When I worked acute care, oral care and ambulation were the most neglected tasks on our unit. The nurses simply did not have the time to walk around the floor with patients, and the few aides usually had 12-15 pts. apiece, so folks were lucky to get vitals, baths and meals on time.
I don't know what it will take to make American hospital administrators and CEOs understand that nurses are not machines, and that Press-Ganey scores are only a measure of how well we can kiss
butts, not save them! There is only so much we can do when we have five or six heavy care patients with multiple issues (complex treatments, dementia, incontinence, dozens of meds, mobility problems etc.) and NO help. We shouldn't be expected to get a 300-pound hemiplegic out of bed and into a chair by ourselves. We shouldn't have to spend entire shifts getting a LOL knee-replacement patient in and out of the CPM every half hour for bathroom trips, doing Q-30-minute vitals on three fresh post-ops, feed two total-care patients, and dealing with families, doctors, 'suits', therapists, phones, and a continual barrage of new orders.
But all of that, and more, IS expected, and nurses are often punished harshly when they can't perform miracles. This is one of the reasons I left hospital nursing; I couldn't
do it all, and I didn't like carrying around a bunch of guilt because of that. I often wondered what my holier-than-thou manager would have done when two of her
patients were circling the drain and another was climbing out of bed every five minutes---go brush someone's dentures?
How much 'basic care' would she have had time to do if one of her
patients was throwing up black blood and needing to go to the ICU two hours ago, another was on the call light every two minutes asking when she's going to be discharged, yet another was demanding to be transferred to a private room NOW because her roommate is chatting with a couple of friends and 'making too much noise', and still another had a blood sugar of 42 and there was no juice to be found on the unit?
There are no easy answers, of course.........at least, none that the powers that be are willing to PAY for.
But don't even get me started on that.........it wouldn't be pretty.