Clinical Skills · Activity Assessment and Management

Transferring Patients

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On this page 9 sections

In 30 seconds
Why this matters
The college version
Eli explains
Worked example
Key takeaway
Check yourself
Study tools
Sources & references

In 30 seconds

Transferring a patient means moving a person from one surface to another: bed to wheelchair, bed to stretcher, chair to commode, or back again. It is one of the most frequent — and most dangerous — moments of the day, for the person and for the staff. A is not just lifting; it is a sequence of decisions: Is the person strong enough to help? Which side needs support? Are the brakes locked? Where do the IV line and catheter go? Nurses plan the move before they touch anyone.

Transfers differ from repositioning, which changes position on the same surface. This topic builds on the earlier chapter topics: the mobility assessment determines which transfer method is appropriate, and that method shapes the positioning and movement devices covered later in the chapter.

Why this matters

Falls are among the most common safety events in health care, and many happen during transfers — when a person stands, pivots, or sits down with help. A transfer done poorly can also injure the staff member; lifting-related musculoskeletal injuries are a leading occupational injury among nurses. A safe transfer protects two people at once.

There are clinical stakes too. A person recovering from a stroke, a hip repair, or low blood pressure tolerates a transfer very differently than someone who is strong and rested. Choosing the wrong method — or skipping the pre-transfer check — can cause a fall, a fracture, skin tears from dragging, or damage to IV sites and catheters. Transfer technique is also a favorite of skills checkoffs and nursing exams because it is full of small safety details.

The college version

Core Concepts

The pre-transfer assessment

Before any move, gather the information that determines the method:

Weight-bearing and strength: Can the person stand and bear weight? Grip and push up from the bed? The mobility assessment from the previous topic supplies much of this.
Balance and endurance: Does the person get dizzy sitting up? How long can they stand?
Cognition and cooperation: Can the person follow instructions such as "stand when I count to three"? Confusion, sedation, or fear changes the plan — an uncooperative person needs more help.
Equipment and environment: Is the wheelchair close, with working brakes? Is the path clear? Is the bed at a safe height?
Lines and tubes: IV pumps, catheters, drains, and oxygen travel with the person — plan where each goes before the move.
Orders and restrictions: Activity orders, , and post-procedure precautions tell you what the person is allowed to do.

Body mechanics and safe patient handling

means using the body efficiently: feet spread for a wide base of support, knees bent, the load held close to the center of gravity, lifting with the legs, and avoiding twisting. Good mechanics prevent staff injury and make the move steadier for the person.

Modern practice frames transfers under programs, which favor equipment over manual lifting: mechanical lifts, stand-assist devices, slide boards, and friction-reducing sheets. Many facilities have policies on when equipment must be used — for example, when a person cannot bear weight. Equipment, staffing, and delegation rules vary by facility and jurisdiction; the nurse knows the local policy, follows it, and asks for help rather than lifting beyond what is safe.

Common transfer methods

Independent: the person moves with supervision only; the nurse stays close and watches for unsteadiness.
Assisted (one or two staff): the person helps but needs physical support or balance guidance; a is commonly used.
Pivot: the person stands and turns to sit on the destination surface; staff guide the turn, and the stronger side leads.
Slide board or friction-reducing device: the person slides between surfaces of similar height (bed to stretcher) with minimal lifting.
(floor or ceiling): a sling supports the person while the device lifts — for people who cannot bear weight; check sling size and weight capacity, and follow the manufacturer's and facility's instructions.
Stand-assist lift: helps a person with some weight-bearing rise from sitting to standing.

The transfer sequence

Verify the person's identity and the transfer order; explain the move.
Gather equipment, check brakes, clear the path, and adjust the bed to a safe height.
Position the person to start — usually sitting at the edge of the bed.
Apply a transfer belt if used; stand on the side needing the most support.
Move together on a count of three, keeping the person's weight close to you.
Seat the person, place their feet on the footrests, lock the wheelchair, and put the call light within reach.
Reassess breathing, pain, dizziness, and comfort; document the transfer.

Safety before, during, and after

Lock brakes before every transfer — and verify by testing. A rolling wheelchair is a fall waiting to happen.
Rise in stages: let the person sit at the edge of the bed ("dangle") before standing, to prevent dizziness from a blood pressure drop.
Never drag: use a lift sheet and slide rather than pull; dragging injures skin through friction and shear.
Stay until settled: call light and personal items within reach; follow facility policy on bed rails.

Special situations

One-sided weakness (e.g., after a stroke): stand on the weaker side to support it; have the person push off with the stronger side.
After surgery or when sedated: more staff, slower pacing, and close monitoring of pain, blood pressure, and surgical sites.
Larger bodies: bariatric-rated equipment, extra staff, and the facility lifting policy — with the same dignity and communication as for anyone.
Children and older adults: adapt communication; older adults lose balance quickly and often have fragile skin.

Common Confusions

Do Not Confuse	With	The Difference
Transferring	Repositioning	Transfer = moving to another surface; repositioning = changing position on the same surface
Applying a transfer belt	Lifting the person with it	The belt guides and supports balance; it is not for hoisting body weight
"The brakes look on"	"The brakes are locked"	Always verify by testing; locks can fail or appear engaged
"The person can stand"	"The person can transfer safely"	Standing once is not balance and endurance; assess sitting, standing, and pivoting
Helping from the weak side	Facing the stronger side	Stand on the weak side to support it; guide the person toward their strong side
Counting "1-2-3" for the person	Counting for the staff	The count coordinates everyone moving at the same moment

Eli explains

The same idea, in plain words

Explain it like I’m 10

Transferring a patient means helping someone move from one surface to another, like from a bed into a wheelchair. Nurses plan the move first: they check how steady the person is, lock the wheels, and clear the path. Then they use their legs, not their back, and move together on the count of three. A good transfer keeps both the person and the nurse safe.

Worked example

Mr. R., age 82, was admitted after a fall at home. He can bear weight but feels dizzy when he first sits up. The nurse plans a two-person assisted transfer to a wheelchair with a transfer belt.

The nurse checks the activity order, gathers the wheelchair, and confirms the brakes lock. The bed is raised, the path cleared, and the IV pole positioned to travel with him. After the head of the bed is raised, Mr. R. sits at the edge and dangles his feet until the dizziness passes, and a transfer belt is secured around his waist. One nurse stands on his weaker left side holding the belt; a second nurse positions the locked wheelchair close. On the count of three, Mr. R. pushes up with his stronger right leg and pivots, and the nurses guide his hips into the chair. His feet go on the footrests, the brakes stay locked, and the call light is placed in his hand. The nurse documents that he tolerated the transfer without dizziness and records his vital signs. When he asks to return to bed later, the nurses repeat the routine in reverse — the plan is the same in both directions.

Key takeaways

Assess before you touch: weight-bearing, strength, balance, cognition, pain, lines, equipment, orders.
Lock and verify all brakes before moving.
Use equipment: transfer belts, slide boards, lifts. Never lift beyond your ability — get help.
Stand on the weaker side; move the person toward their stronger side.
Use body mechanics: wide stance, bent knees, load close, lift with the legs, no twisting.
Count together so everyone moves at the same moment.
Rise in stages and watch for dizziness before standing a person up.
After the transfer: brakes locked, call light within reach, tolerance documented.
Follow facility SPHM policy — equipment, staffing, and delegation vary by institution and jurisdiction.

Check yourself

6 review questions from the chapter. Try each one, then open the answer.

List four things to check before any transfer.
Show answer
Weight-bearing and strength, balance and endurance, cognition and cooperation, lines and tubes, equipment and environment, and activity orders or restrictions (any four).
Why must wheelchair and stretcher brakes be locked before a transfer?
Show answer
So the surface cannot roll away mid-move; a rolling wheelchair or stretcher during a transfer causes falls.
What is the purpose of a transfer belt?
Show answer
It gives staff a secure, comfortable grip for guiding balance and support during the move — it is not a lifting device.
When is a mechanical lift the right choice?
Show answer
When the person cannot bear weight, when manual lifting would exceed safe limits (per facility SPHM policy), or when the person is too large or unsteady for a manual assist.
A person becomes dizzy when sitting up. What should the nurse do before standing them up?
Show answer
Let the person sit at the edge of the bed and dangle until the dizziness passes, then stand slowly in stages while watching for unsteadiness.
What should the nurse verify after the person is seated in the wheelchair?
Show answer
Brakes locked, feet on footrests, call light within reach, and the person comfortable and tolerating the position; then document.

Keep learning

Ready to build on this? Continue to the next lesson.

Study tools & related lessonsKey vocabulary · Related

Key vocabulary

Transfer: Moving a person from one surface or location to another (bed ↔ wheelchair, bed ↔ stretcher)
Transfer (gait) belt: A padded belt fastened around the person's waist that staff hold during transfers
Safe patient handling and mobility (SPHM): A program that uses equipment and techniques to avoid hazardous manual lifting
Mechanical lift: A device with a sling that lifts a person who cannot bear weight
Body mechanics: Using the body efficiently — wide base, bent knees, load close, lift with the legs
Weight-bearing status: The clinician's order about how much weight a limb may support
Pivot transfer: The person stands and turns to sit on the destination surface
Orthostatic hypotension: A drop in blood pressure when rising, causing dizziness or lightheadedness

Sources & references

openstax.org — Clinical Nursing Skills

This lesson was adapted from the open educational references above; their licenses and attributions are preserved. See Copyright & Licensing.

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