How to position a client on their side
Side-lying positioning is graded on safety and alignment: you lower the bed flat, raise the side rail on the side the client turns toward, roll them slowly, and then prop four points with pillows so no body part bears its own weight and nothing is twisted. Getting the arm out from under the body and flexing the top knee are the alignment core.
Step-by-step
- 1
Explain the procedure, speaking clearly, slowly and directly while keeping face-to-face contact.
- 2
Provide privacy with a curtain, screen, or door.
- 3
Lower the head of the bed before turning the client.Critical
- 4
Raise the side rail on the side toward which the client will be turned.Critical
- 5
Assist the client to slowly roll onto their side toward the raised side rail.Critical
- 6
Place or adjust a pillow under the head for support.
- 7
Reposition the arm and shoulder so the client is not lying on the arm.Critical
- 8
Support the top arm with a pillow or supportive device.
- 9
Place a supportive device behind the client's back.
- 10
Place a supportive device between the legs with the top knee flexed and the knee and ankle supported.Critical
- 11
Place the signaling device within reach and put the bed in the low position.
- 12
Wash your hands after completing the skill.
Critical steps (do not miss these)
- Raise the side rail on the side the client turns toward before rolling, so they cannot roll off the bed.
- Lower the head of the bed before the turn so the client moves safely and stays aligned.
- Free the lower arm and shoulder so the client is not lying on the arm, protecting nerves and circulation.
- Support four points: head, top arm, back, and between the legs with the top knee flexed and knee/ankle supported.
Common mistakes
- Raising the wrong side rail, or none, before rolling the client.
- Leaving the client lying on the lower arm or shoulder.
- Skipping the pillow between the legs or leaving the top leg straight instead of flexing the knee.
- Turning the client abruptly instead of a slow, aligned roll.
Why it matters
Side-lying is used to relieve pressure and prevent skin breakdown, so the whole point is that no bony surface bears weight and the spine stays in neutral alignment. The raised side rail is a fall barrier the client can also grip during the roll; freeing the lower arm keeps it from being compressed under the body; and the pillows behind the back, under the top arm, and between the flexed legs hold the position so muscles relax and no two skin surfaces press together. A slow roll on a flat bed avoids shearing and lets a weak client help.