Skill: Making an Occupied Bed

Question: What if the resident can’t scoot to the middle of the bed?

Answer: Check the care plan! As CNAs, you do not plan care or make decisions. That is not in your scope of practice. If the patient can’t scoot toward you before turning them, the nurse would have an alternate method of movement listed, such as “use a draw sheet to lift the patient’s torso toward you” or “use a slide sheet to re-position patient closer to you prior to turning” or “move the patient in segments (legs, hips, shoulders, head) gently toward you” or even “two person assist with draw sheet to prevent sliding”. This means the RN has assessed the patient and taken into account all of their specific needs, such as: does the patient have any wounds with dressings? does the patient have fragile skin? does the patient have lots of tubes to work around? has the patient had a recent surgery? does the patient have burns, rashes or sores? is the patient on blood thinners? is the patient sedated? does the patient have weakness or paralysis on a specific side? does the patient have contractures (joints that are bent and unable to be straightened)? There are literally HUNDREDS of things this RN has to take into account regarding this specific patient (patient condition, labs, medications, treatment, goals, past history, etc.) Since every patient is different, every accommodation will be different, too! What works for one patient may not work for another…which is why you must get further instructions from the RN. Since you, as a CNA, only have limited information about the patient, you cannot decide what method is right for this patient. What if you guess…and get it wrong? The patient is the one that will suffer the consequences! So, play it safe (for the patient’s sake!) and ask the RN.

For the exam, the patient is able to move as directed (according to our care plan). So, this won’t be an issue for the exam – you can simply ask them to scoot toward you prior to turning.