What is inpatient care?
A patient who is admitted and stays in hospital for one night or more is an inpatient. A patient who comes, is seen and goes home the same day is an outpatient.
Each inpatient has a patient unit: the bed, a bedside locker, a call bell, an over-bed table and the bedside chart. The general duty assistant (GDA) or patient-care assistant helps the nurse. The GDA keeps the unit clean and safe, helps with daily activities and reports changes. The GDA does not give medicines or make medical decisions.
Golden rules every time
- Greet the patient, check their name and explain what you will do.
- Clean your hands before and after.
- Close curtains for privacy.
- Put the bed rails up and the call bell within reach when you leave.
Bed making
A clean, smooth bed keeps the patient comfortable and protects the skin. Wrinkles and crumbs press on the skin and can start sores.
Layers, bottom to top
- Mattress with its cover
- Bottom sheet, tucked in with mitred (hospital) corners
- Mackintosh (waterproof sheet) where needed
- Draw sheet over the mackintosh (easy to change)
- Top sheet
- Blanket and pillow with a clean cover
Types of bed
- Closed bed: made and covered, waiting for a new patient.
- Open bed: top covers folded back, ready for a patient to get in.
- Occupied bed: made while the patient stays in it; roll the patient to one side, change half, then roll back.
- Post-operative bed: warm, with covers folded to one side so the patient can be moved in from a trolley.
Dirty linen goes into a linen bag, never on the floor, and is held away from your uniform.
Personal hygiene and the bed bath
Hygiene means keeping the body clean. It removes sweat and germs, refreshes the patient and lets you check the skin.
Daily hygiene tasks
- Mouth care (brushing, or cleaning with a swab if the patient cannot)
- Hair care and shaving
- Nail care
- Eye care with clean cotton, inner corner to outer
- Helping with the toilet: bedpan or urinal, then cleaning front to back
Bed bath order
Work from clean to dirty and top to bottom: eyes and face → arms and hands → chest and belly → legs and feet → back → private parts last. Change the water when it gets cool or dirty. Uncover only the part you are washing, then dry it well, especially between fingers and toes.
Vital signs
Vital signs show how well the body is working. They are measured at set times and written on the chart.
| Sign | Normal adult (at rest) | How |
|---|---|---|
| Temperature | about 36.1–37.2 °C (fever ≥ 38 °C) | digital thermometer in mouth, armpit or ear |
| Pulse | 60–100 beats per minute | two fingers on the wrist (radial pulse), count 30 s × 2 or a full minute |
| Breathing (respiration) | 12–20 breaths per minute | watch the chest rise without telling the patient |
| Blood pressure | about 120/80 mmHg | BP machine and cuff on the upper arm |
| Oxygen (SpO₂) | 95–100% | pulse oximeter on a finger |
The GDA reports any reading outside the normal range to the nurse straight away and records the time and value.
Feeding a patient and preventing pressure sores
Some patients cannot eat on their own. Feeding them safely is an important skill.
- Check the diet card (normal, soft, liquid, diabetic, nil by mouth).
- Clean hands; help the patient clean theirs.
- Sit the patient up to 45–90°.
- Give small spoonfuls, slowly, and wait for each swallow.
- Watch for coughing or choking; stop and call the nurse if it happens.
- Keep the patient upright for about 30 minutes after the meal.
- Record how much was eaten and drunk (intake chart).
Pressure sores
If a patient lies still, the weight presses on bony parts (back of head, shoulder blades, hips, base of spine, heels). Blood cannot reach the skin, and a sore (bed sore) begins. Turn the patient at least every 2 hours, keep the skin clean and dry, and keep sheets smooth.
Key formulas and definitions
- Inpatient = admitted, stays ≥ 1 night; outpatient = goes home same day
- Bed layers: mattress → bottom sheet → mackintosh → draw sheet → top sheet → blanket + pillow
- Bed bath: clean → dirty, top → bottom; private parts last
- Pulse per minute = beats in 30 s × 2
- Normal adult: 36.1–37.2 °C, pulse 60–100, breathing 12–20, BP about 120/80 mmHg, SpO₂ 95–100%
- Feeding position: 45–90° upright; stay up 30 min after
- Turn a bedridden patient at least every 2 hours
Worked examples
1. You count 38 pulse beats in 30 seconds. What is the pulse rate, and is it normal?
Pulse = 38 × 2 = 76 beats per minute. It is between 60 and 100, so it is normal for an adult at rest.
2. A new patient will arrive from the operation theatre on a trolley. Which bed do you prepare?
A post-operative bed: warm, clean, covers folded to one side so the patient can be slid across from the trolley. Keep a vomit bowl and tissues near.
3. A patient turned at 8:00 has red skin on the hip at 11:00. What went wrong and what do you do?
Three hours passed; the patient should have been turned by 10:00. Turn the patient now, keep the area clean and dry, do not rub it, and report it to the nurse.
Common mistakes
- Washing private parts before the face: always go from clean to dirty.
- Feeding a patient who is lying flat: this can send food into the lungs.
- Shaking dirty linen or putting it on the floor: this spreads germs.
- Writing vital signs later from memory: record the value and time immediately.