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.

[catshowlady]

while i did not say they would be termed for not wearing a bathing suit, i have termed trainees for not being able to complete the skills needed in their job area such as accurate accounting or poor customer skills. it depends on what skills are releveant for different jobs. let me explain my use of the term down play. what i was referring to was trying to infer expecting a student to do this was not the same as expecting a patient to, inference worse for the student. i would guess, and its just a guess that if you asked 100 people would they be more uncomfortable with someone you know doing a pusedo bed bath avoiding peri while you were in a swim suit or having a stranger do a real one while you were naked, i would bet the majority would feel the nudity was worse. the inference was it wasn't as big a deal for patients as students. my point(s) are yes i believe it is just as stressful for a patient and (2) that is really something the person submitting to it makes the call on, we can not make that call for others. i honestly feel this is somewhat a us and them (providers/patient) and i do not mean that condemning, it is only natural that you would have an elevated level of concern for those we know, we all do. i love all kids, but i would lay my life down for my kids without heistation. doesn;t make you bad, but its important to realize that your perception its easier for a patient than a student may be telling you something. if someone said i have strong feelings against doing this, i understand how hard it is for paitents i would have no problem. you don't have to go through it to feel for your patients, but saying its easier for a patient to do this because they don't know the provider ignores all of the other issues. while there have been a few nurses on other posts that really discounted patients feelings and modesty, i have been heartened by the compassion and understanding the majority have expressed. that has also been my personal experience. as i sat with my father in his final days i saw two different scenerio's in changing his gown. one nurse walked in whipped off the gown and replaced it while my mother, sister, and i were there, at that stage he was in and out of conciousness, several days latter he was no longer returning to conciousness and was in his last hours, a nurse came in, laid a gown over him and removed the old one from under never exposing him though he was completely out...i will never forget her compassion and concern, that i believe is the vast majority of nurses. my intent here was simply to provide the other side, you may feel its harder for a student in a bathing suit, i would suggest to the patient its not...and when it all comes down to it, isn't it relative and isn't the view of the person being bathed..student or patient that should make that call.

i am sorry if you took me to mean that i thought the experience was easier for the pt than the student. i don't believe that. i believe from my own experience that it is harder to be the pt.

what i do believe, however, is that it is a different experience for the student. jmo, but i would rather receive care from a stranger than from someone i would have to see as a colleague for the next 2-4 years. i will probably never see the stranger again, so i don't have to worry about what they are thinking about me. whereas, i would hate for a colleague to think, "she's so fat, it's disgusting," about me (and i have heard this comment made by more than one nurse about a pt, so i know the sentiment is out there). others may not feel the same way, and that's ok.

i think, ultimately, that we agree, that it really should be up to the individual, student or pt, to make the call regarding their own body.

:paw:

eta: you have been far from rude, no offense taken here either. i appreciate your contributions. many non-nurses come onto the boards and are very judgmental. you have not been at all. please continue to contribute your perspective.

[catshowlady]

NO offense taken!!!!!!

I have recently joined the ranks of a professional patient. I have dermatomyositis/polymyositis and what I though was Multiple sclerosis is probable Mysthenia Gravis with a complication of pulmonary hypertension due to pulmonary fibrosis from long being misdiagnosed. I am at present, much to my dismay and chagrin:mad:, wheelchair bound, and have to ask for help to which I find particulary frustrating. But, I have always sought to keep my patients integrity and privacy and I didn't need to be given a bed bath in school either (I was 18 at the time) I have always attempted To maintain their individual needs first and foremost. I have dressed vented patinet in their own night clothes as much as I possibly could because I think a majority of the rules are bunk! I as a patient seldom if ever wear a patient gown and when I demand for them to give me one good reason I usually get a smile and a "Ok you win" I have snuck a pizza and beer and a woman's children in to an ICU because she was dying of ovariian cancer and some mental giant talked her into a massive surgery so she could sit in a chair longer around her children because she was not going to leave the hospital and that is what she wanted when I asked her......."What do you really want right now....this minute" (got busted by the nuns by the way)

I know you meant no offense.......sometimes the typed word misses the point. The point I was trying to make was that Instead of torturing the students. Teach them manners, compassion, common decency, common sense. We now have nurses that are taking pictures of patients and posting them on the internet!!! Professionalism,decorum,and just plain common decency..........Do onto others as you would have them do unto you...........:) If htat was your ...MOm,Dad,child what would you do?????

Wish I could have given this post, including the remarks that didn't copy from the PP, extras kudos. Spot-on.

And, Esme12, you can be my nurse anytime! I hope you didn't get into too much trouble with the nuns. Sorry you've had to become the pt now instead.

:paw:

[middleager]

nurse156, a really great point. If the intent of having students do this is to teach not only the physical aspects, but to teach techniques for easing the concerns and insecurities that patients and students alike share, then say so. If the idea is to give the student some basic skills and get feed back from fellow students as to what they did right or wrong before they "practice" on a patient, then say so, make it clear why. We all nurses, patients, students, employers and employees can all accept more if we understand WHY. Even if we don't agree we will be more likely to co-operate if we know there is a legitimate reason. If the purpose is just to teach the mechanics, don't put students through the discomfort for nothing. Your point really hit home, being asked to do something that seems to have no purpose increases resistance. We are an independent society, we want to know why, and honestly deserve to know why. I think the excercise could be of value if it is done correctly. I would think it would be hard to teach someone on-in front of a patient would be difficult. Kind of hard to say you should have done or said this...how did that make you feel Mr. Jones. I would think while uncomfortable in either scenerio a private area in a teaching setting might have benefits but thats just my opinion and as has been stated, everyone is different. I think to often administration tends over time forget just because they have been doing this for ever, just because they know Why and What they are doing everyone else does to. Very interesting discussion, nothing is ever as simple as it seems. I really wish the general population could read these threads. I think if they did it would make for better patient/provider relationships. I know I have changed my thoughts on several issues after reading the threads. But, this isn't meant to help the genereal public, this is a nurses board. I follow a couple blogs by Dr Bernstien & Dr Sherman, most people are pretty decent, unfortunately there are some who are just bitter and more interested in attacking that discussing. Thanks for the opportunity to learn the other side.

[Esme12, ASN, BSN, RN]

Wish I could have given this post, including the remarks that didn't copy from the PP, extras kudos. Spot-on.

And, Esme12, you can be my nurse anytime! I hope you didn't get into too much trouble with the nuns. Sorry you've had to become the pt now instead.

:paw:

Sister ----, I am sure tells everyone I was the one responsible for all her grey hairs... I am afraid that my unorthodox methods at times....tried her patience and she is a saint! I once packed up a patient,vent and all, and took him outside to feed the ducks! (with permission of course)

With any luck.....this too shall pass....god Bless!

[middleager]

Esme12 I would say as well you are the kind of nurse everyone would want and to be honest I have been blessed to meet more than a few like you. My mother was in a local ICU, the intial diagnosis from the MD was advanced lung cancer. The choice he gave us was leave her here and let her pass or send her to a larger facility but he thought she was going not going to recover. It was one of those moments that scrambled your brains. Try as we might the MD would not give us help in making the decision. Finally the nurse attending her looked at us and said "I am not allowed to tell you what to do but I can tell you if she was my mom I would get her the h*ll out of here". Immediately we requested a transfer, he told us she is my only patient, I am about to get off work so I will ride down with her". Long story short she had accumulated a large amount of fluid outside her lungs which projected a shadow that resembled advanced cancer to the MD. They drained it, and she had two more great years with us. When my father was in the last hours the meds they gave him to keep him down were not lasting between doses. When every he would start to come out he would start to fight and tear at all the equipment. We would have to restrain him until they could give him the next round. We asked if they could give him more, the nurse said he was maxed and she would need a Dr.'s sign off to increase. She came in several times saying they had tried to reach his Dr. but couldn't get him. He started coming out again, she left came back and gave him a shot into the IV and he quieted down. I asked did you get ahold of him...she looked at me a little odd and said "something like that". He passed quietly later. I will never forget these nurses stepping up and going beyond. I think this is the rule, not the exception. I donated money for the NURSES to decide where to use it, they bought recliners on wheels to replace the old ones they had to drag in for family visiting patients. I haven't forgotten these acts of compassion. But Esme12's post reminded me I haven't told them I still remember. Esme12 I am sending flowers or something to the nurses at our hospital in memory of what they did for us, but its your post that triggered me to do so. God bless and may you recovery be quick and complete.

[Up2nogood RN, RN]

we had to do this in my program too, of course they were flexible about it.

i just thanked god we weren't one of the programs that had us practice NG tube and urinary catheter insertions on each other in skills lab. can you imagine!?!

We DID get to practice NG's on one another, very enlightening. I now know I would have to be heavily sedated to keep an NGT in me for longer than 5 minutes. Of course we were the 1st class and last to do this as the instructors did not think of the implications thoroughly.

It wasn't mandatory though, if we wanted to drop one we had to accept to be the recipient.

I think the bed baths on each other is taking it a little far though. One can learn proper technique and be observed just as easily on a mannequin. What would solve the whole waste of time in nursing school is to have it be mandatory to already

have completed nurse assistant training.

[diane227, LPN, RN]

We did not practice on each other in nursing school except in how to make a bed with a person in it. We did not perform any invasive techniques on each other. We just had the instructor watch us when we gave a bath for the first time (as I recall, it was a long time ago).

[middleager]

I find this fascinating and eye opening. diane227 you did not practice on another student during nursing school but your instructor watched you do your first bath on a patient. I think this issue to a large degree comes down to point of perspective. Please don't take this as criticising because I don't intend it to be. If you could disconnect from being a nurse and involved party, and took a step back. Which do you think would make the most sense for all involved patient and student. Doing a practice with an instructor and fellow student in swim suits or having an instructor watch while you did it on a patient. I have tried to step back, but of course thats all we can do is try, and it just seems logical since the excercise either on the floor or in the classroom is part of the learning process, the classroom (secluded of course not infront of a class) makes the most sense, the patient really isn't part of the education system by choice. I have beat this one alot and don't want to "beat a dead horse", but more and more I think this like other issues boils down more to perspective than right or wrong. The patient perspective is different from the providers creating an issue that we try to define as right or wrong vs different. IMO it translates to a us vs them environment, and again I don't mean that mean spirited or indicating anything evil or sinister, as I said I think its natural to be more aligned with those you work and identify with. I think it would be more unusual not to. After you step back and sort out the first emotions of what I put down I would really be interested in you thoughts.

[Esme12, ASN, BSN, RN]

Esme12 I would say as well you are the kind of nurse everyone would want and to be honest I have been blessed to meet more than a few like you. My mother was in a local ICU, the intial diagnosis from the MD was advanced lung cancer. The choice he gave us was leave her here and let her pass or send her to a larger facility but he thought she was going not going to recover. It was one of those moments that scrambled your brains. Try as we might the MD would not give us help in making the decision. Finally the nurse attending her looked at us and said "I am not allowed to tell you what to do but I can tell you if she was my mom I would get her the h*ll out of here". Immediately we requested a transfer, he told us she is my only patient, I am about to get off work so I will ride down with her". Long story short she had accumulated a large amount of fluid outside her lungs which projected a shadow that resembled advanced cancer to the MD. They drained it, and she had two more great years with us. When my father was in the last hours the meds they gave him to keep him down were not lasting between doses. When every he would start to come out he would start to fight and tear at all the equipment. We would have to restrain him until they could give him the next round. We asked if they could give him more, the nurse said he was maxed and she would need a Dr.'s sign off to increase. She came in several times saying they had tried to reach his Dr. but couldn't get him. He started coming out again, she left came back and gave him a shot into the IV and he quieted down. I asked did you get ahold of him...she looked at me a little odd and said "something like that". He passed quietly later. I will never forget these nurses stepping up and going beyond. I think this is the rule, not the exception. I donated money for the NURSES to decide where to use it, they bought recliners on wheels to replace the old ones they had to drag in for family visiting patients. I haven't forgotten these acts of compassion. But Esme12's post reminded me I haven't told them I still remember. Esme12 I am sending flowers or something to the nurses at our hospital in memory of what they did for us, but its your post that triggered me to do so. God bless and may you recovery be quick and complete.[/quote]

THANKS..........................This is a story new nurses need to read........How to communicate with the family and how they never forget. :redbeathe:redbeathe

[Cul2]

Having reread all the posts here, I must say that it seems wise to recognize that there are at least two quite valid perspectives on this. I see the nurse perspective. I see the patient perspective. Some patients do think it unusual that nurses find it difficult working on each other during training in intimate matters. Yet most patients can never fully understand the unique nurse-patient perspective for the nurse point of view. There is this contention -- valid to a significant degree -- that having someone you don't know and and will never see again do intimate work with you is less embarrassing that having someone you know do the work. I say "significantly" valid becasue I dont' think it's 100 percent. But, if you beleive it to be true, it may move you toward a "distancing" demeanor with the patient. This "distancing" may work with some patients, but not with all. Some may regard the distancing as cold and and too distant, being treated as an object. I'm not claiming to know the solutions or answers to these questions -- but I do think clear, honest, authentic, empathetic communication on the nurses part is an essential element here.

[Esme12, ASN, BSN, RN]

When I went to school sooooooooo many years ago. Part of our first clinical time was spent at local nursing homes where we went with our instructors and "clinical leaders" (local RN's approved by the school) to teach clinical (so there was always 2 students together with an RN watching 2 groups of 2) with the students........there is where I learned bed baths, how to make a bed with someone in it, feed a bedridden patient. Plus the local nursing homes got their AM care, and feeds done.

[middleager]

Cul2 I would agree 100% with you that having someone you know do these things is more embaressing than having someone you do not know. If all things were equal other than that I think the vast majority would have no disagreement. There are other issues that come into the equation such as students in bathing suits vs patients nude, etc that create all the questions and comparing apples to oranges. Decades ago when I was going back and forth between a pysch and soc major I took a course on the different coping mechanisms of the mind. The mind is an amazing thing in how it deals with truamatic events and things that conflict with who we are or want to be. They discussed men at war who dehumanized the enemy with derogatory names to help overcome the conflict of killing another human created. I wonder if to some degree this issue is not related to that. Asking a student to submit to the bed bath abiet in a bathing suit brings the dicomfort home at a personal level. Knowing the discomfort it brings personally, asking a nurse to do this or other things they know are uncomfortable for the patient has to create a certain degree of conflict in a nurses mind/heart. By nature I think the kind of people who go into nursing desire to help people and have a high degree of compassion & empathy. Hurting or doing things that uspet the patient, even when in the end result is positive would seem to go against that basic desire. Thus as Cul2 indicated distancing, and other coping mechanisms in the mind might come into play. "The bed bath for a patient isn't as traumatic" (without arguing the whole bathing suit/nude) becasue... I know being a nurse requires you to do things to people that you don't want to and you know creates "truama" for patients, I mean who wants to stick a needle in a baby, even though its beneficial. It appears to me the adminstrative side of hospitals etc create some of these for the nurse/patient to deal with for financial reasons adding to the internal conflict. From an outside view point I find it interesting to watch all the dynamics involved in nursing, I would think these internal "conflcits" if thats what they are would be very draining on a person. Mental-emotional exhaustion by itself is hard, add physical exhuastion and nurse burn out is easily understandable, almost predictable.