i need some feedback regarding h.s. care.

Hi,
Oh for the "good ole" days..........I remember them well.
All of what you're speaking about should not be "lost" in this new millenium of Nursing.
A lot of it has to do with how your unit is staffed on a daily basis. If you have Nursing Assistant's, for example, the things of which you speak (back rub, tidying up the room in general at the end of the shiftd) would most certainly be something within their job description.
However, with the Nursing Shortage such a serious problem these days, back rubs and tidying up the room gets relegated to the "lowest" of priorities in most instances.
I have worked in the LTC setting for the past three years, after a thirty year career in the acute care setting. In my current setting, "hs cares" is an all inclusive event at the bedtime hour.....face, teeth, oral care, peri-care, backrub, etc. and I'm sure that in either setting getting the patient or resident out of bed daily, or several times a day, is a normal routine that gives the patient's back a much needed and necessary "rest."
I can only speak for myself, but whenever I go into a residen'ts room, for whatever the reason, I am also paying attention to whether or not the bedside table area is at least "orderly" and things are where the resident can reach them. If not, it only takes a matter of seconds to put things in better order.
For our resident's who are too ill to be OOB we use a "turn schedule (usually q2h or more frequently depending).......but back care for the bedridden is a must in order to maintain skin integrity, and I also inspect the resident's skin at this time.

Hope this helps.........

Bonnie

Sure, those things would improve satisfaction, but until administration will start safely staffing, it won't happen.
I would love to be able to take an extra 10 minutes to devote to EVERY patient for a backrub, but I'll leave the room tidying to housekeeping.

Hi. Yes, anything that helps increase a patient's level of comfort would help satisfaction. But, why just at night? The provision of comfort measures may be a good time to teach or instruct the patient or family in self-care of their illness or injury. It also is a good time to interact with the patient in general. It may lead to you being able to make your care more pertinent to that individual patient's needs. While back rubs should be offered routinely if not contraindicated, they should not just be a routine activity or marketing gimmick. Like other posters have indicated, you need to have adequate staff to increase your quality of nursing services for the patient and their families.

I work as a CNA and I have always tried to make the patient more comfortable and to pick up their room s at bedtime. Isn't that just part of being kind? What a nurse is supposed to be?

This is kinda on the same subject.... we had a rough draft policy on Pain management in our report book and we were asked to comment on it.... Mind you We are a STATE PSYCH HOSP... i work on the forensic unit.... The crimminally insane...... well, one of the directives were to provide comfort measures such as therapeutic massage and or back rubs.... well, I was floored.... I wrote my comment as follows: It would be open season on nurses, we would have spend half of our days responding to grievences and doing depositions for sexual misconduct or harrassment. In another hospital setting it would be a wonderful idea, here where I work it would be chaos. Needless to say every nurse who read my comment was greatful that I had the nerve to write it since it was a draft policy written by a doctor who does not like any thoughts other than his own.

I am amazed at the suggestion nurses give back rubs in this setting. Do you really have pain management issues on your unit?

I guess I am nuts, because my patients do get a back rub and their rooms are tidy.

I have recieved patients from nurses and walked into the room and it will look like an explosion happened in there.......believe I mention it to the nurse the next time I see her. why should I clean up her mess?