Turning Total Dependent/Aphasic Patient

[valliloves]

Hi There,

So I'm assuming it was very difficult because it was my first actual experience of turning an elderly patient who was totally dependent and aphasic, but I became stressed out by it.

Here is this woman, looking at me and I can't even turn her over. What am I doing wrong?

I had to get another classmate to help but she ended up doing it for me. I was trying to give her a bed bath so that requires me to turn her 3 times (once to remove adult briefs, once to wash bottom and place clean briefs, and once to pull pants up while dressing). When my classmate did it, she seemed to have no problem doing it but the lady looked like it was too rough but I'm not sure because she can't speak.

When I tried to do it myself, I was so afraid to hurt her and felt very discouraged. I read somewhere online that it is easier to raise the side rail and pull her toward me using the draw sheet? Is that best?

Or is this something I will just get better at in time? I consider myself to be strong physically, but I felt so weak trying to turn her on my own. My instructor wasn't upset, but she did mention that I need to not ask anyone for help because when I become a CNA, nobody is going to do it for me or be available to help. I will heed her advice, but I'm just not sure how to get better at it. What if I don't do a bed bath for that patient again during clinicals?

[Missingyou, CNA]

Yup!! It is something that you get better at.

Some tips:

~!!!!!Raise the bed up to a comfortable height for you to work.

~Make sure the head and foot of the bed are flat. It makes a difference!

~Place the patient's leg over the other leg in the direction you are rolling them. (so they are "pointing with their foot" to the direction they are going)...

~Take hold of the draw sheet or soaker pad at the patient's shoulder and hip area and roll either toward you or away. The direction depends on what is comfortable for you. For me, it's easier to roll them toward me. I find it easier on my back, but everyone is different.

~You will sometimes get looks from patients. Sometimes they don't understand or are afraid they will fall. That's why it's important to tell them what you are about to do and that they are safe, even if it appears as tho they don't hear/understand.

~I have a resident who resists being on her side. She attempts to roll back while I clean her bottom so, once I roll her, I place her pillow just under her shoulder blade to "prop her up" in that position so we aren't stuggling with each other.

~This is one of those skills where upper arm strength comes in handy!!!

[valliloves]

Missingyou, thank you so much for the tips!!!!! I took your advice and used the draw sheet. I also flattened the bed out and when I rolled a pt toward me, I told her it's okay, that I have her and that nothing will happen to her. Today was just as frustrating as yesterday, but I started to feel more confident in turning. Your tips made it SO much easier. Now, to get the one handed multi tasking down :)

I did push a pt in his wheelchair for at least a couple of miles today because we took some patients to a farmers market nearby to get them out for a little while. I think I got a total upper body workout!

[JessicaDanielle]

Please, please, please, ask someone for help when you need it! It is not worth an injury. I would gladly help my cna roll a patient, even if I'm busy, if it means there's less risk for an injury. When I have had completely immobile patients I have never hesitated to ask for help. A back injury is never worth it!!!

[Red Kryptonite]

That seems like a lot of turning. When I do a bed bath, I remove top linens and bag them first, then undress the patient and cover them with a large towel or bath blanket. If I'm washing hair, I put a chux under their head and do that first then remove the chux and replace with a dry towel which I wrap around their wet hair so it doesn't get cold. Then I wash and lotion their limbs and trunk, folding back and replacing the cover as I work, saving the brief area for last. I fold up the cover from the bottom, open the brief, and squeeze a good amount of warm soapy (no rinse) water over the peri area and clean the front well with the washcloth. Then I turn the patient away from me, wash and lotion their back, thoroughly clean the back part of the peri area, dry, and then pull off that side of the sheet and roll everything up against their back. Apply fresh sheet to those corners, tuck under old sheet and patient, place new geri pad and brief, one side rolled,under patient's hips, apply emollient and whatever else I've been instructed to onto the coccyx/buttocks, and then roll them toward me. If they are able I have them hold the bedrails; if they aren't or are a heavy turn, I have a helper. If I have a helper, they then pull everything through and get the sheet, pad, and brief straightened out. If I'm alone, I walk around the other side and do it myself. Roll the patient onto their back, apply whatever creams, etc. are needed in the front peri area, close the brief, dress them, position them in bed correctly, place top linens, and you're done. And the patient only has to put up with one full back-and-forth turn.

Missingyou's tips above are all great ones, too. People with expressive aphasia can usually still understand what's said to them, so talking and explaining what you're doing may help lessen anxiety.

That was long, but hope it helps.