What is the importance of patient sitting up in chair?

[stellaRN1983]

Hi,

I'm a new RN, I feel like this is a stupid question...but I wanted to know what is the importance of patient sitting up in chair. I had a patient today that one of the nurses and nursing assistant that was helping me put him on a lift and got him into the chair. I was turning and repositioning him q 2 hrs but they put the work in getting him to the chair. I see other RN who emphasize getting up in the chair. Is this to help them be more awake, breathe better (when he is breathing fine?)

Thanks.

[thenameismac]

I see it like this...would you want to lay in bed all day? I know I hate it. Even if I am sitting up. It's nothing like leaning your back against the chair with your feet touching the floor. Also change of view, I suppose. Maybe when he's in bed he slides down a lot and that could compromise his breathing. I mean, that's just what I can think of. Maybe you just haven't really thought about it before but hopefully I presented new ideas to you regarding the issue.

[nursej22, MSN, RN]

A few reasons to get out of bed:

Promote lung expansion

Shift pressure points

Strengthen trunk muscles

Easier, safer to eat

Increase activity to decrease risk of DVT, bone demineralization

Prepare patient for mobilization

Demonstrate to patient they are getting better

Comfort

Better digestion, elimination (on BSC instead of bedpan)

I have seen many patients reluctant to get out of bed initially but admit they feel better once they are up.

[NeoPediRN]

DVT prevention, postural drainage, and to help move air are the top three reasons that come to mind.

[barbfrank]

Changing position, (i.e. getting into a chair) is not only advantageous physically, but mentally as well. No matter how well you think someone is breathing, when they're up in a chair they have better lung expansion and are able to mobilize pulmonary secretions much better. Also, if someone is lying down all the time, they have a tendency to fell lightheaded and dizzy when they do get up because of a drop in BP. Muscle strengthening (like someone else said) is another advantage. When we sit upright, we're also less likely to experience gastric reflux. Even though we reposition patients in bed, being upright is another position all together which is important for the prevention of skin breakdown. And psychologically, the patient is going to feel better and more alert when they aren't lying in bed 24/7.

[K+MgSO4, BSN]

think how you feel after lying in bed sick for a day or 2. Your muscles are weak, your light headed and your back is sore from lying on it or on your side.

Getting your patient up reduces these issues, is a lot safer and more appropriate for them to eat (personally I worry when some one is eating in bed no matter how well positioned they are about aspiration and reflux). It promotes core strength, it reduces the sick role and it is reassuring for family members to see their loved one out of bed. It reassures them that they are getting better.

Plus what everyone else said.

[steelydanfan]

Changing position, (i.e. getting into a chair) is not only advantageous physically, but mentally as well. No matter how well you think someone is breathing, when they're up in a chair they have better lung expansion and are able to mobilize pulmonary secretions much better. Also, if someone is lying down all the time, they have a tendency to fell lightheaded and dizzy when they do get up because of a drop in BP. Muscle strengthening (like someone else said) is another advantage. When we sit upright, we're also less likely to experience gastric reflux. Even though we reposition patients in bed, being upright is another position all together which is important for the prevention of skin breakdown. And psychologically, the patient is going to feel better and more alert when they aren't lying in bed 24/7.

I'm just a little shocked that mobilization and it's benefits was not taught to you in school.

[backatit2]

you know when i was 23 years old and healthy as could be - i was begging to take a shower the day after i had a c-section. the nurse told me to get up and SIT IN A CHAIR for awhile and then i could shower (with assistance) if i did ok. i didn't know if it was a stall tactic or if it was because i had been taking pain meds she was afraid i may be unsteady - i don't know. i remember sitting there thinking would this lady come back so i can get in the shower? but i'm sure having me get to the chair and sit awhile was a meaningful part of her assessment (i hope) or she wouldn't have done it.

btw, i showered fine by myself. she just stayed in the room incase i needed help and then helped my put on my funky underwear/stockings.

[blue heeler]

along with everything else that has been said, it feels good to the patient.

[AZRNHopeful]

I'm not a nurse (yet!), but I've been on the patient side of this situation. Here's the deal. When I was in what I consider a ton of pain (7-9, if you want to use that lovely scale), for the first 2-3 days following surgery, the last thing I wanted was to go from my multi-thousand dollar awesome bed to sitting in a chair.

It was uncomfortable, and it sucked. Lots of things in the hospital are uncomfortable and sucky, but there was no benefit to putting me in that chair at that time. However, my first ICU nurse literally demanded that I sat in that chair. In retrospect, I could have said "no," but morphine does funny things to one's reasoning.... Let's just say I would have much preferred to be in my bed.

After being in the hospital for awhile, I do think it was important for my nurses to get me into a chair every day. Not just for the physiological reasons, but really for the psychological reasons. To eat a meal in a chair every day versus the bed helps bring structure to the patient's life. It helps alleviate depression that can come along with long-term (or even short term) hospital stays.

What I think it all boils down to is how much you, as a nurse, can get a snapshot of your patient's needs in such a short amount of time. Long-term high pain patients need the chair because it represents structure. At other times, it's simply inappropriate and unnecessary.

Sorry this post is so long-winded. Obviously this is not just about the chair, but the fact that as nurses, it's such an important, and a truly amazing skill, to be able to accurately access what patients need, both medically and psychologically.

[backatit2]

i tried to edit my post, but i couldn't - to say:

most responders to this thread have said sitting is important because of what seems like physical/psychological reasons for LONG TERM care patients.

i re-read the OP and now see that maybe this is a LTC patient who is wondering what the benefit is of sitting in a chair vs. lying in the bed might be. i guess because i would never personally think that would be a logical question about a LTC patient - i assumed the OP meant in general - why would a patient (period) perhaps post-op or whatever be made to sit in a chair. i obviously understand the reasoning behind a LTC patient sitting in a chair, but does anyone have any comments about why a post-op patient (a healthy, young patient) such as i mentioned would be asked to sit in a chair?

i know i totally missed the point of the post bc i have too much common sense, but i'm still curious.

[Bruce_Wayne, ASN, RN]

In addition to what everybody else has said, which has been great, having pts sit up in chairs can have some diagnostic purposes as well. I've seen it used to check for spinal leaks, basically get them up and see if it gives them a headache or not.