When transferring a person which side moves first

Follow these steps to move a patient from bed to a wheelchair. The technique below assumes the patient can stand on at least one leg.

If the patient cannot use at least one leg, you will need to use a lift to transfer the patient.

Think through the steps before you act and get help if you need it. If you are not able to support the patient by yourself, you could injure yourself and the patient.

Make sure any loose rugs are out of the way to prevent slipping. You may want to put non-skid socks or shoes on the patient's feet if the patient needs to step onto a slippery surface.

The following steps should be followed:

• Explain the steps to the patient.
• Park the wheelchair next to the bed, close to you.
• Put the brakes on and move the footrests out of the way.

Before transferring into the wheelchair, the patient must be sitting.

Allow the patient to sit for a few moments, in case the patient feels dizzy when first sitting up.

The following steps should be followed when getting ready to transfer a patient:

• To get the patient into a seated position, roll the patient onto the same side as the wheelchair.
• Put one of your arms under the patient's shoulders and one behind the knees. Bend your knees.
• Swing the patient's feet off the edge of the bed and use the momentum to help the patient into a sitting position.
• Move the patient to the edge of the bed and lower the bed so the patient's feet are touching the ground.

If you have a gait belt, place it on the patient to help you get a grip during the transfer. During the turn, the patient can either hold onto you or reach for the wheelchair. They should not wrap their arms around your head or neck.

Stand as close as you can to the patient, reach around the chest, and lock your hands behind the patient or grab the gait belt.

The following steps should be followed:

• Place the patient's outside leg (the one farthest from the wheelchair) between your knees for support. Bend your knees and keep your back straight.
• Count to three and slowly stand up. Use your legs to lift.
• At the same time, the patient should place their hands by their sides and help push off the bed.
• The patient should help support their weight on their good leg during the transfer.
• Pivot towards the wheelchair, moving your feet so your back is aligned with your hips.
• Once the patient's legs are touching the seat of the wheelchair, bend your knees to lower the patient into the seat. At the same time, ask the patient to reach for the wheelchair armrest.

If the patient starts to fall during the transfer, lower the person to the nearest flat surface, bed, chair or floor.

Pivot turn; Transfer from bed to wheelchair

American Red Cross. Assisting with positioning and transferring. In: American Red Cross. American Red Cross Nurse Assistant Training Textbook. 4th ed. American National Red Cross; 2018:chap 11.

Bergman R, De Jesus O. Patient care transfer techniques. [Updated 2021 Oct 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK564305.

Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Body mechanics and positioning. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2017:chap 12.

Timby BK. Assisting the inactive client. In: Timby BK, ed. Fundamentals of nursing skills and concepts. 11th ed. Philadelphia, PA: Wolters Kluwer Health: Lippincott Williams & Wilkens; 2017:unit 6.

Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

In this video on stroke care, we look at various safe handling and transfer techniques for stroke patients.

​Stroke is the fourth leading cause of death in Singapore. Stroke survivors may continue to have some form of physical disability after they are discharged from hospital, thus requiring assistance to roll in bed, get out of bed and to sit out on a chair.

Here is an example of a patient transfer technique that reduces risk of injury to the patient and caregiver. If you have not been taught by a healthcare professional on these techniques, please speak to a neurological physiotherapist before attempting them yourself.

Moderate Assistance Transfer: Position a chair in line with the bed. Ensure there is sufficient space at the edge of the bed before rolling the patient over. First, ask the patient to hold onto the weaker arm. Bend the opposite knee. With one hand on the pelvis and the other hand on the shoulder blade, ask the patient to roll towards you with you guiding as necessary. Next, ask the patient to use her stronger leg to bring her weaker leg over the edge of the bed. Stabilise the patient's hip and ask the patient to push up to sitting.

If the patient is sitting too far in the bed, shuffle the patient's bottom forward. Lean the patient on the right and guide the left buttock forward. Then. lean the patient to the left and guide the right buttock forward. Ensure that both the patient's feet are placed flat on the floor.

Place the chair near the patien't strong arm. If it is a wheelchair, ensure the brakes are applied. Stabilise the patient's knees between yours. Lower yourself to the patient's eye level by bending your knees but keeping your back straight. Commuicate to the patient what you are about to do. Place her strong hand on the armrest of the wheelchair. Ask her to participate by leaning forward and turning towards the bed to bring the buttocks across to the wheel chair seat. Make sure your path of view is not blocked by the patient's head. Cue the patient by saying, "1, 2, 3, Up". To transfer, lean the patient forward, pivot at the patient's knees, then bring the buttocks over to the chair.

Assist the patient to sit well. Make sure the patient is seated up straight at the centre of the chair. Secure the footplates.

If you have difficulty in transferring your loved one affected by stroke, ask a doctor to refer you to a neurological physiotherapist. 

Check out our other patient transfer videos using the minimal assistance technique and maximum assistance technique.            

When transferring a person the person's strong side moves first?

What is the correct way to transfer a patient?

When transferring a person with a weak side which side moves first?

Do you transfer a patient towards his good side?