Post surgery patient refuses to take a shower

  1. 0 I have been put in charge of medications and some other details for a patient who just had eye surgery. The doctor specifically told him he could take a shower as long as he keeps his eyes shut to keep water from getting into them.

    He has a convenient memory about what the doctor said and is refusing to take one.

    I have given him sterile bedding and towels. If he does not take any shower this ruins and wastes my efforts.

    I told him that the shower will drive up his body temperature and help him avoid infection. He has an excuse that "that's what the antibiotics are for."

    I think some people still get infections even if they take the medications provided after surgery.

    I think refusing to have a shower in the days after surgery is a safety issue. I think it might result in contamination.

    This particular doctor told me not to worry about it (the opposite of what my teachers have kept on saying from day one)

    Does anyone have any advice on how to convince someone they need to stay clean after surgery?
    Does anyone share my concerns?
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  3. Visit  Saiderap profile page

    About Saiderap

    Saiderap has 'about twenty' year(s) of experience. From 'USA'; Joined Jun '10; Posts: 523; Likes: 218.

    30 Comments so far...

  4. Visit  loriangel14 profile page
    6
    I don't really think that not having a shower will put the patient at risk for an eye infection.I have never heard of having a shower to drive up your body temperature.Also patients have the right to refuse. Is the patient washing at all? You really can't force someone to have a shower.All you can do is what you have done. Provide towels and change the sheets.Eventually the patient will return home and care for themselves as they wish.I work occasionally on a post surgical floor and most of the patients don't shower.
    Last edit by loriangel14 on Jul 1, '13
    Fiona59, GrnTea, ajaxgirl, and 3 others like this.
  5. Visit  MunoRN profile page
    8
    Your teacher has that exactly backwards. The reason why the Doctor specified that he has to make sure he keeps his eyes shut if he showers is not to keep water from getting in them, after all our eyes always have water on them, but to keep the bacteria in the water from getting to his eyes. Showering doesn't sterilize the body, and it often transports bacteria to surgical wounds. Post-operative guidelines typically include some period of time where a patient should not shower specifically because a shower is more likely to move bacteria to a surgical wound that it is to remove bacteria from a surgical wound. In the case of an eye, I really doubt it makes any difference whatsoever, but it's certainly not correct to assume that there is a higher infection risk from not shower than there is from showering.
    Fiona59, Not_A_Hat_Person, nrsang97, and 5 others like this.
  6. Visit  TheCommuter profile page
    6
    Quote from Saiderap
    Does anyone have any advice on how to convince someone they need to stay clean after surgery? Does anyone share my concerns?
    If an alert & oriented x4 patient is refusing to shower, I will certainly respect his autonomy and allow him to refuse.

    In my opinion, twisting someone's arm to get them to do something is not worth it most of the time, especially if they do not want to do it in the first place. To keep the peace, I'll respect the patient's wishes.
    kat7464, Not_A_Hat_Person, nrsang97, and 3 others like this.
  7. Visit  DoeRN profile page
    0
    I usually highly encourage and if it's been several days since they have had a shower then I have no problems with telling patients they have an odor and again highly encourage washing. But if this patient is alert and oriented x 4 then he has every right to refuse. And I've learned throughout the years of being in healthcare that many people don't have the same bathing guidelines that I have. There are a lot of people who do not bathe everyday. I'm not one of them but I can't force them either.

    So if he doesn't want to bathe his has this right OP. You can encourage it but can't force him too.

    Sent from my iPhone using allnurses.com
  8. Visit  Pepper The Cat profile page
    7
    Sterile linen? Really? That's a little overkill.
    I have never heard anyone say that a shower raises body temp and prevents infection. Can you state your source?

    As others have said, as long as the pt is clean and odour free, don't worry.

    As a aside, one reason for not wanting to shower post eye surgery could be due to some post-op dizziness.
    Fiona59, GrnTea, nrsang97, and 4 others like this.
  9. Visit  Altra profile page
    0
    OP, what kind of setting do you work in?
  10. Visit  Isabel-ANP-BC profile page
    3
    Um..the patient does not need to take a shower to stay clean. He can take a bath, basin wash, whatever. He needs to keep his eyes closed if he does shower to prevent getting contaminated water in his eyes. I've never heard of "you need to take a shower to raise your body temperature to ward off infection". A healthy immune system doesn't need help.

    If he doesn't smell and he's washing every day, let him be. If he does smell, address the concerns about bathing, but you can't force him.
    Fiona59, GrnTea, and nrsang97 like this.
  11. Visit  Saiderap profile page
    0
    To answer the question about hot showers (or baths) to fight infection, I do not remember the class books that I read this in but was able to find similar information on the web. Heat is often used to fight infection.

    http://answers.yahoo.com/question/in...6151228AAjvWbD






  12. Visit  Saiderap profile page
    0
    Quote from Altra
    OP, what kind of setting do you work in?
    To answer the question, this patient is already home and has asked me to handle his eye drops. There are a lot of them and it's confusing. I created my own MAR on from Excel. As for why I would sterilize the bedding, he sometimes falls asleep without putting on his eye patch so sterile sheets are not a bad idea.
  13. Visit  Altra profile page
    10
    I'll ask again -- what kind of care setting is this?

    I ask because I'm concerned about the care.

    Bath/shower water should NEVER be hot enough to raise body temperature. Among the many safety regulations for care institutions is that maximum hot water temperature is at a safe level in places in the building where patients have access. Intentionally raising body temperature is NOT standard practice in prophylactic infection prevention. And it should require a physician order, as there are a number of serious cardiac & vascular considerations.

    Please reconsider pursuing this type of treatment until speaking with the patient's physician. And ... I'm trying to say this in the nicest way ... anonymous questions asked on yahoo.com CANNOT be considered as evidence for best clinical practice.
    poppycat, GrnTea, Surprised1, and 7 others like this.
  14. Visit  Pepper The Cat profile page
    11
    Quote from Saiderap
    To answer the question, this patient is already home and has asked me to handle his eye drops. There are a lot of them and it's confusing. I created my own MAR on from Excel. As for why I would sterilize the bedding, he sometimes falls asleep without putting on his eye patch so sterile sheets are not a bad idea.

    How the heck are you sterilizing sheets at home? Are you boiling them? Are you handling them with sterile gloves? I am sorry, but that is just silly. I've had 9 operations on my eye and have never gotten an infection from bed sheets.
    poppycat, Fiona59, Madras, and 8 others like this.
  15. Visit  JustBeachyNurse profile page
    6
    Quote from Saiderap
    To answer the question about hot showers (or baths) to fight infection, I do not remember the class books that I read this in but was able to find similar information on the web. Heat is often used to fight infection.

    http://answers.yahoo.com/question/in...6151228AAjvWbD





    Random strangers on a public forum known for erroneous information is not evidenced based practice. I strongly suggest you consult with the treating physician. Hot water can promote the growth of deadly bacteria like legionnaires. http://www.osha.gov/dts/osta/otm/leg.../hotwater.html

    And other thermophilic bacteria. Presence of Thermophilic Bacteria in Laundry and Domestic Hot-Water Heaters

    How exactly are you "sterilizing" the sheets? Do you have access to an autoclave? Are you obtaining sterile sheets from a hospital laundry/central supply? Home washing machines do not get hot enough to sterilize much of anything from a microbiological standpoint.


    Edited to add you admit that you are not following physician direction to NOT force a shower due to your (non evidenced based) beliefs.
    I think refusing to have a shower in the days after surgery is a safety issue. I think it might result in contamination.

    This particular doctor told me not to worry about it (the opposite of what my teachers have kept on saying from day one)
    The shower will more likely INCREASE his infection risk not lower it. Sterile sheets even if you pulled them from an autoclave are useless in a home environment hence why they are left for the OR.

    Are you in the US?
    Last edit by JustBeachyNurse on Jul 2, '13 : Reason: add quote
    Fiona59, Not_A_Hat_Person, nrsang97, and 3 others like this.


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