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..

[kguill975, MSN, APRN, NP]

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

Are you serious?

[nursel56]

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

Exactly. Especially when we are taught to view our patients in a holistic manner. This can be emotionally invasive, if you will.

Strictly talking about logic, a bed bath "only" strips away personal boundaries to teach a simple skill that most of us can imagine. It really victimizes those with an emotional make-up or past experiences relating to privacy/personal space or whatever, because the potential liabilty is so much less than when one does an invasive procedure.

The vast majority of us will not ever know what procedures our patients undergo feel like, so we develop our observational skills to pick up cues of the patient's distress and respond to it, even if it's a gesture to support them through it.

If the real lesson is along the lines of sensitivity training under the guise of learning a fundamental nursing skill, then not to upset people with good intentions . . .the subterfuge isn't right.

I don't think other components of assessment like heart and breath sounds are harmful, but if a student has a convincing reason why it would be as emotionally invasive as the bed bath can be I would listen to them.

[SummitRN, BSN, RN]

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?[/quote']

What will you say for a Foley? IV? NG? Thank heavens you wiped a washcloth on a real person one time!

[kguill975, MSN, APRN, NP]

What will you say for a Foley? IV? NG? Thank heavens you wiped a washcloth on a real person one time!

That was actually a rhetorical question. I'm an NP, and I find your outrage laughable. There will be many things that you will find offensive over the course of your career, IF you pass nursing school. You will even laugh at this yourself, when you make it out into the real world and realize that no one cares what you think, until you've had at least 5 years nursing experience under your belt. It's a free world, you don't have to do anything you don't want to do, so refuse to do the bed bath, and watch all of your friends cave, because they want to be a nurse bad enough to not care about the embarrassment. Just curious, how old are you?

[nursel56]

That was actually a rhetorical question. I'm an NP, and I find your outrage laughable. There will be many things that you will find offensive over the course of your career, IF you pass nursing school. You will even laugh at this yourself, when you make it out into the real world and realize that no one cares what you think, until you've had at least 5 years nursing experience under your belt. It's a free world, you don't have to do anything you don't want to do, so refuse to do the bed bath, and watch all of your friends cave, because they want to be a nurse bad enough to not care about the embarrassment. Just curious, how old are you?

It's concerning that you would call another nurse's opinion laughable. The rest of your statements might be true, but they have nothing to do with whether your classmate practices a bed bath on you or not. If a school is actually threatening to fail a student out of the program because of the bed bath thing, they must not be terrribly concerned about the impending monster nursing shortage.

[AmesRT6510]

What do you think a surgeon says to his first patient he cuts into as a resident? Or a cardiac surgery resident assisting with open heart surgery? Obviously those are extremes but consider the comparisons and logic behind the argument saying you must practice every skill on a live person before touching a patient. There are sim mannequins for a reason and the technology is unbelievable. Clinical time is also an excellent time to learn and usually its in a teaching hospital where most patients understand that people are learning.

I am an experienced respiratory therapist and we intubated sim mans, practiced blood gases on the fake arm and so forth and when it came time to the real patient we felt prepared and we were still able to learn how to be efficient.

I'm glad this has provoked interesting discussion. I agree there are points to both side but it comes down to how effective a practice of a certain skill can really be. In this case, for some it really doesn't help us learn empathy or feel what the patients feels... so the goal would not be accomplished. The option should be there - bathe/practice bed baths on a real person or mannequins and people can do so according to their comfort level.

[ChooSoul]

lol.

its easy! you just make sure you and pt are comfortable, and you just clean the pt. the way you would clean yourself. we didnt even have to practice on mannequins. let alone bathe each other. thats too much. its enough they make us go shirtless for mock health assessments

in my school we learned bed bath by theory. we did our first actual bed baths when we went to our first clinicals in a nursing home. it was like automatic response. we were assigned to follow CNAs and Nurses and they just tell us what to do like VS, reposition, hygiene feeding etc, and we just do it except giving meds.

this is just like a natural skill.

[SummitRN, BSN, RN]

That was actually a rhetorical question. I'm an NP, and I find your outrage laughable. There will be many things that you will find offensive over the course of your career, IF you pass nursing school. You will even laugh at this yourself, when you make it out into the real world and realize that no one cares what you think, until you've had at least 5 years nursing experience under your belt. It's a free world, you don't have to do anything you don't want to do, so refuse to do the bed bath, and watch all of your friends cave, because they want to be a nurse bad enough to not care about the embarrassment. Just curious, how old are you?

1. I am a RN, not a student.

2. During school, I performed bedbaths on my classmates, and they on me, and I did not voice an objection based on a simplistic game theory approach. In a phrase, it was not a fight worth fighting at that time in the vulnerable position of a nursing student.

3. I am not young. Nursing is my third healthcare career.

4. I have worked and continue to work in adult education.

5. I will argue my logical and ethical viewpoint on the subject in order to present a view to my juniors, peers, and seniors in the profession that we ought to eliminate a practice with little practical gain and a potential for harm that is based upon a faulty rationale.

When making sound arguments, age and experience do not enter into the equation. If you have to whip out appeals to authority and dismissive arrogance based on seniority without a cogent counterargument, I have little respect for your point of view, NP or not. I recommend reading more closely before you decide to get all presumptive and condescending, as these information items were found within my prior post in this thread. You know what they say when you assume...

[Bringonthenight]

I really don't see what the problem is. When I was a student we practiced bed bathing each other- we all wore bathing suits, it's not like your stripping your class mate down and inappropriately touching/perving on them. It was the same when we learnt how to shower patients, we all got in our suits and got showered- but it wasn't some sexually inappropriate wet tshirt contest. We were learning skills and getting signed off before we could go on clinical practice. You'll learn a lot more and gain more confidence if you practice on a person and not a mannequin. Also i'm assuming the class is predominantly female so its not like a couple of guys will be washing you down and making you feel uncomfortable. That being said, our instructors always allowed for people to opt out of the exercise if they felt uncomfortable for whatever reason eg: religious reasons, didn't feel comfortable being viewed in a bathing suit.

I agree with what others have said: if this simple exercise makes your uncomfortable, what is it going to be like when you go to a real floor and your dealing with real things- death, angry Drs/nurses/patients/patients families, (lots of angry people in hospitals) REAL BED BATHS and REAL SHOWERS on actual naked people.

Hoping it all works out ?

[brillohead, ADN, RN]

Also i'm assuming the class is predominantly female so its not like a couple of guys will be washing you down and making you feel uncomfortable.

That's what I find so odd here... I'm an old fat married lady whose partner for this particular skill was an attractive gentleman in his 20s who has a girlfriend. I wore shorts and a t-shirt while he bathed me, and he did the same when I bathed him. The curtain was drawn around the cubicle at all times, so no other classmates saw me and my pudge.

Two years later, we're in a class together again for the first time since Fundamentals; this is our last class before graduation. We haven't seen each other in two years, and he's had the distinctly unpleasant experience of having bathed my fat arms and legs, yet I'm sitting right next to him in class, we're joking like nothing ever happened, and we're enjoying sharing our last semester together as we shared our first semester together.

It's just not that big of a deal....

If you've been abused in the past or if you have religious or other reasons for not exposing your arms and legs to another person, discuss it with your instructor and work around it. But the majority of people don't have extenuating circumstances that make a fully-clothed bed bath problematic.

Unless you go into chart auditing, nursing is pretty much a "touching" profession. You will touch and be touched by other people. If you can't handle being touched on the arm or leg by another person, you might want to think about another career.

[nursel56]

It truly amazes me how many people are saying "what's the big deal?" "I have bigger fish to fry", etc. Do you not understand that it isn't just about you, for reasons enumerated farther back in the thread? The "rethink your career" has now made it's appearance, right about on schedule.

[SummitRN, BSN, RN]

^Well said nursel56

I find it shocking that people can talk about the caring profession of nursing and empathy, and in their next breath say "It didn't bother me, therefor everyone else should feel the same, and deviations are signs of INADEQUACY." How is that empathetic or logical? How is it empathetic or logical to imply that being uncomfortable with being personally bathed by others, violating your own intimacy, somehow correlates with your ability give patients in need a bed bath (it is thier intimicy being compromised, not yours). Many are unwilling to acknowledge the violation of professional and collegial ethos and instead fall to the insufficient rationale of "that is how it is always done, and it is effective." Effective is not the same as best practice!

The illogical and emotionally biased arguments combined with harsh and unjustified value judgements in this thread are quite disheartening. No wonder nursing has trouble with interprofessional respect.