes in LTC, Home Health.

ROM is very important. I will admit, I was once an "on call" floater and often got stuck with very difficult sections, so I never had a lot of time to do a lot of ROM's on my patients. (especially during 7a-3p) I would encourage the patients to do whatever they could for themselves. I would also do ROM on bedridden patients during a 3p-11p shift. Since I would often be the only one doing it, the only patients who truly benefitted from it where the ones who had a regular CNA who was complient with the ROM careplan.

I was told in my CNA class that getting them dressed and moving their arms and legs during the dressing/bathing process could be considered ROM as well. So encourage them to move those limbs!:up:

Many places are now recognizing that ROM's are not getting done by CNA's because of the demands of the job. Many places are creating positions for CNA's called a "PT/ROM Aide (physical therapy aide or Range Of Motion aide), which is basically a CNA who's job is to go around the facility doing ROM and ambulating residents all day. This also includes helping the Licensed Physical Therapist ambulate/transfer patients.

Many CNA's are so busy, they only have time to do the bare minimum care. As a result, unfortunately, things like ROM's get cut out. It is very sad because ROM's are so important. How many elderly patients have you seen contracted almost into a fetal position?:cry: I have seen quite a few. If ROM's were practiced more often, there would not be as many contracted residents.

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Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.
ROM is very important. I will admit, I was once an "on call" floater and often got stuck with very difficult sections, so I never had a lot of time to do a lot of ROM's on my patients. (especially during 7a-3p) I would encourage the patients to do whatever they could for themselves. I would also do ROM on bedridden patients during a 3p-11p shift. Since I would often be the only one doing it, the only patients who truly benefitted from it where the ones who had a regular CNA who was complient with the ROM careplan.

I was told in my CNA class that getting them dressed and moving their arms and legs during the dressing/bathing process could be considered ROM as well. So encourage them to move those limbs!:up:

Many places are now recognizing that ROM's are not getting done by CNA's because of the demands of the job. Many places are creating positions for CNA's called a "PT/ROM Aide (physical therapy aide or Range Of Motion aide), which is basically a CNA who's job is to go around the facility doing ROM and ambulating residents all day. This also includes helping the Licensed Physical Therapist ambulate/transfer patients.

Many CNA's are so busy, they only have time to do the bare minimum care. As a result, unfortunately, things like ROM's get cut out. It is very sad because ROM's are so important. How many elderly patients have you seen contracted almost into a fetal position?:cry: I have seen quite a few. If ROM's were practiced more often, there would not be as many contracted residents.

I can confirm this. Some of the better LTC facilities in the MS/LA area are now using Restorative CNAs, which I think is an excellent idea. I do not have time, and it intrudes on the scope of PTA/OTA.

Funny thing is, a long time ago when I was in CNA clinicals, a preceptor told me turning for Q2s and bed changes/baths counted as a form of ROM. However, since it is not one of the things people check me off on, I usually put the "actual" ROM on PTAs who come in. However, the PT/PTA guys do not really visit enough.

It is in the CNA book, but I have yet to see a CNA checklist that asks if I did ROM. They are mostly concerned with baths, changing diapers, I&Os, vitals, feeding, and the 50 other things I need to do. But, I do not worry, the CNA book talks about back rubs, too. I never do that because I am not a massage therapist.

Its kind of hard to sit in a room for 20 mins doing ROM when 5 folks need changing.

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I have never done ROMs or seen any of my fellow CNA's do them in any of the 3 places I have worked.

I agree that it is important and should be done but how can you when there are other people are waiting to go to the bathroom and you have already skipped your lunch break?

It is sad.

I would not feel comfortable in most cases doing them because no one else does and I would not want to hurt them.

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Specializes in CV Surgical, ICU.
I think if I did it I would get in trouble though, because it's not in any of our books.

Ohh.. You mean in their care plan?

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Specializes in LTC.

Yeah. Not in their nursing care plans or their PT program. And when you first get hired at my facility you go on a tour with PT and they show you a bunch of the different braces, splints, etc. And those things are all in our CNA books and we have to document that we put them on. They never mentioned ROM at all, in the tour or the books.

It's not like I have time to do it anyway but maybe like one person a day would be feasible, depending on who I am working with. Like maybe they could get ROM on their bath day once a week.

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Specializes in CV Surgical, ICU.
Yeah. Not in their nursing care plans or their PT program.

That's kinda odd huh? Maybe it's something you could ask PT? Like ask them to screen residents you have in mind to see if they're appropriate and if so, what types of exercises to perform?

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Specializes in LTC.

Yeah I just don't want to suggest something that we can't follow through with. There's usually no time for nail care, and that's something that IS in the care plans. If we had restorative aides that would be great!

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Specializes in CV Surgical, ICU.

Definitely! Time to get the wheels started! :)

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