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..

[brithoover]

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.

Like!

[brillohead, ADN, RN]

Just be glad you're not going to midwife school.

If you can't handle getting bathed while wearing shorts and a t-shirt, you certainly wouldn't be able to handle getting a pelvic exam multiple times by every student in your class!

[SummitRN, BSN, RN]

Just be glad you're not going to midwife school.

If you can't handle getting bathed while wearing shorts and a t-shirt, you certainly wouldn't be able to handle getting a pelvic exam multiple times by every student in your class!

Haha very funny.

[brillohead, ADN, RN]

Haha very funny.

It's not a joke, not meant to be funny.

It's just reality.

[tendrlovencare]

I think this is extremely inappropriate! Teaching dignity and empathy at the cost of embarrassment in front of your peers is NOT the right way to learn! This can be humiliating for people who are not comfortable in just a bathing suit, let alone being bathed by them. To me this is a pretty unethical way to teach someone and definitely may contribute to isolation and humiliation. What about empathy & dignity for fellow classmates?

[Rose_Queen, BSN, MSN, RN]

For those who say this is inappropriate, what do you suggest? A mannequin can't give you feedback or act realistically. Another person can. Same with assessment. There are some things that should be practiced before done on real patients.

I graduated nursing school seven years ago. We spent an entire semester living in sports bras, bike shorts, and patient gowns for our assessment class. I learned so much more doing that (both as assessor and assessee) than I would have with a mannequin or Sim-Man.

[kguill975, MSN, APRN, NP]

I guess I don't get it. The bed baths on classmates wasn't a big deal back then, and I still don't see why it's a big deal now. We were too afraid of not passing the skill to even care about being embarrassed. All I remember is trying to limit the amount of soap and water I used and to make sure my friend was covered at all times, so I wouldn't get a fail. Ya'll are in for a long road ahead, if this is upsetting to you. When you get chewed up and spit out by a doctor for the first time, then I'll be a little sympathetic, but all I can say right now is get over it.

[SummitRN, BSN, RN]

I hear a lot of "it didn't bother me, why should it bother anyone" and "I did it so others should have to as well." Clearly, you all didn't learn enough empathy during your bed bath sessions.

For those who say this is inappropriate, what do you suggest? A mannequin can't give you feedback or act realistically. Another person can... There are some things that should be practiced before done on real patients.

Bed baths are not a complex or difficult skill. I don't practice breathing before I get out of bed every day. I completely reject that argument outright and it is a sidestep from the rationale frequently presented which is that it somehow imparts empathy and understands upon the student.

But, just saying I accepted your argument that we for some reason have to skills on well persons before sick persons, why aren't you doing Foleys, IVs, enemas, and NG tubes on classmates?

[Rose_Queen, BSN, MSN, RN]

I hear a lot of "it didn't bother me, why should it bother anyone" and "I did it so others should have to as well." Clearly, you all didn't learn enough empathy during your bed bath sessions.

Bed baths are not a complex or difficult skill. I don't practice breathing before I get out of bed every day. I completely reject that argument outright and it is a sidestep from the rationale frequently presented which is that it somehow imparts empathy and understands upon the student.

But, just saying I accepted your argument that we for some reason have to skills on well persons before sick persons, why aren't you doing Foleys, IVs, enemas, and NG tubes on classmates?

Liability. It's not illegal or immoral for someone who is wearing more coverage than a bathing suit to be seen in public and have non-invasive skills practiced on them. However, there is liability when performing invasive skills. My school stopped allowing students to practice injections and IVs on each other the semester before I was to learn those skills. They are limited by what the school's legal team will allow. As someone else mentioned, student midwives and nurse practitioners do go a bit farther by practicing pelvic exams on each other.

As to your bolded statement above, I learned plenty from my experience as a "patient". It's not about "I did it so you should too" or "It shouldn't bother you", it's about using an effective teaching method.

[SummitRN, BSN, RN]

Liability. It's not illegal or immoral for someone who is wearing more coverage than a bathing suit to be seen in public and have non-invasive skills practiced on them. However, there is liability when performing invasive skills. My school stopped allowing students to practice injections and IVs on each other the semester before I was to learn those skills. They are limited by what the school's legal team will allow.

By your reasoning, students SHOULD be performing enemas and foleys on each other and would except for those pesky lawyers. That is absurd.

If you change your argument to there being some chance of physical harm, then you open yourself to the counterargument of mandatory bed baths of students resulting in emotional harm. If you discount emotional harm, then where is your empathy? You probably should have given your classmates more bed baths

As someone else mentioned, student midwives and nurse practitioners do go a bit farther by practicing pelvic exams on each other. ... as to your bolded statement above, I learned plenty from my experience as a "patient".

As I said, we don't expect surgeons to be cut, dentist to be drilled, etc as part of their schooling. If we stuck by this metric, there'd be a real shortage of hospice nurses. One person claimed that nurse midwives repeatedly give each other pelvic exams. That is extraordinarily unprofessional. Medical students and OBGYN residents do NOT do this. I have trouble believing that poster's claim. I am further disappointed in nursing academia if it is true. I'd further ask what happens if there is a male nurse midwife student? Would they make an exception for other students who don't want to be examined by a male? And why should that be a special case versus a student who didn't want to be examined?

it's about using an effective teaching method.

Paddling nursing students for poor performance would be an effective motivational teaching method, simple operant conditioning. Do we do that? "Effective" is not the same as "desirable."

Your logic must reasonably carry through and not be a special case for your preferred position. Please reevaluate your critical thinking.

[Miiiilk]

Last time I checked bed baths involved peri-care so I would give a yes it's a little inappropriate :\

[kguill975, MSN, APRN, NP]

It was never presented to us as a tool to learn empathy, it was presented as a skill that had to be learned and passed before going on to the first clinical site. Skills such as taking vital signs, demonstrating how to pass meds, how to lift a person out of the bed into the chair safely and back again, how to turn a patient, etc., etc.,etc. We did all of these skills on each other, and once again, we were so worried about not passing the skills, that we didn't bat an eyelash at wearing a tank top and shorts.

When your first patient asks you how many times have you done this before (and they will), will you answer, I've only bathed a mannequin?