Appropriate way to Check off Bed Baths (Fundamentals)

[AmesRT6510]

Hello Nursing friends :)

I have a question - my classmates and I went into our practice lab tonight and our professor told us that in order to practice bed baths, we had to be in bathing suits, bring our own towels, soap, etc etc. We all were completely thrown off guard because number 1- she never told us although she swore she did 2- I find it almost unethical to be bathing a classmate. Many of us are very uncomfortable with this and luckily we have two instructors so many of us will check off the skill with her in clinical.

What do you think of this? I know many skills are practiced on a classmate - I am a respiratory therapist so I know we practiced skills on one another when appropriate. I find this really not appropriate. My question is, is this normal? Is this something that we should speak up about or just accept?

Thanks for the input..

[nurseprnRN, BSN, RN]

If I see anything in the posts of many new nurses, it's how much they see their patients as a workload, a bother, a burden, the families a pain in the neck, abusive, argumentative... I rarely see a post that projects any kind of empathy. NO, not all posts. But many.

I think this kind of lab is an excellent way to teach empathy, not just for how you yourself feel being bathed and touched by a comparative stranger, but how you can also imagine your friend behind the next curtain in lab and how s/he is feeling about it. And more than that, it broadens your horizons in a way that many younger (and some older) people cannot begin to imagine.

I used to do a lab that was ostensibly about positioning, but was really about this issue. The students paired off, one got into the bed (fully clothed) and was positioned to one side with pillows. The "patient" was not allowed to talk or move, as if paralyzed. After the "patients" were all positioned, the curtains were pulled closed around the beds, and there was a seven minute wait period when all the "nurses" gathered in the middle of the lab, where they inevitably got chatting. Then everyone came out and we had a little talk.

What should happen after this kind of lab is a discussion period where everyone talks about this...and if the discussion doesn't spontaneously roll around to how much patients feel like objects, not people, then the instructor should gently guide it there. In my classes, the "nurses" felt good about their skill in positioning, felt like they were really doing real nursing, and couldn't wait until the next skills lab.

The "patients" all felt like meat, were panicky, were alone, wondered if their "caregivers" thought about what it was like to be in that bed while they all chatted about the game on Saturday or what was for lunch in the caf. It was an eyeopener for all concerned. Just about everybody (including each "patient") was stunned at the depth of feeling felt by the "patient" side...and how they all completely missed it.

And that's why I think the special snowflakes should realize that this lab is about far more than bed baths, about being aware of another's embarrassment at being dependent, or about having societal roles between strangers violated in a care situation. Your body is not so special, no more so than anyone else's is to him/her; it really isn't. A sense of proportion and empathy here, and lose the entitlement. Being a nurse does not put you on a higher plane than the patient (see the first paragraph); they are not your workload, they are people no different at all from yourselves.

THAT's what this lab is all about. Sometimes it takes a bigger jolt than you think to make people see it, is all.

[Kimynurse]

I agree with green tea

It does make you pause, and think.

Does that person want you do this?

Makes you think to cover and screen for privacy.

[dah doh, BSN, RN]

My first quarter of nursing school we practiced bathing and hygiene on each other; we picked our partner so you got a "friend". We wore swim suits or shorts & tank tops. The beds had privacy curtains but it was still uncomfortable. It gives you an idea what patients go through as well teach you skills with bathing, hygiene, and bed making. Of course, I went to nursing school a long time ago. The instructors did tell us about it beforehand so we weren't shocked. I recall there was a lot of giggling in that lab.

[nursel56]

I know we had the bed bath exercise, but the only thing I remember about it was the bright red face of one of my fair-haired classmates, K. K was the sweetest person in our group of about 15 people. She was the only "nurse's aide" as we called them then, but you practically had to drag it out of her. She was also a good fifty pounds overweight. Her humiliation was so palpable. I suppose you could argue that this was a good thing. Maybe it motivated her to lose weight. Maybe the others who witnessed that never made fun of a fat person again. It's hard to say, but it always is when you do something to provoke an emotional reaction in a group of people who's background and personality you know nothing about.

Did it teach us empathy? I think I had the empathy when I imagined how this person was feeling right then. I don't recall a noticeable change in the people who were selfish, spoiled young people who looked at nursing school as a lark, the earnest single mothers who were betting it all on the chance to have a job that would support her and her child without the short of breath that fathered the child, or Roger. Roger was too much of a kick to describe. If stripping people of their personal boundaries causes empathy to grow, there are number of people I've worked with over time who should undergo another bed bath ASAP, because it appears there's an expiration date on a few out there.

What I really think is that it can cause some people to find out what empathy feels like for the first time. But that the ground was tilled before that, and any number of experiences can cause the change in the emotional radar. I don't remember what it was like to have a bed bath, but I make a point of remembering how everything I've gone through on the patient side of things (which will happen to most of us) can help me be a better nurse.

[Esme12, ASN, BSN, RN]

If I see anything in the posts of many new nurses, it's how much they see their patients as a workload, a bother, a burden, the families a pain in the neck, abusive, argumentative... I rarely see a post that projects any kind of empathy. NO, not all posts. But many.

I think this kind of lab is an excellent way to teach empathy, not just for how you yourself feel being bathed and touched by a comparative stranger, but how you can also imagine your friend behind the next curtain in lab and how s/he is feeling about it. And more than that, it broadens your horizons in a way that many younger (and some older) people cannot begin to imagine.

I used to do a lab that was ostensibly about positioning, but was really about this issue. The students paired off, one got into the bed (fully clothed) and was positioned to one side with pillows. The "patient" was not allowed to talk or move, as if paralyzed. After the "patients" were all positioned, the curtains were pulled closed around the beds, and there was a seven minute wait period when all the "nurses" gathered in the middle of the lab, where they inevitably got chatting. Then everyone came out and we had a little talk.

What should happen after this kind of lab is a discussion period where everyone talks about this...and if the discussion doesn't spontaneously roll around to how much patients feel like objects, not people, then the instructor should gently guide it there. In my classes, the "nurses" felt good about their skill in positioning, felt like they were really doing real nursing, and couldn't wait until the next skills lab.

The "patients" all felt like meat, were panicky, were alone, wondered if their "caregivers" thought about what it was like to be in that bed while they all chatted about the game on Saturday or what was for lunch in the caf. It was an eyeopener for all concerned. Just about everybody (including each "patient") was stunned at the depth of feeling felt by the "patient" side...and how they all completely missed it.

And that's why I think the special snowflakes should realize that this lab is about far more than bed baths, about being aware of another's embarrassment at being dependent, or about having societal roles between strangers violated in a care situation. Your body is not so special, no more so than anyone else's is to him/her; it really isn't. A sense of proportion and empathy here, and lose the entitlement. Being a nurse does not put you on a higher plane than the patient (see the first paragraph); they are not your workload, they are people no different at all from yourselves.

THAT's what this lab is all about. Sometimes it takes a bigger jolt than you think to make people see it, is all.

While I agree with you my friend.....I still think it is excessive and unnecessary. But when I think about the thin privacy attitudes of people these days with social media maybe it isn't such a bad idea.

[AmesRT6510]

Thanks Greentea, while I agree with some of the principals that you are standing on - I don't completely agree with a few things. First of all, my classmates are genuine and we are eager to learn how to best care for our patients. We don't see them as a workload or a chore... if we did we wouldn't be in the nursing profession. Second, we didn't respond to this situation with entitlement.. We felt threatened, embarrassed and upset. We don't need to strip down to our bathing suits and bathe one another to understand empathy and what our patients go through. It's just not right and we all value our own personal privacy. I agree with labs such as positioning like you mentioned and a long list of other things that don't violate someone's privacy.

As for mentioning that our bodies just aren't special, I disagree. Everyone's body and every person is special, important, and deserves respect just like we should show our patients. We can all learn how to continue to have empathy, respect, compassion, and genuine care for our patients without being put in a situation such as this. I also hope that when you say "special snowflakes" you aren't referring to nursing students... Classmates aren't strangers - we spend more hours together then we do with our families. A patient-nurse relationship is professional and completely different then 2 classmates making this exercise inappropriate.

[mom_coach_nurse, LPN]

What about how the patient feels about their privacy? It's a catch-22. The patient might feel threatened, embarrassed & upset too.

[Wrench Party]

I gave a bedbath to a 100-year-old LOL today, and her body is a testament to the century she has spent on this Earth. I kept thinking "this is someone's grandmother, and needs to be treated with respect". In comparison, students have some clothing, their health, and familiarity to the situation when giving each other bedbaths. There are bigger fish to fry, I think.

[brithoover]

If I see anything in the posts of many new nurses, it's how much they see their patients as a workload, a bother, a burden, the families a pain in the neck, abusive, argumentative... I rarely see a post that projects any kind of empathy. NO, not all posts. But many.

I think this kind of lab is an excellent way to teach empathy, not just for how you yourself feel being bathed and touched by a comparative stranger, but how you can also imagine your friend behind the next curtain in lab and how s/he is feeling about it. And more than that, it broadens your horizons in a way that many younger (and some older) people cannot begin to imagine.

I used to do a lab that was ostensibly about positioning, but was really about this issue. The students paired off, one got into the bed (fully clothed) and was positioned to one side with pillows. The "patient" was not allowed to talk or move, as if paralyzed. After the "patients" were all positioned, the curtains were pulled closed around the beds, and there was a seven minute wait period when all the "nurses" gathered in the middle of the lab, where they inevitably got chatting. Then everyone came out and we had a little talk.

What should happen after this kind of lab is a discussion period where everyone talks about this...and if the discussion doesn't spontaneously roll around to how much patients feel like objects, not people, then the instructor should gently guide it there. In my classes, the "nurses" felt good about their skill in positioning, felt like they were really doing real nursing, and couldn't wait until the next skills lab.

The "patients" all felt like meat, were panicky, were alone, wondered if their "caregivers" thought about what it was like to be in that bed while they all chatted about the game on Saturday or what was for lunch in the caf. It was an eyeopener for all concerned. Just about everybody (including each "patient") was stunned at the depth of feeling felt by the "patient" side...and how they all completely missed it.

And that's why I think the special snowflakes should realize that this lab is about far more than bed baths, about being aware of another's embarrassment at being dependent, or about having societal roles between strangers violated in a care situation. Your body is not so special, no more so than anyone else's is to him/her; it really isn't. A sense of proportion and empathy here, and lose the entitlement. Being a nurse does not put you on a higher plane than the patient (see the first paragraph); they are not your workload, they are people no different at all from yourselves.

THAT's what this lab is all about. Sometimes it takes a bigger jolt than you think to make people see it, is all.

I would absolutely refuse this task. Being a nurse does not make me entitled and I do not need to learn empathy through somebody invading my privacy. We just have to remind ourselves that yes this is a job for us but our patients feel very out of their element.

[nursel56]

I respect what Grn Tea is saying, too. I haven't really noticed recent crops of students having a higher percentage of special snowflakes or that they view patients as a workload or burden before they actually take care of a real one. Still, if you believe your own reaction or opinion is enough information to pursue a policy that affects everyone you are having empathy for an imaginary patient and not showing it to your classmates. It's a huge stretch to imply that unless you've had a classmate give you a bed bath you're incapable of realizing that your patient is somebody's grandmother.

Consider the possibility that a classmate has psoriasis and it's flaring, or is a survivor of child abuse and is working with a therapist over his or her aversion to being touched, or that they are a victim who is still repressing the abuse, and the situation triggers his or her recall, or maybe your classmate is midway through a breast reconstruction, and has to explain why she has a tissue expander and no nipples. I still don't think the theoretical gain is worth it.

You do not need to be given a bed bath to feel empathy.

[elprup, BSN, RN]

Not exactly a bath, but we had to put peanut butter around and inside of our elbows and then put a diaper on and wear it for entire class. Gave us a great idea how sitting in a dirty diaper felt....not good. Funny thing is my elbow was so soft that next day!!!

[SummitRN, BSN, RN]

If I see anything in the posts of many new nurses, it's how much they see their patients as a workload, a bother, a burden, the families a pain in the neck, abusive, argumentative... I rarely see a post that projects any kind of empathy. NO, not all posts. But many.

I think this kind of lab is an excellent way to teach empathy, not just for how you yourself feel being bathed and touched by a comparative stranger, but how you can also imagine your friend behind the next curtain in lab and how s/he is feeling about it. And more than that, it broadens your horizons in a

....

And that's why I think the special snowflakes should realize that this lab is about far more than bed baths, about being aware of another's embarrassment at being dependent, or about having societal roles between strangers violated in a care situation. Your body is not so special, no more so than anyone else's is to him/her; it really isn't. A sense of proportion and empathy here, and lose the entitlement. Being a nurse does not put you on a higher plane than the patient (see the first paragraph); they are not your workload, they are people no different at all from yourselves.

THAT's what this lab is all about. Sometimes it takes a bigger jolt than you think to make people see it, is all.

Sweet... let's make students uncomfortable to teach them empathy. That's logical and professional. Hey, why not just yell at them like a drill seargant to drive home the value of therapeutic communication? Maybe they can start Foley's on each other for skill practice and to learn about privacy and understanding what patients endure! HOW ELSE WILL THEY UNDERSTAND WHAT IT IS LIKE TO HAVE A TUBE SHOVED UP THEIR URETHRA?

Yes, that's a textbook reductio ad absurdum of that poor rationale.

Professional education methos must not cause harm and must be universally applicable across the lines of culture, gender, and health while maintaining professional and collegial relationships. Thus, comparatively, Dental students do not drill each other, Surgical interns do not cut each other, women's health NP students don't do gyn exams on each other, and Proctology residents do not perform digital rectal exams on each other to "understand their patients feelings." Nursing students bathing each other with the rationale that the exercise may be shocking or traumatic in order to teach empathy not only violates the educational spirit of being professional colleagues, it is far more like hazing than education.

My school did this and it was wrong. So, if you have a special snowflake, and you cannot find a better way to enlighten them than hazing, you've failed as an educator. GrnTea, your example of scenario acting paralysis is an appropriate way to approach this issue.