After 22 years of RN experience, I am once again faced with hating the reality of nursing practice and seeking the ideal. I do not understand how a nurse can provide only the care that she must sign for, if that much, and ignore basic care. Through this orientation, I have not seen one nurse perform basic care to include hygiene and repositioning. I know that I am going to have a tough time getting out of there on time when I am done orienting. The nurses talk about how short-staffed they are and not enough CNA's, but I have been places where we did more with less. I don't know how they can go home and sleep after leaving patients in the same position all shift...if I had not done it, they would not have moved the entire shift. How can they rationalize this level of care? At the same time, I find it very frustrating to be so overwhelmed doing it alone. I have been an agency nurse and know what it is like to manage six M/S patients with four of them belonging in ICU, but eight is just not manageable. I have considered returning to ICU, but those nurses are complaining that three patients is the norm rather than two. I think once the orientation is over, I will be better off so that I don't have to observe what others don't do...
Any suggestions would be appreciated. I realize it is all about one's perception and standards...I simply won't lower mine.
Apr 15, '04
I agree with you. I have worked some ORs where we got patients down for open heart surgery, who were on a baloon pump, and the patient didn't have a bath for several days, let alone the bath oredered pre-op. :uhoh21:
When I would work extra in ICU or step-down on the week-ends to keep my skills up, my patients always had their hair washed, the men shaved, etc. and even a haircut if they needed it, first thing when at all possible. If no one washed my hair for a week or at least offered, I would be squirming................ :angryfire
Apr 15, '04
Amen...it is a shame that it is often forgotten that we work with human beings. I am not here to portray myself in any idealistic way but I have often times helped patients get a bath while I am assessing them, you see a whole lot more than you normally would and I would rather help someone bathe than smell their odor, I know it makes them feel better too. There are nights that it seems to be all you can do to hit the high points and monitor 6-8 patients but when it is feasible it is always nice to provide the total care. We dont get a whole lot of patients who must be turned as we are a strictly surgical floor but we do encourage our patients to turn/shift in bed. I do like to encourage our patients to be independant...we do a lot of gastric bypass surgeries and it is my PET PEEVE that lots will not wipe their behinds 3 days post-op...they were that big before they came to the hospital and they are going home in 24 hours time to figure out a way to do it!! Well, that is another topic entirely...
Apr 15, '04
One of our patients just returned from a below the knee amputation in one of our "better hospitals' in the area. He was there for well over a week, closer to two weeks. He said he was never repositioned... and not once did anyone attempt to get him OOB after the surgery. He is now so weak, he is unable to stand on his one good leg to transfer from his wheelchair to the dialysis chair.
He is now in LTC rehab supposedly for physical therapy... has been there since Sunday... tomorrow is Friday... and has yet to see anyone from PT... and noone at LTC offers to get him OOB either.
I just don't understand.............
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