Med Clinical... Pt Hygiene

[flyingchange]

Hi all, I am currently finishing off a 5-week rotation on a medicine unit. I am in second year and right now am doing all meds and care for 2 pts. What I am finding to be my biggest challenge is not managing my time, or knowing my meds, or any of that stuff.....

It's PATIENT HYGIENE!!!!

The problem isn't that I'm afraid of it or embarrassed by it. The problem is that my pts seem to be unusually resistant to the idea of... cleaning themselves...?

Every time I bring up the idea of AM care, they will say "No I want a nap first" or "I already did it" (even when I'm pretty sure they didn't). It's going on 4 days now.

I've approached the issue from every way I know how. I've given them options (i.e. "In half an hour?"), I've just plain brought them the basin with everything ready to go, I've offered them showers, I've asked them how I can best help them get clean. Still, they just don't want to. Even getting them to change their gowns is a task.

These are not bed bound people. They have some mobility and are cognitively independent. They are not incredibly sick. Both of them are just waiting for placements for discharge. It's not like I can just say "hold still, here comes the cloth!" That'd be pretty demeaning and rude. I want to foster independence but this is ridiculous. They need assistance for peri care too but they will not accept it from me. Note that they have not said NO, exactly, but they just endlessly defer it.

Does anyone else find that their pts are reluctant to, well, smell better?

How DO you handle it...? It seems like the nurses have no problem.

[SaraFL]

I am not a nurse yet, just interested in the responses you get to this question. I wonder, can you say "Nurse XYZ told me to do this, and I don't want to get in trouble", would that work? Is it OK to fib like that?

[Do-over, ASN, RN]

If they need assistance with toileting that is a good time to do peri care...

Edited to add - Have you asked the assigned nurse assistant/aide/tech for help? I, personally, am glad to help the student (as I have been helped numerous times by staff while at clinical) get a patient bathed - especially considering I'd be responsible for it if the student wasn't there anyway...

[dcRn2b]

I am also still in nursing school but what I found works best for me is after they eat breakfast I go in and remove the tray and politely say "Mrs/Mr.so and so I'm going to go gather all my supplies for you morning bath do you have any special request you would like to share with me" They will usually say oh I have my own lotion in the closet or I prefer baths over showers etc. My first semester I was always being told No No No lol....I soon realized if I don't say "are you ready for your bath or would you like your bath now" it goes allot more smoothly...Good luck hope you find a great routine that works for you!!

[SNtil11]

Hey - i had this problem at one of the hospitals i was out, and it turns out they WERE getting their baths... just at 4 in the morning (yes, they were being woken up for that) so... needless to say, the 4 am bath wasn't a very good one, but they didn't want to deal again because the experience wasn't a good one.

On the other hand... i've had this problem, and partly, i think it's because when it comes to patients, i am not the most assertive person (because i often feel very intimidated, i mean, hey, i'm a nursing student!) lol. so anyway. my advise would be to get in there and not ask if they would like a bath, but say, "it's time for your bath now, I'll make it quick." you're the one in charge of their care. YES, they can refuse a bath, but realistically, if they are able bodied as you say, tell them to do the bath themselves... promote their "self care" . good luck!