Post surgery patient refuses to take a shower
- 0Jul 1, '13 by SaiderapI 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?
- 6Jul 1, '13 by loriangel14 GuideI 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
- 8Jul 2, '13 by MunoRNYour 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.
- 6Jul 2, '13 by TheCommuter, ASN, RN Senior ModeratorQuote from SaiderapIf an alert & oriented x4 patient is refusing to shower, I will certainly respect his autonomy and allow him to refuse.Does anyone have any advice on how to convince someone they need to stay clean after surgery? Does anyone share my concerns?
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.
- 0Jul 2, '13 by DoeRNI 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.
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- 7Jul 2, '13 by Pepper The Cat, BSN, RNSterile 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.
- 3Jul 2, '13 by Isabel-ANP-BCUm..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.
- 0Jul 2, '13 by SaiderapTo 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.
- 0Jul 2, '13 by SaiderapQuote from AltraTo 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.OP, what kind of setting do you work in?