Assisting the Resident to Sit on the Side of the Bed

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: footstool (if required).

Perform hand hygiene.
Explain the procedure to the resident and ask for his or her assistance in following directions.
Lock the bed wheels and ensure the bed is in its lowest position.
If the head of the bed is adjustable, raise it so the resident is in a sitting position.
Slide one arm under the resident’s shoulders and the other arm under the resident’s thighs.
While providing support, pivot the resident so his or her legs dangle off the side of the bed.
Support the resident until he or she has adjusted to the position change.
Provide a footstool if the resident cannot reach the floor with his or her feet.
Allow the resident to dangle for as long as ordered or proceed with the next procedure (taking vital signs, transferring the resident, etc.).
If the resident reports dizziness lasting longer than one minute while dangling, assist the resident in lying back down.
To lay the resident back down, place your arms under the resident’s shoulders and thighs and slowly turn the resident back into his or her original position.
Assist the resident into a comfortable position and adjust the head of the bed, if necessary. Place the call light within the resident’s reach.
Perform hand hygiene.
Document the procedure in the resident’s chart and report any changes in the resident’s condition to the nurse.

Important Information

Having the resident sit on the side of the bed is otherwise referred to as dangling. When a resident quickly changes position, especially from lying to sitting or standing, there can be a rapid drop in the resident’s blood pressure. This drop in blood pressure may cause dizziness or lightheadedness [1]. Dangling allows the resident to reach equilibrium in the upright position. The nurse’s assistant should encourage the resident to remain seated until he or she has regained balance and can safely assume a standing position.

References

1. Postural Hypotension: What it is & How to Manage it

More Resources

Perineal Care of the Male Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis.

Orthopneic Position

Patients with respiratory illnesses such as chronic obstructive pulmonary disease (COPD) find ways to help themselves breathe more easily. This can include sleeping with extra pillows to keep them propped up or leaning forward to ease the work of breathing. The orthopneic position is one forward-leaning position used to help patients breathe comfortably when they are having difficulty.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Feeding the Patient

Not all patients will need help feeding themselves. Some patients will only need assistance opening cartons or cutting their food. To promote independence, always let the patient do as much as he or she can before assisting. It is vitally important that the nurse’s aide verifies that the patient receives the correct meal tray. Patients may have special diets that play a critical role in their health (i.e., pureed diet, gluten-free diet, food allergies, etc.). Feeding the wrong food to the wrong patient could result in serious complications.

Measuring the Apical Pulse

The apical pulse rate is the most accurate non-invasive measurement of heart rate because it is measured directly over the apex of the heart. Apical pulse is preferred in cases when the radial pulse is difficult to palpate, when the pulse is irregular, greater than 100 beats per minute, or less than 60 beats per minute when measured by other means (electronic, radial, etc.).