Help me settle a debate about making an occupied bed.

Well according to my PA Nurse Aide Candidate Handbook it states:

Loosens bottom used linen on working side and moves bottom used linen toward center of bed.

Places and tucks in clean bottom linens on working side and tucks under client.

So from what I gather it's underneath. It guess it makes sense because the dirty part of the linen is suppose to be on the inside, but what I don't get is what to do if the patient has a big blow out and soaks the sheets? I would think you'd have to remove everything and wipe down the bed before putting clean sheets on. Of course if they have a blow out I'm sure it would be shower time and you would just do it while the bed was unoccupied (Although never while the patient is in the shower alone) and the patient would just have to sit in a chair while you did the linens.

I put a towel over the sheet and tuck it under. Sometimes, if the mess is REALLY bad, there ain't no containing, and I have to change that sucker twice anyway because no matter what, it's gonna be soiled.

I always roll it up and tuck it underneath the roll of dirty linens. There may be some poop or pee under the person's hip/leg that you can't see, and by tucking the clean linens on top of the dirty ones, they're more likely to come in contact with the mysterious substances, thereby contaminating them and necessitating another linen change.

If the linens were *soaking* wet and dripping urine (and would then soak any clean linens that come into contact with them, whether they were placed on top or bottom of the dirties), I would have the person roll three times (instead of two for a "regular" linen and brief change): roll to one side in order to tuck the brief and dirty linens under, start cleaning the resident, and clean the bed if necessary; roll to other side to pull out the dirty linens, finish cleaning the resident and the bed, and tuck a new brief and clean linens under them; roll to original side to pull out the other side of the brief and linens.

That sounds like the procedure I would do. I guess there isn't a rolling limit that a patient has.

Well, within reason.

some things in life require multiple rolls to get the job done in general, i always aim for a stack that goes: mattress, clean linen, dirty linen(s), patient's bum.

I tuck the clean linens under the dirty linens, and if the dirty ones are a mess, I put a bath blanket between them and the clean ones.

Well I guess I'm wrong! Ha ha!

One of our CNAs is pretty fresh out of school and he said today that that's how he was taught. The school he went to is a state testing site so it must be.

Thanks guys! :)

A co-worker and I were making an occupied bed when we got into a debate.

When you roll up the dirty linen and then lay out the clean, right before you roll the person to the other side of the bed, does the clean linen go over the TOP of the dirty or UNDERNEATH.

My thought was to go on top so the dirty touches underneath the clean.

I hope this makes sense. How do you do it??

Reguardless how very good you are, making an occupied bed is and will always be difficult andd will always be easier if the patient was not in the bed itself!

It goes underneath.