Core procedures and patient comfort
Many nursing skills focus on keeping patients safe, comfortable, and functioning: mobility, skin care, pain management, and hygiene. For study only, not clinical guidance: always follow your programme, current local protocols, and supervising clinicians.
Body mechanics and safe handling
Safe patient handling protects both patients and nurses from injury. Use lifting equipment and enough staff rather than manual lifting of heavy patients, keep a wide base of support, bend at the knees, keep loads close to the body, and avoid twisting. Many hospitals have minimal-lift policies.
Immobility and its effects
Prolonged immobility causes muscle weakness, joint stiffness, pressure injuries, constipation, urinary problems, pneumonia, blood clots (deep vein thrombosis), and low mood. Early mobilisation after surgery, when safe, reduces these complications.
Pressure injuries
Pressure injuries develop when sustained pressure, often over bony areas such as the sacrum and heels, cuts off blood flow. They are staged from 1 (intact skin with non-blanchable redness) to 4 (full-thickness loss exposing bone, tendon, or muscle), plus unstageable and deep tissue injuries. Prevention includes repositioning, pressure-relieving surfaces, skin care, and nutrition. The Braden Scale assesses risk.
Pain assessment
Pain is whatever the patient says it is. Assess location, intensity (often with a 0-10 numeric scale or faces scale for children), quality, onset, duration, and what makes it better or worse. Patients who cannot self-report, such as those with advanced dementia, need behavioural pain scales.
Pain management
Pain management combines medications (non-opioids such as paracetamol/acetaminophen and NSAIDs, and opioids when needed) with non-drug measures such as positioning, heat or cold, distraction, and relaxation. Reassess pain after interventions and monitor for side effects, especially sedation and respiratory depression with opioids.
Hygiene and personal care
Bathing, oral care, and skin care maintain comfort, dignity, and skin integrity. Oral care in hospitalised and ventilated patients helps reduce pneumonia risk. Respect privacy, encourage independence, and use care time to assess skin and wellbeing.
Elimination
Nurses monitor urine output and bowel function. Adult urine output below about 0.5 mL per kg per hour is often a warning sign. Indwelling urinary catheters raise infection risk (catheter-associated urinary tract infection), so they should be used only when needed and removed as soon as possible.
Worked example
A frail patient on bed rest has redness over the sacrum that does not fade when pressed (non-blanchable) on intact skin. This is a stage 1 pressure injury. The nurse documents it, relieves pressure by repositioning at least every two hours according to policy, uses a pressure-redistributing mattress, keeps skin clean and dry, and checks nutrition.
Key takeaways
Use safe handling equipment and good body mechanics. Immobility harms many systems; mobilise early when safe. Pressure injuries are staged 1-4 and prevented by repositioning, surfaces, skin care, and nutrition, with Braden risk scoring. Pain is what the patient says it is; assess systematically and combine drug and non-drug relief, monitoring opioid effects. Oral care, hygiene, and catheter minimisation prevent complications.
Flashcard
Equipment and staff instead of manual lifting
Check your understanding
What is the earliest sign of a stage 1 pressure injury?