Lateral (Side-Lying) 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

The lateral, or side-lying, position is often comfortable for patients when they wish to sleep or relax.

Achieving Lateral Position

Start with the patient lying supine (flat on their back) with the body in proper alignment.
Stand on the side of the bed opposite the direction the patient will be facing and raise the bed to a comfortable working height. Lower the side rail. Move first the upper trunk (shoulders and chest), then the lower trunk (abdomen and hips) toward you. A draw sheet can also be used for this movement. Raise the side rail.
Walk to the other side of the bed (the one the patient will be facing). Lower the side rail.
Bend the patient’s knee that will be on top once the patient is on their side.
On the side that will be on top (away from the mattress), place one hand on the patient’s shoulder and the other hand on the hip and roll the patient toward you until they are on their side.
Place a pillow under the patient’s head to maintain proper alignment.
The patient’s arms should be slightly flexed with a pillow supporting the upper arm in line with that shoulder.
Place a pillow behind the patient’s back to help them stay in position.
Place a pillow under the slightly bent upper leg to maintain alignment with the hip.
Ask the patient if they are comfortable. Make adjustments as necessary.
Document the position per institutional or unit policy. Report any difficulty getting the patient into position or maintaining position to the nurse per policy.

References

Activity and mobility. (2014). In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 210-216). St. Louis, MO: Mosby Elsevier.

More Resources

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Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.

Perineal Care of the Female Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Proper technique is important for maintaining hygiene, preventing infection, and avoiding skin breakdown. Because of the close proximity between a woman’s urethra, vagina, and anus, it is essential to only wipe in a front to back motion. Wiping in the opposite direction is associated with a greater risk for developing a urinary tract infection.

Applying a Condom Catheter

Condom catheters are used for men who are incontinent. These catheters are external and are meant to be used short-term and changed daily.

Indwelling Catheter Care

Indwelling catheters allow urine to drain from the bladder. They are used when residents are unable to urinate on their own or when the process of cleaning the resident after urination would be difficult for the resident to tolerate (such as during end of life care). Caring for the catheter appropriately is a vital part of preventing infection and skin breakdown.

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

Performing Ostomy Care

Residents who have had a portion of their intestines removed due to illness or trauma may have a temporary or permanent ostomy, which is an opening in the abdomen that is created for the elimination of urine or feces. The portion of the intestine that is connected to the abdominal wall and is visible is called the stoma. A pouch is placed over the stoma to collect feces.