Hey folks.

I completely admire those gifted nurses who are able to make their patients look and smell like a commercial for the 4 seasons after the bed bath. I am so bad at it... any advice?

Thanks

Wash their hair if you can, at least use one of those shampoo free caps you can put on, it gets the grease out, and comb the hair.

I always put shaving cream in the basin with water along with the soap, I find that make all the difference as far as smell goes. It just has a nicer smell then the soap, for the men anyway.

Make sure you always do good peri-care...often thats where odors can come from, especially on women if theyre not cleaned thourougly. With a bath change all the linens.

What also helps to make the patients look perfect, is if your room is perfect. Dont have garbage lying around. Have all your supplies organized and not strewn around the room, if garbages are overflowing and you have time to empty them, do it. Have all your lines organized and not everywhich way. Now sometimes when your patient is crashing, yeah there is no time for this, but when your pt is stable and you have time to tidy up, do it, it makes your life so much easier and you will "look" like a better nurse by the family if the room is tidy and the pt looks clean. Then when S^&t hits the fan, and your pt crashes, having an organized room will make things so much easier.

Cher

Thank you both for your advice! :)

if it wasn't for a.m. care, i might have liked bedside a bit more..

I'm so glad you said that. Nice to know I'm not alone.

I've been doing this for almost 30 years. I love to give bed baths, and pts always feel better after them, almost without fail. I work in a high-acuity cardiac/vasc/thor/gen surg ICU.

My tricks are these: Medicate for pain before starting if appropriate. I dont use the warm wipes that come in a package. I use washclothes, a lot, and towels and a basin with hot water. I never rinse out a used washcloth. I wet the cloth, put soap in it, wash with it, use a fair amt of water, then put that cloth in the linen hamper. Get a new washcloth, get it wet, rinse the pt, dry the pt. I may use the rinse cloth for the next section getting washed. The water stays clear. There is nothing like liberal soap and water, which is then rinsed off.

Try to actually brush your pts teeth, it makes a difference.

I am a fanatic about a tidy room, and tangled lines are just not tolerated.

Of course, change the linens.

Put clean pillow cases on all the pillows.

Put warm blankets on the pt after the bath.

Change all the dressings. Shave the men. Wash and comb hair.

Elevate arms and legs on pillows.

Clean the bedside stands/tables either with alcohol or with the bacteriocidal wipes that are everywhere in units these days.

Turn the lights down after.

I always change the linens after a bath. I make a bed roll so it is easy when you turn the pt. side to side.

I've been doing this for almost 30 years. I love to give bed baths, and pts always feel better after them, almost without fail. I work in a high-acuity cardiac/vasc/thor/gen surg ICU.

My tricks are these: Medicate for pain before starting if appropriate. I dont use the warm wipes that come in a package. I use washclothes, a lot, and towels and a basin with hot water. I never rinse out a used washcloth. I wet the cloth, put soap in it, wash with it, use a fair amt of water, then put that cloth in the linen hamper. Get a new washcloth, get it wet, rinse the pt, dry the pt. I may use the rinse cloth for the next section getting washed. The water stays clear. There is nothing like liberal soap and water, which is then rinsed off.

Try to actually brush your pts teeth, it makes a difference.

I am a fanatic about a tidy room, and tangled lines are just not tolerated.

Of course, change the linens.

Put clean pillow cases on all the pillows.

Put warm blankets on the pt after the bath.

Change all the dressings. Shave the men. Wash and comb hair.

Elevate arms and legs on pillows.

Clean the bedside stands/tables either with alcohol or with the bacteriocidal wipes that are everywhere in units these days.

Turn the lights down after.

How do you wash the hair? Washcloths or the baggy things? How do you untangle several days of ICU tangles in the hair? How do you not get your IJ dressing wet if you use water? How do you not overflex the neck?

Thanks to all for taking the time and energy to answer my post!

Calvin&Hobbes,

Mind if I print out a thousand copies of your post? I'd like to wallpaper our break room with it! I add a sprinkling of baby powder to their backs and sheets if it isn't contraindicated and always make sure that the closed ends of the pillowcases are facing the door. Changing ET and NG tube tapes also makes a big difference. As for washing hair: I have used wet, warm, soapy washcloths with many a collared bloody head trauma. Wrap the hair with a warm soapy washcloths ahead of time to soften up the dried blood. If it is really bad, tuck a thick garbage bag under the head and shoulders, put the bed flat and use warm soapy water poured from a clean urinal. You'll be standing at the head of the bed (think intubation position!) If you put a bottle of mouth wash in the final rinse, it gets rid of the old blood smell. Cover the central line with a thick towel, but expect to change it after anyways.

I add Johnsons Baby shampoo to the hot water....makes for a very clean and pleasant smell. I cannot take credit for this...one of the veteran nurses taught me this one!! (One of many great tips)

we had this amazing ontraption that we used to wash hair, it was like a soft moulded pillow with a channel to drain away the water, we just laid their head on it, laid the bed falt and washed hair like normal with warm water and shampoo. The detangling sprays you can get for kids are also fantastic for getting rids of those knots and tangles.

Another thing i always used to make sure i did, was ask family to bring i personal toiletries and I used them, with the exception of things that might be contraindicated such as perfumes etc, but for ladies I would always, make sure they had their legs and underarms shaved, applies body lotions to stop skin drying out, and use plenty of mouth care products and chapstick on their lips.

I only do the occasional shift in ICU now, but it used to give me great pleasure making my patients clean and comfortable and my room and bedside neat and tidy

The scent of vanilla covers a lot of odors :)

I work in a trauma/medical/surgical/neuro and love bathtime with my patients! It's a great opportunity to "bond" with the patients and really get an excellent skin assessment. I feel a sense of accomplishment when I can stand back after my baths and see a clean, fresh patient on crisp white sheets. I shave my male patient's faces and my female patient's legs and underarms (I buy the big pack of disposable razors at Costco and use one for each patient because the hospital-issued ones are crap; I've cut many patient's faces up with those cheap blades!). In the past, I've even painted toenails on a young lady who, according to her family, was very conscious of her appearance.

I wash my patients hair with either the shampoo caps or use the hair washing tray we have (it has a hose connected to the bottom part of it that you put into the sink or a garbage can to drain water) and in the case of women with long hair (who've been in our unit for weeks and have very tangled up locks), I will put a bit of conditioner in it and braid it so it doesn't continue to get tangled up. My baths take approximately 30-40 minutes from start to finish, including oral care, trach care, and any dressing changes that need to be done.

I have a little "goodie" bag that I bring in filled with quality razors, elastic bands for the hair, hair detangler, conditioner, shaving cream (in case I can't get any from patient supply), linen spray (for those who aren't sensitive to fragrances and aren't on vents), and grapefruit lotion (ambiguous enough for both male and females....again, I don't use unless family/patient is able to tell me if the patient is sensitive to fragrances or has allergies).

I look forward to my bed baths even though in the beginning I was timid about doing it all on my own (I had been giving baths with my preceptor all through nursing school). But I eventually got over it and have made it into my own little "ritual" with my patients. The families are always very appreciative, especially when the little things like shaving legs and armpits (on gals) are done. I know that when I'm sick, I feel tons better when I actually get my butt into the shower and lather up. It may not make me "healthier" or any less sick, but I somehow feel better. I like to think my patients feel much the same way.

Melanie = )

An easy "soak" for fingernails: Before you start the bath, put a little lotion into the fingers of a glove, and slip the gloves on the patient. Keep them on until you're all finished with everything else, then clean the nails last. I call it "Instant Manicure."

For really filthy feet, I'll then get a plastic bag with a bath blanket on top and put the whole thing under the patient's feet. Then wet 2 towels with warm water, wring them out, and tuck them around the feet. Let 'em "soak" like this for a few minutes while you do the hair and the rest of the body.

Not having worked in ICU, I don't know how this translates, but I've had people hospitalized for weeks whose hair was so greasy and tangled, I'd remove their pillow and put a plastic bag (bring it up around their shoulders), put a couple of bath blankets over the plastic, and just go ahead and wash and rinse their hair, then comb it and wrap it in a towel while you do the rest.

If you do the hair first, if the bed gets messed up, you're going to change the bedding anyway. Then while the hair is still damp, braid it or style it.

I love the detanglers; they work very well, but I think you use them first, then wash.

Also, the Johnson's No More Tears shampoo is great for getting that crud out of the eyes.