Turning your patients

TracyB,RN, RN · Mar 16, 2005

Yes, I make sure my patients are turned.... I help the CNA's whenever I can & turning is a perfect time to assess skin condition.

It's the nurses responsibility to make sure his/her patients are repositioned...

unknown99, BSN, RN · Mar 16, 2005

I make sure they are turned. If I am in the room and I can do it, I do it. The nurse aide is there to help me, so I in turn help her.

jeepgirl, LPN, NP · Mar 16, 2005

most of my kiddos are trying to jump out of the bed,not stay in!

however, we do have some that are bedridden.

and yes, we do make sure they are turned. like said above, its a good time to do a skin assess or wound care.

TiffyRN, BSN, PhD · Mar 16, 2005

The nurse is responsible for all care/ADL's in a typical hospital. One can delegate the responsibility to a NA/CNA however it remains the responsibility of the RN/LPN. I have to say in my 10 years of working med/surg/tele I've only been shocked 3-4 times to go in and find that some NA had taken the initiative to turn my patient. Unfortunately it was just easier for me to do it myself than try to convince some other individual they needed to do it.

A few years ago we were going to use more "assistive personnel" and therefore have the RN's/LPN's take another patient or two because supposedly we had less to do on the patient. One thing we were warned about though is that the nurse remains responsible for all the tasks they delegated. So no matter how the division of labor goes at your hospital, it is still your patient and you are the responsible party.

nanna4 · Mar 16, 2005

A lesson learned regarding repositioning, even with the neonates: finding a needle cap in the bed under the patient. I can only imagine how uncomfortable that must be if you can't move and can't verbalize.

mrdoc2005 · Mar 16, 2005

A lesson learned regarding repositioning, even with the neonates: finding a needle cap in the bed under the patient. I can only imagine how uncomfortable that must be if you can't move and can't verbalize.

As a student I have bee supprised just how many caps (among other things) I have found in the beds. Yes, I do turn my patients and as a tech I turn my patients.

LilRedRN1973 · Mar 16, 2005

In the ICU, we turn our patient q2h. IF there is a tech around, we might ask them to help, but for the most part we grab one of our podmates and have them help.

I agree with checking to make sure your patient is lying ONLY on linens and not anything else....I also imagine that to be very uncomfortable, especially judging from the dents and impressions I've seen on patient's backsides and flanks because nobody noticed part of their IV, feeding tube, etc. underneath them. One of the first things I do when I assess my patient is turn, do skin checks, and make sure they aren't inadvertently laying on something.

Melanie = )

talaxandra · Mar 16, 2005

We don't have aides - all mobility-compromised patients are turned by nursing staff 2/24 during the day, by nursing staff and orderlies 3/24 overnight.

Tweety, BSN, RN · Mar 16, 2005

As the RN, I am responsible to see that my patient is turned, even if I'm not the one personally doing it.

We have aides on the unit, and I try to touch base with them at the beginning to let them know my expectations on who needs turning. Then between to two of us it get's done.

But ultimately I am responsible for the outcomes, care and care plan for all of the patients under my care, as I am the licensed nurse. :)

editied. Reading the rest of the posts, I see Tiffy said the same thing. Sorry. I concur. :)

shopgal, RN · Mar 16, 2005

I am the only nurse at noc on an 18 bed Vent unit and I am literally running for 12.5 hrs. I don't have time to turn pts myself, but I am in the rooms all of the checking vent alarms, tube feedings, IVs, etc., I make sure that they are turned. And since my pts are all bedbound the ones who aren't comatose have no sleep cycle, so they are up all noc. We're hoppin' at noc, you don't have to worry about being quiet on my unit! But I have great CNAs on my hall that I trust and I check my pts regularly enough that I know that they get turned and they all have a tx of some kind that I have to change on my shift. It all gets done and my pts are well cared for, they just keep us very busy! :biere:

begalli · Mar 16, 2005

LOL! What a timely start to this thread.

Our unit just institued a turning policy. Every two hours on the odd hours the CNA and a float nurse make "turning rounds." When the CNA leaves at 11pm the resource (charge) nurse does the rounds with the float nurse. They go to every single ICU patient and boost and turn them. During the day and up until 11 pm, there is an announcement on the unit's pa system that the rounds are beginning.

Last night was my first experience with this. Not bad. Of course it doesn't mean that I can't send them away if I've just turned the patient with another nurse or if I need to check out skin or if I simply want them to leave my patient alone!

This was a result of a staff survey on what we RN's feel we need help with. Substantial help with turning, boosting, and simply working with the weight of ICU patients is a priority as far as nurse satisfaction goes. We're lucky to have a receptive management and committees to come up with this stuff! It's especially helpful with large patients...two additional bodies will now always be there to help on the odd hours.

I think it's our units reaction to Arnold's vetoing of the lift bill....but the problem is that nurses are still doing the heavy work. We'll see....