The nurse is preparing to pull a thin, frail client up in the bed. No one responds to the nurse’s call for lifting assistance. Which is the best action by the nurse?

  • call again and apologize to the client for the wait
  • stand behind the bed at the client’s head, and pull her up gently from her armpits
  • since the client is small, pull her up in the bed by pulling on the draw sheet, alternating sides
  • if the client is able to roll and bend her knees, lower the head of the bed and place it in Trendelenburg’s position while helping the client bend her knees and push up
Number 1 is correct.
The nurse should never attempt to pull a client up in bed without assistance, no matter how small the client is. The nurse risks injuring her back by doing so. The nurse should call again and wait a few moments for help. Pulling the client up by the armpits increases the risk of skin shear or a skin tear to the client. Trying to pull the client up by pulling on one side of the draw sheet at a time is ineffective and may result in skin shear on the client. If other help is not available, a lifting assistive device should be used for the client. With a client who can self-position, option 4 may be used if no other help is available and if the client can tolerate the position with the head down; however, another person or a lifting device should be used whenever possible to avoid injury to the nurse and client.