Ethics of patient bathing

Zalan · Mar 25, 2009

I`d say it depends on the reason for the bath. If at a hospital then are they going to an early surgery? Is it a Ortho unit with Joint Camp in the morning?

I have news for most of you that think night time is sleep time at a hospital. Its not really. At night you still have your Q4 vitals, 12 am, 3 am, & 6 am blood sugars to check. & if they are a turn you have to wake them up every 2 to 3hrs anyway. Not to mention when you do hourly rounds you have a good chance to wake them up. Thats either do to pager going off, or a Cell Phone if your unit has you carry Cell Phone(for unit purposes).

rn2bnwi, BSN, RN · Mar 25, 2009

I`d say it depends on the reason for the bath. If at a hospital then are they going to an early surgery? Is it a Ortho unit with Joint Camp in the morning?
I have news for most of you that think night time is sleep time at a hospital. Its not really. At night you still have your Q4 vitals, 12 am, 3 am, & 6 am blood sugars to check. & if they are a turn you have to wake them up every 2 to 3hrs anyway. Not to mention when you do hourly rounds you have a good chance to wake them up. Thats either do to pager going off, or a Cell Phone if your unit has you carry Cell Phone(for unit purposes).

I absolutely understand that but those are necessary things and we do it in a way as to disturb them the least amount possible. throwing in a bath for the staffs convience at 3 am is a little rude and inconsiderate.

Tait, MSN, RN · Mar 25, 2009

OUr techs have an arrangement to complete a bath on two level 4 (confused/Q2 hour turn etc etc) patients each night. Generally they do these at 0600 and the patients are then slean, comfortable and generally back to sleep at shift change.

Baths for regular level patients are reserved for during the day.

Tait

Virgo_RN, BSN, RN · Mar 25, 2009

Many of our patients have orders to be allowed to sleep through the night as long as they are stable. Baths are done on day shift, with the exception of preop showers for our open hearts.

lpnflorida · Mar 25, 2009

I have found there are ways of asking that work best for me. Mr or Mrs soso would you like to bathe now or would you prefer I come back in fifteen minutes or so. I find I get a more positive response to this as it allows some choice in the matter.

Some patient's will say I usually bathe at this or that time, we try to accomodate. It does not always work out. Always document when a bath has been offered, we have had patient's say I was never even offered a bath after being here for 3 days. Not quite accurate, you were offered you refused. However, they might have truly forgotten it was offered.

Still irks me that such a high price tag is placed on the almighty bathing routines, but it is. While I would like to wash up daily, there are others who find it an intrusion when they are not feeling well. Would I want to be bathed in the middle of the night. Heck no, but then again if I were already awake that might be a different matter.

onetiredmomma · Mar 25, 2009

To retiredlady: I used to work home care. Clients can really get annoyed when someone interrupts Price is Right!!!!

To OP I understand the need to get som baths done by night **** staff. Perhaps the day staff could feel pts out to find out who would prefer an HS/early am clean up time?

**canoehead, BSN, RN** · Mar 25, 2009

If you are assisting someone with bathroom needs bring a basin along. when you are helping them clean up afterwards give them an extra facecloth for their face and hands while you do their back, or something extra. It only takes a couple of trips to get a whole bath done, but in pieces. The patient may not even know they had a bath.They just think you are really thorough about cleanups post void.

discontentment · Mar 25, 2009

I appreciate all the replies! You guys are great! I work on a stepdown ICU unit, no vents, small unit, high acuity and high patient turnover. Night shift is responsible for over half the baths, this is a primary care unit in a hospital setting, we do not have CNA's and our LPN's are mostly our unit clerk/lab person. We must escort our patients to whatever test they have on day shift as they are often on cardiac drips that require constant monitoring. Generally speaking, bathing is hard to do on dayshift but we try to do our share, which reserves night shift to do the rest. Our manager is talking of writing people up for not bating the patients but you cant force them, some of the RN's dont give the patients a choice, they just walk in a say.... You are taking a bath and if the patient says they dont want to, the reply is, it will just take a minute and they start bathing them anyway.....

I am not about to enter into the 'battery' zone, especially over a bath. I just feel frustrated over this whole topic and my manager says to document but then pulls stuff like.... do you really think that that lady would tell you she didnt want to bath right then...... who would at MN and 5am after xanax/sonata

Basically, she says to do it anyways as it is in the best interest of the patient... which i agree that bathing is in the best interest of the patient, but everyones personal hygiene habits are not alike.

blondy2061h, MSN, RN · Mar 25, 2009

why are baths scheduled on the night shift when pts should be sleeping???????

Exactly what I was wondering. Days gets 3 aids. On nights, we're lucky if we get one. Why? Because it's dayshift's job to do baths. No one would want to get cleaned up at MN or 5am.

The patient is obviously woken up a lot during the night anyways, but there's a difference between a 30 second set of vitals they barely need to move for and a bath.

Flare, ASN, BSN · Mar 25, 2009

A bath tends to wake people up. fresh clean water and scrubbing tends to be somewhat invigorating especially if you're ill and spending a great deal of time in bed. To have that given in the middle of the night is a little inappropriate as most people are hard wired to use their bath/shower as their start point of their day. It makes me want to tell your manager that she/he should start taking her/his shower at midnight then see if they get restful sleep.

Hygiene is important but so is rest.

lpnflorida · Mar 25, 2009

Our facility works 12 hour shifts, so to say bathing only belongs to night shift would be incorrect. Just as it is equally wrong to say it totally belongs to the dayshift.

Ruby Vee, BSN · Mar 25, 2009

why are baths scheduled on the night shift when pts should be sleeping???????

in icus and stepdown units, baths are frequently done on the noc shift because there is so much going on during the day, there is no time -- or privacy -- to do a bath. these patients don't get a whole lot of uninterrupted sleep due to the need for lab draws, vital signs, dressing changes and other procedures, and once you've woken them up you might as well whip out a quick bath and linen change.

my take on the situation would have been to announce "it's time for your bath now. would you like your teeth brushed first or afterward?" rather than offer them the choice between bath and no bath.