Nursing & Healthcare Programs

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

  1. Start with the patient lying supine (flat on their back) with the body in proper alignment.
  2. 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.
  3. Walk to the other side of the bed (the one the patient will be facing). Lower the side rail.
  4. Bend the patient’s knee that will be on top once the patient is on their side.
  5. 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.
  6. Place a pillow under the patient’s head to maintain proper alignment.
  7. The patient’s arms should be slightly flexed with a pillow supporting the upper arm in line with that shoulder.
  8. Place a pillow behind the patient’s back to help them stay in position.
  9. Place a pillow under the slightly bent upper leg to maintain alignment with the hip.
  10. Ask the patient if they are comfortable. Make adjustments as necessary.
  11. 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

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.

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.

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.

Assisting the Resident to Transfer from the Bed to a Chair or Wheelchair

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.

Performing the Heimlich Maneuver

The Heimlich Maneuver, also known as abdominal thrusts, is used to remove an object that is blocking a resident’s airway and preventing air from reaching the lungs. It only takes four to six minutes for brain damage to occur from lack of oxygen, so prompt action is vital.

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.