Nursing school: Bizarre practice in learning to bed bath..

[Cat_RN]

This is too much:

My significant other came home the other day from nursing school (3rd day) stating that he is going to need to bring his bathing suit to school because they are learning to give bed baths and will be practicing on EACH OTHER. I honestly didn't believe him but he insists that it's true, and that he's heard from more than one instructor that they really will be stripped down to bathing suits and literally, bathing EACH OTHER with soap and water.

I find this astounding that in this day and age, an accredited (community) college would ever think this is appropriate practice to use as a learning tool! I can think of so many things wrong with this on so many levels- for starters, it's a total invasion of privacy, degrading, embarrassing, unprofessional, and at the very least, simply ineffective! (How are they going to proper peri-care? That is something VERY important that I feel isn't emphasized enough on in schools).

Apparently the justification for the practice is that 'the dummies can't get wet'. (No kidding, that's why every other nursing school used dry cloths to 'pretend' bathe). No one I know has ever heard of this. I've informally polled people at work and they all think it's just as bizarre as I do. Disturbing, really.

I will be contacting, (anonymously), the school to inquire what this is all about. I really cannot thinking of a worthy justification for it, other than knowing how it feels to be 'exposed' as a patient??

i just don't know.

Has anyone else heard of this type of thing? I just can't imagine being bathed by my classmates! Even when we learned how to apply EKG's we had the right to volunteer NOT to be a subject (I wasn't). I'm super modest! He even said that there is a quite heavy set girl in the class who is very mortified by this.

[AgentBeast, BSN, RN]

Actually, there IS a lot to be learned about such a basic skill -- and we are seeing problems with patients because some nurses are failing to do a good job with basic hygiene measures. Some of that failure may well be to the nurse being too busy to get everything done, but increasingly it appears that some schools are not teaching these basic nursing skills properly.

If the skin is not properly cleaned, dried, etc. ... if creams, lotions, ointments, and powders are not properly used ... if bed linen is not properly tightened and smoothed ... patients not properly positioned and turned ... etc. skin breakdown, odor, infections, contractures, etc. can result. When we see such problems in our patients and talk to the staff about the routine skin care they are providing, we are sometimes appalled when they tell us they never learned these things in school. Schools who skip over such things quickly are doing their students (and their future patients) a major injustice.

Sometimes people get so focused on the high tech care that they don't realize how important the basics are -- and that there are actully techniques of doing that basic care that actually matter a lot and contribute to the patient outcomes. I see you are still a student, Scott. While such "coursework" may not seem sufficiently glamorous or sophisticated to you now, it really is VERY important nursing content and I hope you learn it sometime in your schooling.

Just this morning, I was consulting with a collegue here at my hospital about a possible researchproject to determine the best way to manage a certain type of dressing and the use of heat lamps to promote drying. Such topics may not seem glamorous, but they sure are an important part of daily nursing care.

As for the students bathing each other: I think it is unnecessary and I wouldn't want to participate.

I never said anything about understanding the importance of, and the skills required to provide proper hygiene care not being important. Were it not for the myriad of reasons why it won't happen (be they medical, logistical, or both) I would say patients should be properly bathed once a day instead of the every second or third day sometimes longer that is seen. It would likely lead to higher patient satisfaction/happiness and better outcomes.

I guess ultimately my position is that these very basic "skills" shouldn't NEED to be taught in nursing school. Sadly however, if what you say is true, they do need to be taught.

[catshowlady]

I honestly don't get what the big deal is. If you have that poor of a body image that you don't want to expose your arms and legs for ten minutes, you need therapy.

I had to do it in CNA class. We wore tank tops and shorts. Those that felt uncomfortable because of body image generally got over it by the time we did demonstrations. If you're doing the bed bath correctly, you'll only show one limb at a time anyway. I doubt anyone does perineal care except on mannequins anymore.

As for infection control, you are BEING WASHED. Honestly, come up with something that makes sense.

For all of those out there that are getting hysterical over this, why? Seriously, I would like to know your reasoning.

Just because I don't particularly want other people to see my body doesn't mean I need therapy. I was raised to value modesty (mainly religious-based). That is a personal belief that you don't need to judge me for. To take your point to the extreme, do you also think Muslim women need therapy because they don't uncover their heads in front of men as you do?

And I'm not hysterical about it. I am simply providing my viewpoint, which is as follows. 1. The relationship context is questionable. 2. It is not necessary from a didactic standpoint (there are other ways to teach both empathy and bathing). 3. It's my opinion. I don't have to either like or approve of the practice. Had my program required it, I would have done it, but I would have preferred not to. We all did head-to-toe and EKG's on each other, and I participated as expected.

Oh, and as far as infection control is concerned, bath basins are a known reservoir for bacteria. http://www.infectioncontroltoday.com/articles/2007/11/bath-basins-as-a-source-of-hospital-associated-in.aspx I doubt every student gets a new, clean bath basin. I am so not a germophobe, that doesn't particularly bother me, but I imagine there are people out there who would be more worried about it than I am.

:paw:

[MInurse.st]

You can bathe me with soap and water all you want, it's the injections I'm worried about.

We practiced using glucometers a couple days ago, and I was getting all cold and clammy with nerves about getting a little finger prick, haha.

[happy2learn]

I honestly don't get what the big deal is. If you have that poor of a body image that you don't want to expose your arms and legs for ten minutes, you need therapy.

That's pretty extreme to say. Just because people are uncomfortable undressing in front of fellow students or they have body image issues, does NOT mean they need therapy. Seriously.

Considering the point of the bath is to show empathy, it doesn't sound like you have much empathy for people who have body image issues (which will likely be many of your patients.) Maybe you need therapy.

Kidding, but seriously....

Are you going to tell your patient to just get over it or get some therapy?

[tammy777]

I graduated 2 years ago, so I guess it was about 5 years ago we practiced bed bathes. We were told to wear a bathing suit or shorts/shirt to get wet. We had a same sex partner and our fake hospital drapes were closed (that was part of the learning as well, pt privacy). I am heavy set, I have body issues, this was no big deal... Definitely a good learning experience, nothing to get weirded out by or jealous over. Now if they said I had to practice catheters on a classmate I would have said no way, but that's alot more invasive... We had to practice injections and IVs on eachother too, it all goes along with learning to be a nurse, and we always have a choice to participate or not, but you can't expect to practice on someone else if you aren't willing to be a guinea pig for others..

[hecallsmeDuchess]

for all of you who think it's disgraceful, let me recommend you never go to graduate school to be a cnm. if you think doing bed baths on your classmates is unbelievable, then i can only imagine how you would react to doing lady partsl and breast exams on your classmates.

:eek::eek::eek:are you serious? there i was freaking over having to have someone else in my class bathe me and giving thanks that i didn't have to submit to that in nursing school. in my mind bathing is a lesser evil and i'll gladly submit to it before i ever opened my legs before a classmate. yikes! are our nether parts no longer sacred??

[canigraduate]

Woohoo! Knew I was going to get flamed. :)

Sorry about the modesty thing. I totally didn't think about religious modesty. If it is against your beliefs, then obviously you need to talk to the instructor and get a dispensation. Otherwise, yes, get over it.

I have lots of empathy for patients. Just none for squeamishness. I know that is a fault of mine, but most of the time I don't care.

BTW - I didn't say anything about undressing in front of other people, just exposing your arms and legs. Most Americans (who do not have religious constraints) do so, and more, every summer day. You should see some of the crack-tastic people on my block.

And, you better believe I'll tell any patient that needs therapy to get it. A couple of my family members have obvious mental health issues and they weren't told to get therapy until way too long after the symptoms disrupted their lives. (Personal pet peeve of mine. Mentally ill is the same as physically ill to me.)

[happy2learn]

Woohoo! Knew I was going to get flamed. :)

Sorry about the modesty thing. I totally didn't think about religious modesty. If it is against your beliefs, then obviously you need to talk to the instructor and get a dispensation. Otherwise, yes, get over it.

I have lots of empathy for patients. Just none for squeamishness. I know that is a fault of mine, but most of the time I don't care.

BTW - I didn't say anything about undressing in front of other people, just exposing your arms and legs. Most Americans (who do not have religious constraints) do so, and more, every summer day. You should see some of the crack-tastic people on my block.

And, you better believe I'll tell any patient that needs therapy to get it. A couple of my family members have obvious mental health issues and they weren't told to get therapy until way too long after the symptoms disrupted their lives. (Personal pet peeve of mine. Mentally ill is the same as physically ill to me.)

That was far from "flaming" by the way. Disagreeing with your post is not flaming.

Having general body image issues (where one simply does not want parts of their body exposed) is not an mental health issue. My bad if that is not what you intended to say, but it is somewhat implied when you discuss how you tell people with obvious mental health issues they need therapy.

Many, many, many people are insecure about their bodies and don't want to expose certain parts in front of peers. It may be "just" arms and legs to you, but in a bathing suit (which by the way is what is talked about in the original post) that exposes a little more than just arms and legs. I don't believe having insecurity warrants the need to advise someone they need therapy.

I know quite a few people who do not wear tank tops and shorts in the summer because they don't want to expose their arms or thighs. I wouldn't say they needed therapy. They are just insecure. And it would probably help if people would be empathetic instead of telling them to get over it. I also see these "cracktastic" people as well. There are more insecure people out there than there are cracktastic.

It's more than "squeamish." It's a shame that you think it's ok to discount your fellow students concerns, unless there is a religious reason behind it.

One point in the exercise is to be empathetic to body image issues. At least, that's what I took from my CNA class. I thought you were supposed to not discount a person's concerns (patient or not -and the students are supposed to be acting like a patient, not a student. You are to treat the student in the scenario the same as a patient) and do whatever you could to make them comfortable. Whether you think it's valid or not, it's not about what you think of their feelings. It's about how they feel.

I wouldn't object to a bed bath, however, I don't like to wear super short shorts because of cellulite and I always put a little foundation on my face before I walk out the door because of my acne scars. Guess having an issue with specific parts of my body makes me mentally ill and/or needing therapy

If said insecurity caused a person to not be able to function normally in life, then it would be a mental illness, which at time I think it would be appropriate to advise them they should seek therapy. Otherwise, I think you can cause more insecurity by telling someone they need therapy when they are just a little insecure about a body part.

[canigraduate]

That was far from "flaming" by the way. Disagreeing with your post is not flaming.

Having general body image issues (where one simply does not want parts of their body exposed) is not an "obvious mental health issue." There is a big difference. Many, many, many people are insecure about their bodies and don't want to expose certain parts in front of peers. It may be "just" arms and legs to you, but in a bathing suit (which by the way is what is talked about in the original post) that exposes a little more than just arms and legs.

I know quite a few people who do not wear tank tops and shorts in the summer because they don't want to expose their arms or thighs. I wouldn't call them mentally ill. They are just insecure. And it would probably help if people would be empathetic instead of telling them to get over it. I also see these "cracktastic" people as well. There are more insecure people out there than there are cracktastic.

It's more than "squeamish." It's a shame that you think it's ok to discount your fellow students concerns, unless there is a religious reason behind it.

One point in the exercise is to be empathetic to body image issues. At least, that's what I took from my CNA class. I thought you were supposed to not discount a person's concerns (patient or not -and the students are supposed to be acting like a patient, not a student. You are to treat the student in the scenario the same as a patient) and do whatever you could to make them comfortable. Whether you think it's valid or not, it's not about what you think of their feelings. It's about how they feel.

I guess you need to call me mentally ill then. I wouldn't object to a bed bath, however, I don't like to wear super short shorts because of cellulite and I always put a little foundation on my face before I walk out the door because of my acne scars. Guess having an issue with specific parts of my body makes me mentally ill

Got me on the flamed. I've never really understood the term. I thought it was when other people disagreed with your post, sometimes vehemently. Thanks for enlightening me.

I didn't mean to equate poor self image with mentally ill, although you will find that they correlate a lot.

And I personally have several body issues. Yes, I have had therapy. I don't see why that's a bad thing. From the way some posters have replied, it seems that the "therapy stigma" is still alive. You don't have to be mentally ill to need a little help.

What I am saying, obviously poorly, is that I think it is ridiculous for a nursing student to miss out on the experience of getting and giving a bed bath. It does foster empathy with patients. It also helps students to understand that they will have to actually TOUCH and BE TOUCHED. I am still amazed at how some of my classmates react to touching people. You should see some of their faces when they change a dressing.

Another point I am trying to convey is that if you won't strip down to shorts and a tank, how can you expect your patients to wear a hospital gown and be practically naked? It seemed to me that the attitude is that nursing students should be "above" that, which they most emphatically aren't.

Also, empathy doesn't mean that you coddle the patient/student either. Sometimes firmness is necessary.

Mostly what I was reacting to, though, was the extreme nature of the post. Gets me every time. I will apologize for flying off the handle. I won't apologize for the content, though.

[happy2learn]

Got me on the flamed. I've never really understood the term. I thought it was when other people disagreed with your post, sometimes vehemently. Thanks for enlightening me.

I didn't mean to equate poor self image with mentally ill, although you will find that they correlate a lot.

And I personally have several body issues. Yes, I have had therapy. I don't see why that's a bad thing. From the way some posters have replied, it seems that the "therapy stigma" is still alive. You don't have to be mentally ill to need a little help.

What I am saying, obviously poorly, is that I think it is ridiculous for a nursing student to miss out on the experience of getting and giving a bed bath. It does foster empathy with patients. It also helps students to understand that they will have to actually TOUCH and BE TOUCHED. I am still amazed at how some of my classmates react to touching people. You should see some of their faces when they change a dressing.

Another point I am trying to convey is that if you won't strip down to shorts and a tank, how can you expect your patients to wear a hospital gown and be practically naked? It seemed to me that the attitude is that nursing students should be "above" that, which they most emphatically aren't.

Also, empathy doesn't mean that you coddle the patient/student either. Sometimes firmness is necessary.

Mostly what I was reacting to, though, was the extreme nature of the post. Gets me every time. I will apologize for flying off the handle. I won't apologize for the content, though.

You'll know flaming when you see it, trust me. It typically involves rude and personal attacks. Which I don't do and if I did I apologize.

Anyways, I realize that is not what you meant, which is why I edited my post, but a little to late I see.

Yes, there is a therapy stigma. I agree that therapy shouldn't be seen in the light that it is, however, it is which is why I would tread lightly when suggesting therapy.

Yes, I agree it can be helpful (as well as many other skills like mouth care, occupied bed, and feeding), but it can be done in a way to lessen the uncomfortable experience for everyone. What got me was the bathing suits. I think you can get that experience in a t shirt (I know some older woman who feel the need to have longer tshirt sleeves and never wear tanks) and shorts. We did ours in t shirts and pants, just rolled the pants up.

I don't think any amount of bed baths between students will ever make a person feel comfortable touching a total stranger. The fear and nervousness comes from being with a real patient.

I don't think students are thinking they are above it (though I'm sure some are). It's just a different atmosphere. I think it is completely different to be a patient in a hospital and be surround by healthcare professionals and other patients. Whereas, the classroom is full of your peers, people whom you will see often. These are people that for the most part (even if we don't want to admit it) we care about what they think about us. I think that is where people get uncomfortable.

I'm not saying to coddle. But yes, I have ensured my resident was completely covered when I gave her a shower or bed bath. It was difficult, but do-able, and she respected me for following her request. I will do everything in my power to make someone comfortable, as long as it's possible.

I agree it's a little extreme to freak about it, but I guess if you just don't know it's common practice, then that would be a normal reaction.

[Cat_RN, ASN, BSN, RN]

Got me on the flamed. I've never really understood the term. I thought it was when other people disagreed with your post, sometimes vehemently. Thanks for enlightening me.

I didn't mean to equate poor self image with mentally ill, although you will find that they correlate a lot.

And I personally have several body issues. Yes, I have had therapy. I don't see why that's a bad thing. From the way some posters have replied, it seems that the "therapy stigma" is still alive. You don't have to be mentally ill to need a little help.

What I am saying, obviously poorly, is that I think it is ridiculous for a nursing student to miss out on the experience of getting and giving a bed bath. It does foster empathy with patients. It also helps students to understand that they will have to actually TOUCH and BE TOUCHED. I am still amazed at how some of my classmates react to touching people. You should see some of their faces when they change a dressing.

Another point I am trying to convey is that if you won't strip down to shorts and a tank, how can you expect your patients to wear a hospital gown and be practically naked? It seemed to me that the attitude is that nursing students should be "above" that, which they most emphatically aren't.

Also, empathy doesn't mean that you coddle the patient/student either. Sometimes firmness is necessary.

Mostly what I was reacting to, though, was the extreme nature of the post. Gets me every time. I will apologize for flying off the handle. I won't apologize for the content, though.

It's the crassness of your posts that is disturbing people. Whether you mean it or not, you are coming across as being unsympathetic and intolerant to the concerns of others that you can't relate to.

Are you going to tell a shy patient to 'get over it' when they are 'squeamish' about being exposed to you? Or only validate it if the patient has 'religious' reasons for being resistant to the exposure?

Stop being so judgmental to others plights. You don't know what they've been through, and the same goes from them to you. I have been a patient many times and am STILL shy about being exposed, even to doctors and experienced nurses. I don't need to be demonstrated to how it feels to be in that bed. Be a little more sympathetic to others modesty.

And I also agree that student/relationship is NOT equitable to nurse/patient relationship. It's a totally different venue, IMHO.

My:twocents:.

[canigraduate]

It's the crassness of your posts that is disturbing people. Whether you mean it or not, you are coming across as being unsympathetic and intolerant to the concerns of others that you can't relate to.

Are you going to tell a shy patient to 'get over it' when they are 'squeamish' about being exposed to you? Or only validate it if the patient has 'religious' reasons for being resistant to the exposure?

Stop being so judgmental to others plights. You don't know what they've been through, and the same goes from them to you. I have been a patient many times and am STILL shy about being exposed, even to doctors and experienced nurses. I don't need to be demonstrated to how it feels to be in that bed. Be a little more sympathetic to others modesty.

And I also agree that student/relationship is NOT equitable to nurse/patient relationship. It's a totally different venue, IMHO.

My:twocents:.

Ouch. I am vanquished.