How to successfully turn a patient in bed

From the diary of an in-home hospice nurse…

Patients who are bedbound should be turned every two hours. This keeps blood flowing to their skin, prevents bedsores and will absolutely keep them more comfortable over the course of the day (and night). I’ve attended to many patients who would rather just stay put because – in that moment – nothing hurts and they’d rather just be left alone. They will, however, feel better in the long run if you keep up this two hour schedule.

The Golden Rule of turning a patient in bed is: Never lift more than you can handle

Step 1: Create a base of support: stand with your feet shoulder width apart and place one foot a half-step ahead of the other. Use your legs not your back when lifting.
Step 2: Prepare the patient:

• Explain what is going to happen and encourage them to help if possible.
• Move the patient to the center of the bed, making sure the rails are up on the side you are turning the patient towards. The patient’s bottom arm should be stretched towards you.
• Place the patient’s top arm across their chest. Cross the patient’s upper ankle over the bottom ankle.

Remember the Golden Rule: Never lift more than you can handle

Step 3: Steps for the caregiver:

1. Raise the bed to a level that reduces back strain for you and make the bed flat (lowering the head and/or foot of the bed).
2. Get as close to the patient as you can.
3. Place one of your hands on the patient’s shoulder and your other hand on their hip.
4. Shift your weight to your front foot as you gently pull the patient’s shoulder toward you. Then shift your weight to your back foot as you gently pull their hip toward you. Make sure the patient’s ankles, knees and elbows are not resting on top of each other.
5. Make sure their head and neck are in line with their spine.
6. Return the bed to a comfortable position with the side rails up. Use pillows as needed.
7. In two hours, return patient to back, and repeat with the other side at next turn.