Range of Motion, Contracted Patients, and the Elderly

mamamerlee, LPN · Oct 28, 2009

The reason those patients are contracted is exactly why passive ROM is needed. We were taught to do PROM every 4 hours while awake. It is supposed to be gentle in nature, and thoroughly done may take 20 minutes or more. Someone should be teaching you all about this in your classes. And ALL muscles and joints should be put through their entire range.

Contractures can sometimes happen in otherwise healthy people who are AAO - the most common I can think of right now would be a frozen shoulder - pt has an injury to her shoulder, it's painful to move the arm, keeps arm in one position all the time. Soon, the patient will be unable to move that arm.

rapkeygurl · Oct 29, 2009

Yes that is a good practice q 4 hours for Passive ROM, Do you have a physical therapy department in your facility? IF SO, ask a therapist some things you can do to help your residents they might even think of getting an evaluation from PT and might order a hand splint, or "carrots" those are these things you can put in a residents hands that start out like 1inch round and get bigger to keep say a resident with a left sided paralysis, some residents get special boots, merry walkers, etc.. to help in restorative care. Now We just started a restorative care program and I did get some good info from hartman publishing out of new mexico. I teach the nurse aide classes in my facility, I use there materials to teach new nurse aides just like you. But if your not up for getting a book go to your local hospital ask if you can talk to PT and ask if you can watch tell them why must are glad you want to help!!! I think your wonderful and someone must have taught you well that promoting independance and maintaining what mobility they have is KEY KEY KEY!!! Good girl!!

Talino · Oct 29, 2009

How often should passive ROM exercises be done? On patients that are already contracted, it how safe is it to do passive ROM. I am very gentile, but I feel like I might hurt them. What about verylarge or very frail patients? (any advice) I never see anyone else doing ROM with their patients. Is that common?

You have good intentions but you should not be performing any procedure without knowing the plan of care for a patient. The knowledge you acquire from outside may not necessarily be applicable to your facility's protocol. Seek guidance from your nurse, educator, or supervisor.

Harparia · Oct 29, 2009

Yes that is a good practice q 4 hours for Passive ROM, Do you have a physical therapy department in your facility? IF SO, ask a therapist some things you can do to help your residents they might even think of getting an evaluation from PT and might order a hand splint, or "carrots" those are these things you can put in a residents hands that start out like 1inch round and get bigger to keep say a resident with a left sided paralysis, some residents get special boots, merry walkers, etc.. to help in restorative care. Now We just started a restorative care program and I did get some good info from hartman publishing out of new mexico. I teach the nurse aide classes in my facility, I use there materials to teach new nurse aides just like you. But if your not up for getting a book go to your local hospital ask if you can talk to PT and ask if you can watch tell them why must are glad you want to help!!! I think your wonderful and someone must have taught you well that promoting independance and maintaining what mobility they have is KEY KEY KEY!!! Good girl!!

I looked up the book you suggested, and it is exactly what I was hoping to find. I think it would be great to shadow the PT for the day or two, as well.

Thanks for the great suggestions!

You have good intentions but you should not be performing any procedure without knowing the plan of care for a patient. The knowledge you acquire from outside may not necessarily be applicable to your facility's protocol. Seek guidance from your nurse, educator, or supervisor.

This is excellent advice as well. I was hoping that there was a "standard practice" to guide me through most situations, since I float to 5 different facilities, but I guess it is not that simple. I will have to make sure that it is part of my shift report to check with the RN about what is in the plan for each individual patient.

Thanks!

SuesquatchRN, BSN, RN · Oct 29, 2009

I think your intenetions are wonderful. I wonder if you have time to do this? You should, but we are always too short-staffed.

Harparia · Oct 29, 2009

I think your intentions are wonderful. I wonder if you have time to do this? You should, but we are always too short-staffed.

Maybe I am just naive because I am so new, but I feel like I have to try. I think that it will take some organization and good time management skills on my part, but I am up for the challenge.