Fig. 13.—The Closed Bed. (From "Elementary Nursing Procedures," California State Board of Health.)

Practice is necessary before it is possible to make a bed quickly and well, and a certain amount of proficiency in making an unoccupied bed should be acquired before undertaking to make a bed with a patient in it. One should learn to work in an orderly way, without confusion, unnecessary motion, or jarring of the bed.

To Change a Patient's Pillows.

—Stand preferably on the right side of the bed and slip the left arm under the patient's shoulders, supporting his head in the hollow of the arm. Raise him slightly and remove the pillows one at a time with the right hand, drawing them outward on the left side of the bed. Place a small pillow under his head. Shake the pillows, change the cases if necessary, and replace them on the left side of the bed, ready to be drawn back into position. Raise the patient as before, remove the small pillow and draw the others into place. It is sometimes better to hold the patient on the upper pillow while removing and replacing the under one.

Lifting a Patient in Bed.

—Patients tend to slip down toward the foot of the bed, and they should be raised if unable to help themselves. To raise the patient, instruct him to flex his knees and to press his feet firmly upon the bed; place one arm

under his shoulders, as when changing pillows, the other arm under the thighs, and lift him upward without jerking. The lifting can be done more easily by two people, and with less discomfort to the patient: if he is entirely helpless two people are necessary. Two people should proceed as follows: Let A place her left arm under the patient's head and shoulders as before, her right arm under the small of his back; let B place her right arm also under the small of his back and her left arm under his thighs, and at a signal let them lift together. In this way the weight is so evenly distributed that a heavy person can be lifted without great difficulty.

To Turn a Patient in Bed.

—A patient may be turned toward or away from you. In turning a patient toward you, place one hand over his farther shoulder and the other over his hip, and turn him toward you. Then flex his knees slightly. To turn a patient from you, pass one hand as far as possible under the shoulders, and the other as far as possible under the thighs. Then raising the patient slightly, draw him back toward you, turning him at the same time, and then flex the knees. Lastly place a pillow firmly against his back to support it.

To change the sheets while the patient is in bed