What is the importance of patient sitting up in chair?

Nurses General Nursing

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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.

Specializes in ICU.

There's an article in the American journal of critical care called Early Mobilty and walking program for pts in ICU: creating a standard of care. The article stated that 20 % of muscle is lost each week by being on bed rest. After one week on a vent, pts loose the muscle mass and their respiratory muscles change too. Early mobilization/ sitting in the chair keeps their muscle mass, prevents pneumonia because they take deeper breaths expanding the alveoli, our bodies weren't meant to lay around. We r an upright animal. I do get my vented pts up in chairs. I get my post op pts up for their sanity. I try to teach this to the new people on the floor. 10 years ago in our ICU every person got up that was hemodynamically stable. As new staff come in I see they do not feel/ see the importance of getting them up. One time I even extubated the pt in the stretcher chair. Doctor was uneasy cause of things went south and pt needed reintubation he was sitting up. I told him relax, it's a stretcher chair well just lay him back and he could intubate then I would put him to bed. Nbd!!! OP thanks for the question it was a good one!

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Specializes in Acute Care, Rehab, Palliative.
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?[/quote

I guess it would still help by shifting pressure on the body and the movement would encourage bowel activity.The patient would feel better psychologically just being out of bed.If they hadn't been out of be since the surgery it would be reasonable to have them sit up first.

I work on a hospital floor that is mostly Complex Continuing Care. We get slow stream rehab(lots of post op hips,strokes and broken legs),pneumonias, and elderly that are waiting for nursing home placement.EVERYBODY gets up whether it be with a walker, in a wheelchair, or in a geri chair.It helps with preventing bedsores, people breathe and swallow better sitting up straight and families like to see the patient up instead of in bed all the time. Most of them get out of their rooms this way too so they get a change of scenery and they get a chance to talk to other patients. We find that patients with swallowing isues are easier to position upright and they eat much better.

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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.

as others have said

decrease risk of clots, decrease risk of chest infections, got pt to return to baseline, decrease hospital stays

alter pressure points.

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Great post!! As many have mentioned the benefits of ambulating to chair! However I just had a patient not even 2 hours ago that had been in a bed for 2 and very interesting case. I'm at a big teaching hospital in the midwest and patient was transfered from small community hospital near by for resp distress, sepsis positive ESBL(not sure exact organism ESBL) blood culture, alveolar hemorrhage related to latent TB per medicine? and cerebral edema with anoxic brain injury. As neuro wanted to make patient family withdraw care she somehow turned around the other day and woke up extubated did well yadda yadda. How I relate to this is she is 320lb we got some new lift equipment within the last 6 months that is rarely uses because most patient we can slide into a chair or stand pivot to chair. I was the first out of the 9 nurses I was working with last night to actually think and utilize it and I think the biggest reason I did it was for her psychologically. With her history and obesity It's very reasonable to assume she wasn't moving around much before maybe to get from a bed to wheel chair so fourth. But the smile and her saying "I owe you a beer" was all I needed and when her family comes today I'm sure they will be elated after hearing all the bad news the past few weeks to see her sitting up. I strongly doubht it's going to improve her health or decrease her chance of dvt, aspiration pneumonia, e.t.c. It was difficult even with the lift and hope they can manage to get her back in bed sometime today. I guess what I'm trying to say is that there is compelling evidence to support the medical benefits but also just the kind gesture to make them feel at ease I mean being 320lb and 2-3 people turn you every 2 hours and clean pooh and pee has gotta just by embarassing and suck. thats all I have to say. From a dude RN

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All of the above reasons and in LTC...we encourage it alot. Esp for meals...lowers the risk of aspiration and who can eat laying in bed?

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Specializes in floor to ICU.

...to assist w/ pulmonary toilet (amongst other things) :)

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I'm surprised you passed NCLEX-RN without that knowledge. Good responses by great nurses! :yeah:

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A patient can breath more deep while sitting up than lying in bed. Have your patient use their incentive spirometer in bed then up in a chair you'll see the difference immediately. In bed their trunk is often scrunch together that does not allow for complete expansion during breathing.

Often patient's don't want to get up. My selling point is that it is as important as any medicine I am giving you. Too often I see staff ask or tell a patient they are going to get them up in a chair and the patient says "no" and they leave it at that. It is our job to tell them why it is important( lungs, skin, joint mobility, digestion etc) and if they still refuse you've done your part.

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wow, 19 responses and only two negative posts directed toward the OP

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Specializes in pediatrics, public health.
wow, 19 responses and only two negative posts directed toward the OP

Honestly, when I read those "I'm shocked you don't already know" posts, it makes it that much less likely that I will ever post a question here, for fear of the same type of response.

I don't (gasp!) remember everything I was taught in nursing school, nor do I remember everything I learned to pass the NCLEX. People should be able to ask questions here -- yes, even basic ones -- without getting slammed for not already knowing the answer!

:uhoh3:

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Specializes in med/surg/tele/neuro/rehab/corrections.

Good question! I learned a lot! Thanks for asking. :) I encourage you to post more questions! :D

I've seen patients in the ICU with a bed that sits them up. It turns into a chair position. The patient is completely sitting up with the feet down like in a chair.

I knew about DVT prevention and pulmonary toilet but wow so many other responses. Things I didn't think of before! You nurses really know your stuff! :D This is one reason why I visit allnurses. I love to learn, and also relearn stuff I had forgotten. :heartbeat

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Honestly, when I read those "I'm shocked you don't already know" posts, it makes it that much less likely that I will ever post a question here, for fear of the same type of response.

I don't (gasp!) remember everything I was taught in nursing school, nor do I remember everything I learned to pass the NCLEX. People should be able to ask questions here -- yes, even basic ones -- without getting slammed for not already knowing the answer!

:uhoh3:

I am sorry you did not like my post. :yawn: I just think sometimes we get far too many nursing students in this world that either slept or texted through important material. The teaching of the need for mobility is a VERY BASIC concept. Would you like to be taken care of by a nurse that missed a lecture that hinges on so many other topics?What else does she not know? I wonder if she is really an RN????? This new RN needs help! Just :twocents:!

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