How to turn a patient???

[Ted D]

Silly question. But I have a very very old patient who needs to turn every hour. She is not really overweight, but should I get another student to help? Do I just have her grab the siderail and pull her towards me, then put a pillow behind her back once she's on her side? Then how long do I keep her "turned?"

[KareBear0609]

Patients are supposed to be turned every two hours if they cannot move themselves. If there is a draw sheet or waterproof pad underneath of her then use that to move her to one side of the bed so you can turn her on her side. Put a pillow behind her back, under her legs, and between her legs.

[Ted D]

How long do I leave her in that position?

[Mandychelle79, ASN, RN]

until the next time you are to turn her. the idea of turning and positioning is to keep the patient off bony areas to prevent break down. If she is to be turned every hour, she will remain in that position for an hour and then turned again.

[opensesame]

OP --

definitely get another student to help you turn. If you haven't had any information in your programs on moving/lifting patients and body mechanics, please do some research yourself on the best way to do these things. Bedside nursing is hard work and it is worth it to learn how to move patients the right way so you don't injure yourself.

At most hospitals, the standard is to turn q2h, not q1h. Turning q1h is not incorrect, but I would question the rationale and benefit of it.

[KareBear0609]

You will leave her in that position specified in her care plan but if there is nothing in there then the rule is no more than two hours because that is when skin breakdown starts to occur. Make sure to put pillows underneath bony areas or heel protector boots if she has them.

[Ted D]

Thanks for the tips and advice, I will double check the order. Do you usually turn the pt. to Sims/semi prone or just a lateral position?

[RN2BKS]

Thanks for the tips and advice, I will double check the order. Do you usually turn the pt. to Sims/semi prone or just a lateral position?

What I do is have the pt on the right side of their body for 1-2 hours then put on the left side, then have them flat on their back with head up about 35-45 degrees.. Put pillows between knees, under knees, each sides(when on one side Rt, Lt) and support shoulders with pillows even put the foot of the bed up if they would like.

[nerdtonurse?, BSN, RN]

Make sure you examine the patient's skin before you start turning them, especially if they are elderly. People tend to have a favorite side to lay on, and there might be stage ones over the hip bone on that side. If so, don't turn them completely up on the point.

If the skin is fragile, in ICU we use a folded sheet, and actually pull on the sheet to turn a patient; if the arms/legs are weeping, we wrap them in a pull pad and reposition by lifting and repositioning them with the pad, then make sure the arms or legs are open to air. You can cause a skin tear with some of these folks with the lightest touch, so a "touch-less" turn might be a good idea.

Don't forget to get someone to pick up the heels if the skin's very fragile, you can cause skin breakdown just by boosting them up in the bed but dragging their heels.