ICU: Nurses Wash Patients + Make Beds?

Nurses General Nursing

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Just curious: In my hospital, ICU RNs wash their patients, make their beds, draw bloods, & do EKGs, while RNs on med-surg floors have Assistants who do these tasks (and of course the RNs on med-surg have far more patients). Is this structure typical throughout the hospital industry? I work at a NYC teaching hospital and wondering if this is standard practice.... Thanks for any input.

If there is no tech to help, are you expected to bath patients and change linens by yourself? Or do you take turns helping other RNs? I am interested in ICU nursing, but it is the physical component that is worrying me. It's not that I feel that I am above bed baths or anything, but I just don't know how I could handle this without any help. My back hurts as it is!

The ICU nurses at the local hospital I mentioned above help each other with their patient care, linen changes, ect. so that it saves on the time and the back. I am sure it is also more comfortable for the patient to have two people rather than one person struggling to get it done theirself.

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Specializes in CCU MICU Rapid Response.

We also are that way in our unit. 2pts to 1 nurse, and though we have a monitor tech, we are responsible for linens, garbage, ekgs, blood draws, baths, room restocking, feeding and toileting assistance and what not. I dont think that its a problem, like some others have mentioned, I need to look at their skin and their backsides, not to mention, I feel much safer having the experience in turning those with extra lines and tubes. With that said, one has to bear in mind that med surg nurses have 6+ pts, where I only have 2. I couldnt do all of that for 6+ patients! ~Ivanna

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Specializes in ICU, Research, Corrections.
In addition to the baths, linen changes, and blood draws, nurses in the ICU where I worked (have been in ER now since May) are also responsible for stocking the rooms and emptying the trash and linen bags. The fun part about stocking is that all of the linen has to be refolded to make it fit into the cabinets.

Yeah, we get to do those chores too. I am a highly paid janitor. Most of the time housekeeping doesn't mop the floors and so I throw a few wet towels down and drag them around with my foot.

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Specializes in Tele, Home Health, MICU, CTICU, LTC.

It has been my experience that most ICU's use the total patient care model. The nurse provides all care to the patient with no help from CNA's. Nurses usually help each other with the physical tasks.

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Specializes in Travel Nursing, ICU, tele, etc.
Yeah, we get to do those chores too. I am a highly paid janitor. Most of the time housekeeping doesn't mop the floors and so I throw a few wet towels down and drag them around with my foot.

Hey HOOZ (CCRN) I can just see you! It works pretty well doesn't it!

hehehe

:lol2::lol2::lol2:

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Specializes in Neurology, Neurosurgerical & Trauma ICU.

In our ICU, we are also responsible for all of the patient care (bathing, linen changes, etc.), but when we have an NA on, they will help you with that stuff. Our NAs also do our blood glucose monitorings, stock our bedsides and help us with our roadtrips. Our linens are stocked in a room, so other than an extra pad or pillowcase, we don't keep too much linen at the bedside. We do all of our own IV starts and blood draws, but there are techs that come around for EKGs and RT does our ABGs. As for our procedure trays, most of those come from central and it's the NAs job to make sure it's there.

As someone previously explained, many ICU patient's have so many tubes and wires hanging out of them, that it requires a little finesse when doing even basic nursing care.

A little interesting thing that we do with our crash carts is that ours are kept on the unit (we have 3) and have a little plastic lock on them (all you have to do is give it a little pull and it comes right off). Then, after a code, the US calls and central brings up a whole new, stocked and locked cart and they take the used one away. It's kinda nice because as long as you see the lock still on there, you know it's stocked and ready to go.

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Nurses do baths and linens here too. There is a stock clerk/CNA who keeps things stocked and assists with turns, linen changes and helps to transport. We have a unit secretary.

Beware when you hear people telling you that you didn't go to nursing school to do (fill in the blank). If more CNA's are used, the next step would be to give the nurses more patients to be responsible for. I would like to have control over the care and monitoring of my patient, so baths and linens are fine with me.

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I've noticed that ICU nurses do EVERYTHING regarding their patients as well..Since their patients are so fragile, and things can go wrong at the drop of a dime, it's much safer to put the responsibility on licensed personnel as opposed to a CNA, for example, the RN knows how to move about with all the vents, IV's, and respiratory equipment around the patient, as well as the trachs, colostomy bags, and urinary AND fecal catheters IN/ON the patient. I think safety here is key, they'd rather pay an RN double/triple the money they pay a CNA and be sure that the patient is in more capable hands.. my 2cents.

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Specializes in icu, er, transplant, case management, ps.

When I worked in ICU, back in the 70's and 80's, I did total patient care, including baths and bed changes. I had to empty foley bags out and restock necessary supplies by each patients bedside. I didn't empty linen bags, garbage, count linen, wash equipment or beds down. And a year ago, when I was a patient in Charlotte Regional's ICU, none of my nureses washed bedside equipment down. They did basicall the same things I had done years ago. Washing equipment down or counting linen is not using a nurse's time properly, IMHO.

Woody:balloons:

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Specializes in Tele, Med-Surg, MICU.

IN GENERAL, are ICU nurses good about helping each other? With patient care, covering for breaks, covering for patient transport?

I am a med-surg nurse and on my floor, the nurses are always great about helping each other, we don't get a lot of help from the CNA's - I'll leave it at that. When I have 5-6 patients who are high acuity, in uncontrolled pain, unstable vitals, psychotic, C-Diff+ with multiple loose stools, Q2 turns, who have demanding visitors, or are on the call light all the time because they're feeling needy, AND a new admission on the way, it's just too much because I'm on my own basically. The RN's pitch in and help each other when we can, but it's still too much. This is the status quo on my floor - it's not because I'm a new nurse and don't delegate.

So I'm just wondering if in the ICU environment staff tend to be professional enough to work together to take care of the patients, or if politics, infighting, attitudes, etc. exist to the same extent as in my situation, to the detriment of the patient.

Thanks for any responses, I'm trying to figure out whether an ICU setting would be a better fit... or just same stuff, different floor....

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Specializes in neuro, critical care, open heart..
IN GENERAL, are ICU nurses good about helping each other? With patient care, covering for breaks, covering for patient transport?

I am a med-surg nurse and on my floor, the nurses are always great about helping each other, we don't get a lot of help from the CNA's - I'll leave it at that. When I have 5-6 patients who are high acuity, in uncontrolled pain, unstable vitals, psychotic, C-Diff+ with multiple loose stools, Q2 turns, who have demanding visitors, or are on the call light all the time because they're feeling needy, AND a new admission on the way, it's just too much because I'm on my own basically. The RN's pitch in and help each other when we can, but it's still too much. This is the status quo on my floor - it's not because I'm a new nurse and don't delegate.

So I'm just wondering if in the ICU environment staff tend to be professional enough to work together to take care of the patients, or if politics, infighting, attitudes, etc. exist to the same extent as in my situation, to the detriment of the patient.

Thanks for any responses, I'm trying to figure out whether an ICU setting would be a better fit... or just same stuff, different floor....

\

Generally speaking, MOST ICU nurses are good about helping each other, however there are a few that aren't. IMHO if you don't help each other out, the patients are put in a more precarious situation. As far as the baths go, when I went from Med-Surg nursing to ICU, the most frequent response I got was "You know that you will have to give baths, right?" My response to them was, "that's ok, I'll be able to do a great head to toe assessment!" So, I use it as an opportunity to evaluate everything from skin condition to mental status. Plus, in the few cases where the pt is able to converse with me, I get to know them pretty well!

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Specializes in ICU, Research, Corrections.

Yes, my coworkers are excellent at being team players. Sometimes we need to put the pts in precarious positions to help though.

I have had several instances where a pump was alarming air in the line out of nowhere on an important drip that I am titrating and walk in the room and the patient is circling the drain. I can't even hear the IV pumps the way our unit is set up. In cases like that, it would be nice to have a CNA to help since we don't have to leave two critical patients alone to go help bathe someone or turn a large pt Q2hr. It's a safety issue. And the bariatric patients......sometimes it will take 5 RNs to move these pts. That is a lot of manpower off the floor for Q2hr turns.

This safety issue is one of the drawbacks of doing complete care. You need a complete crew of workers to do it. Heck, even a unit clerk would be nice.

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