Supported Side Lying Position CNA Skill

A NEWER VERSION OF THIS SKILL CAN BE FOUND HERE: • Change Position to Sup...
THIS IS AN OLDER VERSION OF THIS SKILL. View how this skill should look when performing for the Florida CNA State Exam. View to proper way to safely position an immobile patient onto their side and use pillows to keep them in that position. This must be done every two hours around the clock for immobile patients to keep the patient from developing bedsores. This skill is one of the 21 testable skills on the Florida State CNA exam and is also used in RN and LPN training. Additional resources can be found at 4YourCNA.com.
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[@jazminewilliam3000]

I took my exam yesterday and passed, your videos definitely helped. Thanks

[@nanderlohr]

The one thing/step that these videos forget is elevating (either the head of head and the entire bed too) the bed and lowering the bed once finished with the skill or helping the patient with what ever needs to be done. Other then that most of the steps in theses cna skills videos are spot on.

[@Teekayt1]

This was the first skill I did on the day of my exams! thank you so much for these awesome videos! I PASSED! the evaluator referred to all of my skills as "PERFECTO" AND SHE CLAPPED FOR ME! You are indeed an exceptional and an amazing tutor! I would like to recommend your classes to the whole world!!!! Love you! Taku

[@georgejgilles.3999]

That was your first skill but I must ask was that your only skill?

[@4yourcna]

No. You will not be graded on side rail usage for the exam and this means that even if you use the side rails, they will not count. You must provide for safety regardless of side rail usage because many settings do not use side rails (they are a restraint). Scoot the patient toward you before turning so they remain in the middle of the bed to ensure safety.

[@4yourcna]

The overbed table is not considered clean (patients may have put used kleenex, urinals, etc on it) so you should put some type of barrier on the top of the table to provide a clean surface for the pillows. Privacy blankets should be used to protect privacy and keep the patient warm anytime the sheet has been removed. Not providing privacy is an invasion of patient's rights, which is a graded point for the exam on all skills. You should use the blanket when you test. Good luck!

[@4yourcna]

I am not familiar with California standards, specifically, but these are general nursing principles that should be employed in all nursing settings. Good luck!

[@4yourcna]

Raising the bed to a comfortable height is optional (but don't forget to put it down at the end, if you do raise it). Siderail use is not graded on the exam, and many testing facilities won't even have siderails because siderails are considered a restraint and cannot be present in many settings so you must learn how to accomplish these skills safely without the use of siderails. Scoot the patient toward you and roll them away from you so they are on their side in the center of the bed. Thanks!

[@4yourcna]

I am glad that you are finding our videos helpful as you prepare for the state exam. Good luck!

[@4yourcna]

Thank you for your kind comment! We are happy you are finding our videos helpful! Good luck in your new career!

[@tanyaalexander7681]

I took my test today and passed, these videos were very helpful.....Thanx!!!!!!!!!!!

[@4yourcna]

In a clinical setting, you would have to scoot the patient toward you in sections. For the exam, to prevent injury to yourself or the "patient", you are allowed to ask the patient to scoot toward you at the beginning of the skill. You will not be allowed to use items like draw sheets or additional staff to move patients safety for the exam and they do not want injuries, so they allow this action FOR THE EXAM only. Thanks and good luck!

[@4yourcna]

Yes, you will get your exam results on the day of the test, as you leave the testing center. You will receive two results, one for written and one for skills. Both portions must be passed for certification.

[@4yourcna]

Thank you so much for your recommendation! We are so happy that you have found these videos helpful in preparing for the exam! We wish you great success in your new career!

[@4yourcna]

Providing privacy is important in every skill, as it is an important patient right. You can provide privacy with the sheet on the bed or the privacy blanket. I prefer the blanket because it allows easy access to the feet, but you can use either. Good luck!

[@4yourcna]

@annieD72 Yes, that is acceptable, however it will require more effort on your part and may injure the patient needlessly. By bending the leg first, the body weight is shifted toward the side you are turning them on, making the roll much easier on both of you! Save your back - bend their knee! Thank you for your comment!

[@4yourcna]

We wish you luck on your exam and in your new career!

[@4yourcna]

Thanks for the great comment! We are happy that you have found our videos interesting and informative and wish you luck in your pursuit of a new career!

[@4yourcna]

We are putting up new instructional videos with close-up camera views of many of the skills. I do not know when this one will get completed and processed, however. The first pillow goes behind the patient's back, the second one between the knees AND ankles, the third one under the upper arm to keep it in alignment and then you have to adjust the pillow under the patient's head to make sure it is NOT under the shoulder, only the head and neck. Hope that helps! Thanks for the question!

[@4yourcna]

The pillow between the legs is positioned to support both the knees and the ankles, when positioned properly. Putting two pillows between the legs may be uncomfortable for the patient and is unnecessary (you will not always have adequate supplies if you use that many pillows). The blanket removal does not cause shearing if the blanket is repositioned with every pillow placement to keep the blanket from becoming wrapped up around the patient or the pillows. Good luck!

[@4yourcna]

Your opening is "Hi, Mrs Jones (identifying patient), my name is Patti and I am your CNA today. I am going to change your position, is that ok?" This identifies the patient by name (armbands are not used in all settings and cannot be relied on to be correct), identifies yourself by name and title, tells the patient why you are there and obtains permission. Hope this helps!

[@georgejgilles.3999]

Excellent demonstration. Thank you so very much for making these videos. My exam is next week. I surely hope I pass.

[@4yourcna]

Yes, you have to verbalize somehow that you are finished with the first task assigned and moving on to the next. You may make any corrections necessary on that skill up until you verbalize that you are finished. Good luck!

[@4yourcna]

Flash cards on the skills will assist you in learning the specific steps and reviewing these videos should help you remember how to perform these skills when you test. It is always best to physically practice these skills yourself to help develop a "muscle memory" to increase your comfort level when performing the skills for the test. Good luck on the test!

[@mariecanal1962]

Thank you Miss

[@4yourcna]

Good luck! We hope you did well on your exam! We wish you luck on your new career!

[@4yourcna]

@phillbanger These videos reflect curent Florida state standards. You will need to check with your state for their specific requirements. That being said, these basic skills require the same infection control standards, safety considerations and patient rights in all states. There may be minor differences in how these physical skills are taught or tested, but the basics will remain uniform according to best nursing practices. Thank you for your comment!

[@esperanzasantos44]

Thank you Patty, I passed my test today, I did Respiration, mouth care, and this one, I passed thanks to your video, they only made two observations.

[@4yourcna]

+Esperanza Awesome Job! Congratulations! Best of luck in your new career!

[@esperanzasantos44]

+4yourCNA Thank you Patty, you are the best!!!

[@mrandmrs2k596]

+4yourCNA HELLO MS.PATTY CAN I ASK YOU A QUESTION I TOOK MY CNA CLINICAL SKILLS TEST , AND FAILED. IS IT TRUE WHEN YOU FAIL YOUR SKILLS YOU WILL TAKE THE SAME SKILL AGAIN NEXT TIME WHEN YOU RETAKE YOUR TEST?

[@mrandmrs2k596]

+MRAND MRS2K5 OH THIS IS FOR FLORIDA CNA

[@4yourcna]

Thank you for your comment! We are so happy that you are finding the videos helpful to you. Good luck on your test and in your new career!

[@jeanjuniormontinard3044]

Thank you so much now I am ready to pass my exam cause of your help. Good job Lady P

[@26araya]

I just want to say : THANK YOU FOR THE VIDEOS! I PASSED AND REALLY LEARNED SO MUCH FROM THESE VIDEOS!! ♥

[@verybeautifulrachel3571]

Thanks for your skills they made me they pass my test yesterday.

[@SelfloveSoftlife]

Mrs patty thank u so much for the time u took out to make these videos. You have helped me pass and ive told others how great u are. once again thank u.

[@4yourcna]

Unfortunately, I cannot speculate on whether you passed. Correcting your mistakes certainly helps improve your chances of passing. It shows you are aware of the errors. I certainly wish you luck and let us know how you did! Sending you good wishes!

[@4yourcna]

Yes, you may wear gloves when you handle linen. It is not required for the exam (since they are not soiled with body fluids) but you may wear them if you wish! Just be careful in what you touch with your gloves before and after the skill so that you do not violate infection control standards. It is important to recognize clean vs dirty areas and not cross-contaminate. Thanks!

[@4yourcna]

You may adjust the height of the entire bed if you prefer to do so, but it is NOT a requirement for the state exam. The state exam understands that not all settings have adjustable beds (home care and assisted living, for instance), therefore this is not a requirement. If you do wish to raise the bed, you should do so before handwashing because the bed controls are not clean and you do not want to contaminate your clean hands after handwashing. Thanks and good luck!

[@4yourcna]

Yes, the pillowcase opening should be away from the door (this is explained in the instructional video and in our classroom program). The pillow between the legs should also have the pillowcase opening facing downward. These videos (demonstrational) are designed to demonstrate the skills but do not provide comprehensive teaching. View our Instructional videos for greater comprehension. Good luck!

[@stevenwilliams5403]

in my class...well in the book we are learning in the book says to position the arms across the chest before rolling a resident and or patient on to his or her side. but i have seen two videos on here in which you have raised the arm above the head. so i assume its correct. also i noted the leg being lifted, not to insert the pillow but to position on the side. that was also new to me. but i also assume this is correct. im very detail-oriented and i do not want to fail but i see some videos that are not as accurate as yours. but i will use your technique yet also following the prometrus guidelines they will be using. but your videos have taught me to be more cofident and comfortable when doing these skills. thank-you.

[@4yourcna]

Glad you found the videos helpful! Good luck in your new career!

[@millimeter1030]

Thank you so much for these video. I take my CNA state test today and i passed.

[@4yourcna]

That is SO AWESOME!!! We are so proud of you! Congratulations and best of luck in your new career!

[@4yourcna]

You can use the sheet if you prefer, but it is hard to place the pillow between the legs when using the sheet. It also tends to wrap around the patient when turning. Many people find it easier to use the privacy blanket (plus, it is consistent with othe skills) but you may use the sheet, if you prefer. Just maintain privacy in some way during the skill.

[@4yourcna]

For the exam, the patient will be able to be positioned as demonstrated in the video. This keeps the patient from lying on their arm for an extended period of time. If you have a situation, with a real patient, where this is not possible, you will need to talk to the nurse about possible ways to adjust the skill for that specific patient. Testing will use another candidate as your patient for all skills except personal care skills, which will use a manikin (peri-care, partial bedbath, dressing)

[@4yourcna]

Yes, you should limit the wrinkles under the patient as wrinkles will contribute to bedsore formation. However, it is next to impossible to remove ALL wrinkles under the patient and is not expected on the exam. Just smooth the sheet as best you can, considering there is a person in the bed. Good luck!

[@4yourcna]

Privacy is important with EVERY skill you do. Think about how you would feel lying in the bed. Take the time to talk with the patient, explain what you are doing each step of the way and protect their privacy and dignity. It is the right thing to do and it is what you would want when you are the patient.

[@4yourcna]

No. A pillow in this position is not necessary unless specified in the care plan. You do not want bony areas to touch (that is the reason for the pillow between the legs) but if the patient has particularly bony ankles, inadequate protein intake, poor skin integrity, impaired circulation or another condition such as diabetes the RN may specify that all bony prominences in contact with the mattress be padded. In this case we often use an alternating pressure mattress but every case is different.

[@vanessafawcett9695]

Oh, I took the crash course a few months ago (I am also in Florida but on the East Coast)...I notice you do some things relatively the same however you take a few more steps, I am so nervous for my exam I really really hope I pass. I am trying to watch as many videos as I can!!! LOL

[@4yourcna]

I am sorry that you are experiencing confusion. These videos were created using Florida Guidelines and developed by an RN utilizing best nursing practice principles. The clinical skills checklist (located on Prometric's website, the testing agency) does not specify this as a testing checkpoint, so you will not be graded on which way you roll your patient, as long as you keep the patient safe. Rolling away from you is the accepted practice and generally done for the test. Good luck!

[@4yourcna]

In the state of Florida, you are NOT graded on the use of side rails. You CANNOT rely solely on side rails to keep your patient safe. You MUST scoot the patient toward you then turn them on their side so that they are in the center of the bed. Using side rails to keep a patient in the bed is a restraint. This is a FEDERAL law, no matter what you teacher said.

[@MommaNessa0624]

I was taught you needed to make sure there was no wrinkles in the sheet or it could cause bed sores? My test is Saturday I want to be sure I know the correct information

[@richardolivia]

Memories of when I was a patient in rehab! One of the first things I was adamant about learning was how to roll myself in bed...mainly because I got sick of being woke up all the time to be position changed.

[@4yourcna]

Gloves are optional for this skill for the exam. Gloves should be worn if you are going to be exposed to body fluids or touching personal skin. This patient is continent (able to hold their bowels and bladder) and fully clothed, so there is no possibility of contact with personal skin or body fluids, therefore gloves are not necessary. If you are unsure of what is under a patient in a clinical setting, by all means, wear gloves! But for the exam, it is not necessary. Thanks and good luck!

[@Gardenofaden]

I learned about how you should have the open side of the pillowcase away from the door? Or for the pillow in between the legs going away from the patient?

[@Panicatthejazz]

These videos are my study guide when it comes to the skills part

[@tarahawkins1574]

i only watch cna4all, my exam is in 3 more weeks...i know i will pass it watching patty

[@4yourcna]

This was not "left out" because it is not a testing standard. Providing water is a function dictated by the care plan. There will be patients that cannot have water because they are on fluid restrictions. Because of that, this step is NOT TESTED. You will ask about comfort and if the patient needs anything else at the end of the skill, but providing a cup of water is not tested. Thanks!

[@jazmathompsond]

Your videos have been very helpful but I thought when turning the patient the siderails had to be up from preventing the patient from rolling out the bed

[@4yourcna]

Best of luck to you!

[@4yourcna]

Siderails are not graded during the Florida exam because siderails will not be present in every setting (they are considered a restraint). Therefore, you must be able to perform the skill safely without the use of siderails. This skill demonstrates how to perform the skill without siderails. You may choose to use siderails (if they are available) during the test, but you should position the patient in the center of the bed for safety, even with siderails. Good luck!

[@angie70595]

Why is the bath blanket needed? Couldn't the top bed sheet just be used? Thanks

[@4yourcna]

First, you will NOT elevate the head of the bed for this skill. You cannot position the patient properly if the head of the bed is up. Second, the entire bed may be raised to a comfortable working height if you wish, but it is NOT REQUIRED for the exam. This is not mentioned in the video because it is not a testing standard. These videos reflect current testing standards. Raising the bed will be covered in a classroom setting where the safety implications can be covered more completely. Thanks!

[@davidmcfarlane9395]

Thank you very much for these helpful videos. Keep up the good work.

[@ukas4e]

this very helpful to me. Thank you. .You are the best.

[@karloceasar72390]

hellow.. your video is so informative.. but i just want to ask one question.. when and how do you identify the resident? like you just immediately identify your resident without clarifying it. thanks :)

[@Loveionable3000]

Do you have another angle so that we could see where the last pillow will be placed?

[@brista128]

Do you have to say at the end "i have reviewed my skill and my skill is done"?

[@26araya]

I have my state exam soon! I am so nervous! !

[@karloceasar72390]

why did you not adjust the bed into your waist level? and when are we going to adjust it? before or after handwashing?

[@Panicatthejazz]

They are I'm taking my test next week and I'm not as nervous as I was

[@KoreaXFan]

Do we not require a fourth pillow to act as a barrier between Mr. Jone's left foot and the bed?

[@annieD72]

Is it ok to roll the patient on his side first and then position his leg in the bent position?

[@jorgitoherrera9983]

why do I have to use privacy blanket instead of using the same sheet the patient is using?

[@sotoalexandra57]

Hello Patty, I took my state test today, i was very nervouse i made a few mistakes like i forgot the call light but then i remembered and i fixed the mistakes before i ended my skills. Do you think i have a chance of passing? It takes 3 weeks here in MA to get the results.

[@barb8335]

Wouldn't that cause shearing when she pulled the cover off of him before she covered him back up? What about placing another pillow to support his ankle and foot? Florida CNA?

[@youniquesworld]

if you forget to use tue privacy blanket will you fail that skill

[@ariegreg95]

I'm In Florida And I Was Told That We Need 5 Pillows For This Skill.. I Take My Exam Tuesday.. Please Help. Thanka

[@challindickenson4982]

Arie KeysI am from NEW York....supplies 3 pillows

[@iCandySuperb23]

i've watched a few of your videos & i've noticed that you do not state the necessity of gloves or that you haven't used gloves

[@nursechristielynn12]

Bed rails are not to even be considered in any exam any longer. The prometric site clearly states and if there are side-rails at your testing site, to disregard them.

[@MegaRafaelloco]

Presley Saleh 2 Bed rails are to be considered in my state, NC

[@kerryannjohn5671]

can we use gloves for this skill

[@jmichelle83]

Why do you roll away from you? My instructor here in Fl said you always roll toward you. Now I don't know what to do. I want to pass and I am getting so much conflicting information.

[@4yourcna]

No, you do not need gloves on this skill. You only need gloves if: 1) you will be touching body fluids 2) you will be touching non-intact skin (wounds, rashes, incisions) or 3) you will be touching "personal" skin, such as the genitals. None of those apply, so gloves are not necessary. Good luck.

[@zyleah4594]

do u have to keep resident covered when performing this skill

[@faithimani5480]

Making occupied bed is it a tested skill?

[@4yourcna]

You can, but it is not necessary if the patient is continent and has no sores. Gloves are not required for the exam. Please like our facebook page!

[@brianperez8368]

do you need to put on gloves for this skill?

[@gregengler1743]

What about raising bed rail?

[@nanderlohr]

One more step that is left out in these videos is placing the patients water within reach using the over bed table.

[@siemprecuba]

HI, NO PUT GLOVES AT THE Supported Side Lying Position AND MAKE AN OCCUPIED BED?, EXAMINATION MY IS TOMORROW

[@1988RLO]

If a patient is immobile, how will they be able to scoot toward you?

[@karloceasar72390]

@4yourCNA ok :) is that also used in california when having a skill test? coz im taking the test in red cross :) im kinda nervous ryt now :)

[@4yourcna]

You do not have to state that you will or won't use gloves. If gloves are needed (if you are going to be touching any body fluids, non-intact skin or personal skin), then you should apply your gloves at the proper time. If you do not need gloves, you do not have to say anything about gloves. Good luck.

[@kerryannjohn5671]

hey patty how r u? in florida do we get our exam result the same day we do our exam

[@loyalhufflepuff8869]

What is T&P positioning?

[@brianperez8368]

do u need to put up the bed rail?

[@4yourcna]

Congratulations! We are so proud of you and wish you great success in your new career! We are so happy that you found our videos helpful. You can make a small thank you donation on our website if you wish! Please tell others about our videos! 4yourcna dot com

[@mewstix]

I was taught to roll resident TOWARDS you not AWAY. If you roll the patient away, the patient may fall. Its safer for the resident to go the other side and roll them towards you.

[@jeanjoyce663]

Taking my exam tomorrow but I was told u knew roll a pt away from u a bit confused

[@4yourcna]

Never roll a patient toward you! Their body weight is too far away for you to control (most body weight is along our backside when we are on our side) and if they roll backward (the most common way of rolling), you have no way of controlling their movement and preventing a fall! This is very poor body mechanics. One other thing...the patient should never be eye level with your crotch. Rolling a patient toward you puts their face in an uncomfortable position and should be avoided. Always roll a patient away from you! Please view our newest skills videos for updated skills performance! Thank you and good luck!

[@Panicatthejazz]

Ok this is good because I know you needed 3 pillows I just forgot how to position them the right way

[@karloceasar72390]

thanks for the information. that helps a lot :)

[@4yourcna]

Thank you for your kind comment! Please feel free to visit our website 4yourcna dot com for additional resources. Plus, donations of any amount are appreciated and will help keep these resources free! Best of luck to you!

[@vladimirjoseph5847]

Not raising the bed to your level could cause back injury, but otherwise she is the best!!!

[@4yourcna]

Thank you for your comment! We are glad you are finding our videos helpful! please view our newest videos for updated skills instruction (this is one of the older videos)! Best of luck! Raising the bed to a comfortable working height is not REQUIRED for any skill in Florida (or any Prometric-testing state). It IS required in some other states, however, so check with your state board for clarification if unsure. Since it is not a required step for testing, it is not demonstrated in these videos. Please remember that if you DO elevate the bed to a comfortable height, you MUST lower it at the end of the skill (because the patient expects the floor to be right where they left it when they got into that bed). Hope this helps!

[@ALEXOO11]

taking my test tomorrow

[@lids6641]

body mechanics!! raise the bed! 2:12

[@4yourcna]

For the exam, you are not required to raise the bed to a comfortable working height - this is NOT a testing standard. You may raise it if you wish, but if you raise it, it MUST be lowered at the end of the skill to prevent the patient from falling (because the floor won't be where the patient left it...). Since this step is NOT required and can cause you to fail, it isn't demonstrated in the video. Height adjustable beds are not present in every patient care setting (home care, assisted living, low income nursing facilities, etc.) so it is not a required step. Thank you for your comment.