Basic question, almost ashamed to ask

[questioneverything]

I am a nursing student and I have a silly question. I have been hearing that patients need to be "turned q2h". I understand the rationale and the importance of this.

However, what is meant by "turning" the patient? Do they mean to just move the patient in bed; turn the patient to rest on their sides or stomach; or to place a pillow under one side of the patient to redistribute blood flow?

[sparklie.lady]

I've never seen a patient turned on their stomach, yes, this is exactly what turning means.

[NuteRN]

Turning the pt from side to side and using pillows to prop them up to change pressure points. Depending on their current skin condtion, having them on their back between sides might happen too.

[SlightlyMental_RN]

Whatever area they are putting their weight, change it to something else. Examples: Patient on left side, place them on their back. Patient on back, roll them to their left side. The pillows are usually there to keep someone from inadvertently rolling back onto their back, and give some support, cushioning. It's a good idea to use pillows between feet or knees to prevent pressure ulcers from forming. Hope that helps.

[P_RN, ADN, RN]

Many doctors will order amputees to lie prone to prevent hip flexion contracture.

And yes the prime reason is to redistribute pressure and also to increase pulmonary function.

[MisterSimba, BSN]

It's not a silly question at all! It generally means turning or shifting the patient by placing a pillow or a couple of pillows under their right or left side. You're redistributing their weight to take the pressure off their sacrum/coccyx area to prevent pressure ulcers. This is also why some patients wear those big fuzzy heel protectors, to prevent pressure ulcers.

[P_RN, ADN, RN]

MrSimba thank you for your post. No question is ever silly, and I should have said that too.

[himilayaneyes]

In patients with ARDS in the ICU, you may turn a patient prone to recruit the alveoli from the lobes in the back. However, in most patients, you won't turn them onto their stomach. However, place pillows between legs, under arms, behind backs, etc. And I agree with the previous poster that there is no such thing as a stupid question.

[mskate]

Proning patients will be very rare, usually for pulmonary or spinal issues - and then, they are usually in the ICU and have special proning beds.

Turning is to change the weight of the patient around in the bed to prevent bedsores, some hospitals do not allow supine positioning at all unless the patient is unstable, getting a procedure or refusing. You would always turn the patient from their left side to their right side and back and forth.

Pillow placement is important when you are turning an immobile patient. I use two pillows behind their back - one for the upper back and one for the lower back and buttocks. The goal is to try to keep the booty off the bed as much as possible and is comfortable. I place a pillow under their head, a pillow under each arm, one between the knees and another between the feet, be sure to float their heels off of the bed if they are not in boots to prevent this already.

You want to make sure that the basic areas where you would expect to get pressure sores are supported by pillows or floated off the bed and that you are turning the patient to relieve the pressure as frequently as you can - generally q2hs. If you have time, do it more frequently, (but frankly that is rarely possible). You make sure that the back of their head, , elbows, shoulder blades, spine, lower back, sacrum, buttocks, hip bones, knees, ankles and heels are all protected and checked for redness and skin breakdown on each turn.

:) lots of pillows and barrier cream is your friend, as is *documenting* that you are turning, how you are turning, where the pillows are, that the pressure is off set, that you are using barrier cream and boots, etc... - take your credit. In some states (if not all...) skin breakdown is something that the facility is mandatory to report to the board of health and your charting WILL be examined and you can be interviewed and disciplined for this - so be thorough!!

[shiccy]

Many doctors will order amputees to lie prone to prevent hip flexion contracture.

And yes the prime reason is to redistribute pressure and also to increase pulmonary function.

Hopefully they can be on one side or the other - I find that I can only sleep on left or right sims position these days... or supine ... usually nothing in between hehe

[Confused000]

Does anyone know about Depaul's Menp program, what is so special about this program compared to an accelerated bachelors nursing program?

[Confused000]

Does anyone know about Depaul's Menp program, what is so special about this program compared to an accelerated bachelors nursing program?