Nursing & Healthcare Programs

Fowler’s Position

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

Fowler’s position is used when a patient is eating, is having difficulty breathing, or is ordered by a doctor. This position is easily recognized because the patient will be sitting äóìstraight up.äó Semi-Fowlers is sitting äóìhalf-way up,äó and is used when patients cannot be laid flat, but wishes to be in a more relaxed position than Fowler’s. This position is often used for patients who are receiving feedings from a nasogastric tube to prevent aspiration while they sleep.

Achieving Fowler’s Position (aka, High Fowler’s)

  1. Start with the patient lying supine (flat on their back) with the body in proper alignment.
  2. Gently raise the head of the bed to 90 degrees.
  3. Place a small pillow behind the patient’s head and one at the lower back. These are not to make the patient lean forward, but to help support and keep the body aligned.
  4. Place a small pillow under the thighs. Place pillows lengthwise under the calves, but leave the heels unsupported. This helps prevent pressure injury to the heels.
  5. If the patient has difficulty moving their hands or arms, support the hands and arms with pillows.
  6. Ask the patient if they are comfortable. Make adjustments as necessary.
  7. Document the position per institutional or unit policy. Report any difficulty getting the patient into position or maintaining position to the nurse per policy.

Achieving Semi-Fowler’s Position

  1. Start by ensuring the patient has proper body alignment.
  2. Gently adjust the head of the bed to 45 to 60 degrees.
  3. Follow steps three through seven above.

References

Activity and mobility. (2014). In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 210-213). St. Louis, MO: Mosby Elsevier.

More Resources

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It is important to remember on which side to place the chair when assisting a patient in transferring. Putting the chair on the resident’s unaffected side allows the resident to lead with his or her strong extremity. This eases the procedure for the resident and reduces the risk of falling.

Oral Temperature Measurement with an Electronic Monitor

Body temperature is one of the vital signs frequently measured in healthcare settings. Changes in a body temperature can indicate improvement or worsening of a patient’s condition, so accurate measurement is important.

Using a Gait / Transfer Belt to Assist the Resident to Ambulate

Walking (aka, ambulating) helps residents maintain mobility and independence, and prevents complications. However, ambulation must be done safely so that the resident does not have a fall or injury. A gait or transfer belt, when properly used, can increase resident safety. Gait belts can vary between facilities, so make sure you know how to use the one in your facility.

Measuring Blood Pressure

Many factors can interfere with obtaining an accurate blood pressure. The most common mistakes that lead to inaccurate blood pressures are a result of improper technique, including: not supporting the patient’s arm, using the wrong sized cuff, positioning the cuff too low on the patient’s arm, improper positioning of the cuff’s artery marker, and attempting to measure blood pressure through clothing.

Putting on Personal Protective Equipment

Personal protective equipment is worn to protect the mouth, nose, eyes, clothing, and skin from unwanted pathogens. In the health care setting, a patient’s condition often prompts the use of personal protective equipment; however, a health care worker is able to wear personal protective equipment whenever he or she deems it is necessary (e.g., during procedures with the potential for excessive contact with bodily fluids).

Making an Occupied Bed

If a patient is bedridden or on bedrest, the bed linens will need to be changed while the patient is in the bed. For safety reasons, the nurse’s aid should avoid making an occupied bed if the patient is able to get out of bed. Bed linens should be changed according to the facility’s policy or anytime they are wet or soiled.