Nursing & Healthcare Programs

Fowler’s Position

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

Fowler’s position is used when a patient is eating, is having difficulty breathing, or is ordered by a doctor. This position is easily recognized because the patient will be sitting äóìstraight up.äó Semi-Fowlers is sitting äóìhalf-way up,äó and is used when patients cannot be laid flat, but wishes to be in a more relaxed position than Fowler’s. This position is often used for patients who are receiving feedings from a nasogastric tube to prevent aspiration while they sleep.

Achieving Fowler’s Position (aka, High Fowler’s)

  1. Start with the patient lying supine (flat on their back) with the body in proper alignment.
  2. Gently raise the head of the bed to 90 degrees.
  3. Place a small pillow behind the patient’s head and one at the lower back. These are not to make the patient lean forward, but to help support and keep the body aligned.
  4. Place a small pillow under the thighs. Place pillows lengthwise under the calves, but leave the heels unsupported. This helps prevent pressure injury to the heels.
  5. If the patient has difficulty moving their hands or arms, support the hands and arms with pillows.
  6. Ask the patient if they are comfortable. Make adjustments as necessary.
  7. Document the position per institutional or unit policy. Report any difficulty getting the patient into position or maintaining position to the nurse per policy.

Achieving Semi-Fowler’s Position

  1. Start by ensuring the patient has proper body alignment.
  2. Gently adjust the head of the bed to 45 to 60 degrees.
  3. Follow steps three through seven above.

References

Activity and mobility. (2014). In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 210-213). St. Louis, MO: Mosby Elsevier.

More Resources

Measuring the Radial Pulse

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.

Axillary Temperature with Electronic Thermometer

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for the patient.

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

person wearing orange and white silicone band

Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

Oral Temperature Measurement with an Electronic Monitor

Body temperature is one of the vital signs frequently measured in healthcare settings. Changes in a body temperature can indicate improvement or worsening of a patient’s condition, so accurate measurement is important.