Bathing in LTC

  1. 1 Okay, I need more help or suggestions. My facility has serious issues with the number of resident's who receive daily baths. There are two sides to my facility, one side gives atleast 14 baths per shift. A total of 28 baths per day just on one side. I have a bath aide but the problem is when we are without the bath aide residents don't get their bath. The CNA's have grown accustom to not giving baths anymore so when they are responsible for the bath it usually doesn't get done. Instead of have four CNA's on the floor with a bath aide, I am thinking about having five CNA's on the floor and having everyone responsible for their own baths. The concern I have with this is how to manage that baths are getting done. Any suggestions?
  2. Visit  txdon profile page

    About txdon

    Joined Mar '11; Posts: 82; Likes: 8.

    12 Comments so far...

  3. Visit  caliotter3 profile page
    1
    We had a bath team who did certain residents. Residents not bathed by the team were the responsibility of their own CNA's. To make certain that baths get done, you have to check up on a regular basis and use disciplinary actions if a certain CNA is shirking.
    virgo,student nurse likes this.
  4. Visit  FocusRN profile page
    2
    Having been a CNA, honestly a bath aid or team is necessary. CNAs manage a lot of time consuming tasks with multiple patients, to expect them to do all of the normal ripping and running and then add on daily baths for all of their patients is asking too much. Even if you do add on an additional CNA, you are going to find the baths not getting done. I would suggest actual baths every other day with a bath aide, and have the CNAs give bed baths with the pre-moistened bath wipes on the off days.
    interceptinglight and paddler like this.
  5. Visit  ltclovnrn profile page
    0
    ohhh i love the idea of a CNA that would specifically do showers. i know know know that our showers don't get done. they do bed baths. but i might see 2-3 CNAs take a patient to the shower in a shower chair/stretcher a week. granted i'm not on the floor 24/7. Our census is already low and the CNA's complain constantly about how they have too much work. so taking a CNA away to specifically do showers would really put them in a tizzy i think. i've learned that no matter what you do they always want one more! always!
  6. Visit  noc4senuf profile page
    1
    What hours are your bath aides working? You need to offer the bath/shower in the evenings also. Per regs, the resident should be able to choose if they want it in the morning or evening.
    Not_A_Hat_Person likes this.
  7. Visit  pnurse68 profile page
    0
    Our nurse aides are responsible for their showers. The showers are split between 2 shifts and the residents can choose their preferred time. The nurse aides must report to the nurse any deviation from the shower scedule such as refusal by the resident or held due to family outing ect. The nurse is responsible to confirm that information by visiting the resident and offering the shower again or scheduling an alternate time. That being said, it is also the residents right to refuse. Documetation and care planning are key.
  8. Visit  michelle126 profile page
    0
    This is a big problem in my facility. Its a smaller place with 50 beds. 5-6 cnas for 7-3 and 4 or 5 on 3-11. Baths/ showers rarely get done even when we are at the high end of staffing. The only time they are getting done is when the resident/ family asks for it. It is killing me. The excuses are always plenty and what kills me is that I let them get away with it for the most part..if I'm running in circles the last thing I think about is who is getting a shower tonite. I know that is my fault but I rarely get backed up when I counsel or write up cnas.
  9. Visit  Aem1215 profile page
    1
    I have 140 bed facility, three separate units. Each resident gets a shower twice a week, and they are divided between 7-3 and 3-11 with no showers on Sundays. If a resident prefers a different shower time, we switch them with another bed's shower days. The CNAs have to turn in " skin sheets" for each shower. In the mornings, we review the sheets to ensure everyone got their shower. The CNAs are not allowed to write refused on the sheets without the nurse speaking to the resident first. If no shower, then discipline.
    noc4senuf likes this.
  10. Visit  CapeCodMermaid profile page
    1
    I must be blessed. My residents always get their baths or showers. The CNAs are the best I've ever worked with. The residents get showers at least twice a week on the shift of their choice. If they refuse, the nurse is notified and the shower is rescheduled.I've been in the business for more than 25 years and have never heard of the concept of a bath team or a CNA who just gives baths.
    noc4senuf likes this.
  11. Visit  DixieRedHead profile page
    0
    We have sixty skilled residents. They get a shower twice a week unless requested otherwise. We have 5-6 nursing assistants on days AND a two bath aides. Of course our most frequent complaint "short staffing".

    The showers are given as scheduled. It is not an option. If one of the bath attendants is out sick the nursing assistants split the baths for that bath aide.

    We have 40 assisted living beds. Three nursing assistants on first and second shift. The showers are split between the two shifts, no bath team.
  12. Visit  BrandonLPN profile page
    0
    To the OP: do you really have multiple residents who get *daily* showers? Our CNAs would be totally overwhelmed.
  13. Visit  Staragate profile page
    2
    5-6 CNAs for 50 people? That's 10 residents per CNA. Showers take average 20 minutes each, longer if they are a difficult transfer. So that's 200 minutes of shower time for all 10 residents if they get it daily. In addition, they may need brief changes, 5-10 min each depending on mobility and weight. Passing trays can take 1/2 hour - 45 min depend on interruption and set up. Vital signs take between 3-5 minutes a person. In addition: call lights, setting up oxygen/braces, ice water, morning/evening care, transfers, smoking chaperone, stocking the linen cart, etc.

    My point? Please add up the time the tasks take that CNAs are expected to do. They may not be shirking as much as trying to keep everyone clean, fed and alive. They really care, but can't be everywhere at once.
    interceptinglight and caliotter3 like this.
  14. Visit  horrorxgirl profile page
    1
    Quote from Staragate
    5-6 CNAs for 50 people? That's 10 residents per CNA. Showers take average 20 minutes each, longer if they are a difficult transfer. So that's 200 minutes of shower time for all 10 residents if they get it daily. In addition, they may need brief changes, 5-10 min each depending on mobility and weight. Passing trays can take 1/2 hour - 45 min depend on interruption and set up. Vital signs take between 3-5 minutes a person. In addition: call lights, setting up oxygen/braces, ice water, morning/evening care, transfers, smoking chaperone, stocking the linen cart, etc.

    My point? Please add up the time the tasks take that CNAs are expected to do. They may not be shirking as much as trying to keep everyone clean, fed and alive. They really care, but can't be everywhere at once.
    This is what I was thinking too. Our residents get at least a weekly shower or more if they request it, but it's all scheduled and split between two shifts. Nobody gets a shower every single day though. It would be impossible for our CNAs to get done if this was the case and many of the residents would get ignored for bathroom and other needs due to the huge amount of time just spent on showers. Generally a resident takes 20 minutes to shower, but we have some that take waaaay more time than that. One specifically on my unit that takes 45mins or more comes to mind. When it's not a resident's shower day, they get a bed bath.

    Granted, it's difficult to judge how difficult or easy another facility might be in comparison to my own, but daily showers seems like a bit much if you don't always have somebody there to do it.
    pwnewman likes this.


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