Debate: Bed rest impact

All human beings are designed to move, and sedentary behaviours are associated with adverse health outcomes (Theou and others, 2017).

Florence Nightingale called on nurses to “do no harm” in their nursing practice and yet today the consequences of bed rest, regardless of setting or sector, remain profoundly harmful. Any period of extended bedrest effects the person’s muscles and bone, the skin, cardiovascular function, the respiratory and metabolic systems and the brain.

The evidence tells us that deconditioning, the term used to describe the decrease in muscle mass, and function decline, which is the consequence of those physiological changes, can happen very quickly, particularly when a person is older or living with a number of long-term conditions. Nearly one-third of hospitalised adults over the age of 70 showed a decline in their ability to undertake their activities of daily living on discharge (Graf, 2006).

Our role as nurses includes educating the person and their carers about the dangers of immobility, assessing the reasons why somebody is not engaged in exercise both physically and psychologically, supporting patients or residents to do all they can with the appropriate aids and using the evidence about strength and balance activities.

Encouraging patients to move is essential and sometimes risky. Mobility may mean an increased risk of falls, and assisting someone to walk takes time and staff, or family members if they are at home. However, without movement we are putting our patients or residents in danger of a cascade of dependency (Graf, 2006).

A Cardiff and Vale University Health Board (UHB) staff award winner (2017) developed the idea that promoting patients wearing their own clothes is more dignifying, provides a sense of normality and allows patients to be more independent while in hospital, reducing the risk of deconditioning, The Get Up, Get Dressed, Get Moving campaign will be formally launched across Cardiff and Vale UHB (Cardiff and Vale University Health Board, 2017).

As Richard Asher wrote many years ago: “Teach us to live that we may dread unnecessary time in bed. Get people up and we may save our patients from an early grave.” (Asher, 1947).  

View all of the Congress debates.