Sims' position: what it is, why the left side, and when to use it

Sims' position is side-lying on the left, rolled partway toward the stomach. The lower arm is behind the body, the lower leg is almost straight and the upper knee is drawn up toward the waist. Nurses use it to give enemas and rectal suppositories.

Sources checked 18 October 2026.

What Sims' position looks like

• Body: on the left side, halfway between lateral and prone.
• Lower (left) arm: behind the body.
• Upper (right) arm: bent in front, resting on the bed or a pillow.
• Lower (left) leg: almost straight.
• Upper (right) leg: knee drawn up toward the waist, often on a pillow.
• Bed: flat.

You will see it spelled Sims, Sims' and Sim's. The position is named after J. Marion Sims, a 19th-century American surgeon. His gynecologic work was done on enslaved Black women without anesthesia or consent, and some nursing educators now name the position by its description instead: left semi-prone.

Why the left side

The rectum and the sigmoid colon curve to the left side of the abdomen. With the client on the left, an enema solution flows with gravity into the rectum, sigmoid and descending colon, and the client can hold it longer. A suppository also goes in along the natural curve.

When the nurse uses it

• Enemas, both cleansing and retention.
• Rectal suppositories and other rectal medications.
• Rectal examination and taking a rectal temperature.
• Comfort and pressure relief, as part of a turning schedule.

How to place a client in Sims' position

1. Explain the procedure, close the curtain and raise the bed to working height.
2. Lower the head of the bed until the bed is flat.
3. Turn the client onto the left side, close to the edge nearest you.
4. Bring the lower arm behind the body and let the chest roll slightly forward.
5. Flex the upper knee toward the waist and support it with a pillow.
6. Drape the client so only the area you need is exposed.
7. After the procedure, help the client to a comfortable position and lower the bed.

Sims' compared with lateral and prone

Every other position, with drawings, is in patient positions for the NCLEX. The raised-head positions are in semi-Fowler's, Fowler's and high Fowler's position.

Practice questions

1. Question 1Multiple choicePharmacological and Parenteral Therapies
   The nurse is preparing to give a rectal suppository. Which position should the nurse help the client into?

   Left side, with the upper leg flexed toward the waistRight side, with both knees straightSupine, with the knees bentHigh Fowler's
   Check answer
2. Question 2Multiple choiceManagement of Care
   Before an enema, an assistive person has turned the client onto the right side with a pillow between the knees. What should the nurse do?

   Turn the client to the left side, with the upper knee drawn up toward the waist.Give the enema, because any side-lying position works.Raise the head of the bed to 45 degrees first.Ask the client to lie prone instead.
   Check answer
3. Question 3Multiple responseBasic Care and Comfort
   Which describe Sims' position correctly? Select all that apply.

   The client lies on the left side.The upper knee is drawn up toward the waist.The lower arm is placed behind the body.The head of the bed is raised to 45 degrees.Both legs are kept straight.
   Check answer