Supine Position

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: pillow.

  1. Perform hand hygiene.
  2. Explain the procedure to the patient and ask for his or her assistance in following directions.
  3. Lock the bed wheels and raise the bed to a comfortable working height.
  4. Lower the side rail on the working side. Ensure the opposite side rail is raised.
  5. Lower the head of the bed until the bed is completely flat.
  6. If the patient is in the prone position, turn the patient onto his or her side.
  7. Once the patient is side lying, decide if there is enough room to complete the roll onto the patient’s back.
  8. If there is not enough room, move the patient to the center of the bed while he or she remains in a side lying position.
  9. When there is adequate room, complete the roll by assisting the patient onto his or her back.
  10. Place a pillow under the head. If desired, place pillows underneath the arms and/or knees for support. A small towel roll can also be placed under the back to support the curvature of the spine.
  11. Ensure the patient is comfortable, return the side rails to their original position, lower the bed, and make sure the call light is within the patient’s reach.
  12. Perform hand hygiene.
  13. Document the procedure in the patient’s chart and report any changes in the patient’s condition to the nurse.

Important Information about the 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). The most commonly affected areas are the back of the head, shoulder blades, coccyx, calves, and heels [1]. The nurse’s assistant should always check these areas when turning patients and report any redness, irritation, or other issues to the nurse.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495374/

More Resources

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The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.

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Fowler’s Position

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 “straight up.” Semi-Fowler’s is sitting “half-way up,” and is used when patients cannot be laid flat, but wish to be in a more relaxed position than Fowler’s.

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.).

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.

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.