[RNnewgrad]

Our baths are expected to be done before midnight. No one gets written up for not doing one...if your busy, your busy! But day shift definetly won't be doing them.

[Bronx1560]

Ok this will **** me off!

U need to bath the pt's. As a military officer we have to work both night's & day's. I work on a 14 Bed SICU/TICU & policy is night shift baths the pt's between 9pm & 11pm. There's just no excuse not be bath your pt. how in hell are documenting skin intergity if U aren't bathing them.

The only way U don't bath a pt is he's unstable (open hearts, septic pt) or a very, very, crazy busy night.

We also don't have aides the RN's do it all but on night shift we have team bath nursing. My head nurse expects pt's to be bathe expecially the soldiers who come back for Iraq & Afghanistan they are filthy. They need to be hosed down, spray & scrub down. If it's not done U'll hear in in the morning.


Infection Control #1 is a clean skin your 1st underline protection from bugs!

[walk6miles]

Sorry, but Mr. Military got my dander up. You, sir, have obviously never spent a 12 hour night shift keeping one of your patients alive. Titrating drips, infusing blood products, managing the respiratory status and all the other systems that can crash on a patient. And you want me to bathe the patient? Turn and replace linen that, unless bloodied or stooled or urine-soaked, doesn't matter an inch when skin integrity may not be a problem if I fail at what I am trying to do - KEEP THE PATIENT ALIVE!!

When nurses get so darn tunnel-visioned, the patient suffers. Let me share an example with you: 42 yr old middle division weight lifter post valve replacement. The patient was a difficult intubation (per cardiac surgeon and anethesiast - DO NOT TURN THE PATIENT - DO NOT BATHE THE PATIENT - DO NOT MESS WITH THE PATIENT EXCEPT TO CARRY OUT WHAT YOU ARE TOLD..... enter I AM THE WORLD'S BEST NURSE - I KNOW MORE THAN THE DOCTOR. She convinced her pal, I WILL GO ALONG WITH HER OR SHE WON'T LIKE ME, they bathed and turned the patient in order to change perfectly clean linen , the tube fell out and by the time the anesthesiologist was able to reintubate, the man was brain dead!!

I still say that bathing is important, but use common sense. No one ever died from one day's dirt.
He was the sole parent for a 6 yr old daughter.

[RNperdiem]

The military man did make an exception for the unstable patient. I appreciate his gung-ho style and sense of work ethic.
Laziness can creep in unless there is an understanding about baths. These patients need turning every 2 hours anyway, they get soiled linen often enough. What is so hard about adding on a bath and fresh linen? In 8 years at my current job, I have only had one patient who didn't get bathed by the night shift, and she was alert to refuse a bath.

[Bronx1560]

Thanks RNperdiem U understood what I had to say.

U don't move a unstable pt NO WAY. I said that clearly. These pts U don't move beside U are to busy with them throught the day/night to bath them for the reason walk6miles mention above.

Wake6miles to let U understand the military. Iraq & Afghanistan nursing U are tunnel-visioned 24hrs a day 7 days wk for 12hr shifts. U get use to that after a 1year . They still got bushed down. That's a long flight to the states stinking up the plane with others on it who are trying to keep U alive.

And for the record I was a civilan nurse in NYC I now what it's like to saving lives on both ends.

Oh and its Ms. Military to U.

[Indy]

Our unit is pretty relaxed about the baths. I try to bathe people on nights. My coworkers try as well. When we're full (6 beds) we get an aide and it gets done. Sometimes we just team up and go on a "mad bathing spree" and get 'em all done within an hour or so, if they're all stable. It's kinda fun, builds teamwork, no one hurts their back, or if they do, they don't do it alone.

I've also done the style of bath that I call "piddling" where I keep the wipes handy and go head to toe, in between a bunch of other stuff, with a big break for a bunch of dressing changes and emptying drains and stuff. There may not be a bucket of water and it may have taken me all darn night, but they're alive and clean. Weeee! This bath style is reserved for the bedridden, vented, patients who don't realize I've been fiddling with this or that thing all night.

[meandragonbrett]

It depends. Try to do it on nightts. Doesn't always get done. And not everybody gets a full bath. Sometimes it's literally pits and slits due to staffing, census and acuity (27 bed Trauma ICU).

[nursenpnk]

This discussion comes up constantly in my unit. I think some nurses are so compulsive that they feel they HAVE to give a bath. Personally, if my pt is awake and alert and can refuse a bath or request then so be it, not too many of them want a bath at 12am, maybe in the morning, but I have found that most just want pits and peri and they feel refreshed. If i have a super sick pt I am not gonna further increase their discomfort by scrubbing them and what not, sometimes I find baths help relax pts, others it just makes matters worse. So really i think the focus should be what is the best interest for the pt. Not the fact that a. it is nites, b. you are the nite nurse and c.all baths must be done on nites. I personally love giving baths, it really helps the pt to feel better and is great for assessment, but sometimes you just need to let that pt rest and clean them up as needed.

[SICU Queen]

I work in a 13 bed SICU, and night shift does 99% of the bathing. All vented/sedated and confused patients are bathed at some point during the night, unless they're unstable. Alert/oriented patients get bathed between 7p and 11p so that they can "sleep". The A/O's rest better when they're bathed early!

Night shift generally has more time to do the "maintenance" type things... and therefore should be responsible for the bathing. There's no clipboard sorts around, the docs are generally gone, there's less traveling for tests, and limited family visitation.

Before I get flamed for my opinion let me assure you that I've worked both shifts for 14 years and I can appreciate what nurses on each shift have to do. Aside from having a crappy night with a super sick patient, there's no reason why nights can't do baths.

[SICU Queen]

Let me clarify too that if someone refuses, I respect that. AND, some people just need to rest. Period. I don't bathe those except on a PRN basis.

I guess what I'm saying is that unless there's a good reason NOT to, that nights should be doing most of the bathing.