Hey guys, this is my first time posting anything to this site, hope to this works out.
I have just started my first clinical rotation and at this time we are focusing heavily on getting experience assisting with ADL's, but the clinical site I am assigned to has already provided a challenge that was not addressed in our training (only 2nd day). In lecture we were taught the method for giving a complete bed bath and checked off on that in skills lab. The facility I am assigned to, however, uses showers for anyone who can ambulate to an from a chair, even if they need fully dependent for hygiene care. So here is my problem: I can't quite figure out how I am supposed to preserve the patients modesty with a bath blanket, while cleaning rinsing them off with a detachable shower head. One other student and I were asked to assist with a shower and found it quite awkward and by the end the bath blanket was quite soaked. Also I am not sure how to clean the back side and perinial area if I cannot role the patient. Hopefully someone has experience with this technique or even better can direct me to tutorial of videa explaining the process. My clinical instructor was not entirely familiar with the process and the staff nurses don't want to be bothered as the facility is under staffed and the expect competence from the students working with them...
Feb 17, '11
I gave a couple of those last week, didn't use a bath blanket. Instead we closed the door, pulled the curtain around the bathing area, and bathed the client. The client will probably handle this better than you will, as they've had baths this way before.
If you still feel uncomfortable with this, ask a CNA in the area. Tell her point blank that you need a little guidance. When they see you truly want to learn, and ultimately will do some things that will save her some time, she'll probably help.
Feb 18, '11
While doing bed baths, our instructors had us use bath blankets like you mentioned. But when using shower chairs, we did what echo56 said: close the door and drapes with no cover. Ask your instructor to see how they feel about it.
As for peri care, ours had toilet seat like bottoms so access to the peri area was easy. If your chairs have a solid bottom, I couldn't even fathom the difficulty!
Feb 18, '11
Thnx, for the quick replies (and sorry for the poor grammar
earlier - I wrote my question while on the go) I think what you are suggesting makes sense as a practical solution. I am a little confused that the CNA handed me a bath blanket on the way to the shower room. Perhaps it was only to keep the client warm and covered during transit back to the room and not for keeping him covered as you would during a bedbath. Unfortunately the environment was very fast paced (25 patients to 1 nurse and 2 CNA's) and my clinical instructor was floating between two floors so I was not able to get my concerns addressed. Next week I will be sure to pull someone aside early and before I am on the spot.
Feb 18, '11
Yes, the bath blanket is for covering to and from the shower room. You remove it for the actual shower. Go to it in the shower and work as quickly as possible but be thorough. The ability to do a good job is one of the advantages of doing bathing this way. This method comes in particularly handy when they inundate themselves and their bed with an episode of diarrhea. I always count on getting wet myself in the shower. It may be helpful to change into a set of shower shoes if you don't want your regular shoes to get wet.
Feb 18, '11
If the client can stand, help them stand while they or you clean their backside. Otherwise, clean their backside when you get them back into bed.
Hand them a washcloth for them to use, or lay it in their lap as a bit of modesty. Be quick but thorough. Make sure you get in all the cracks and crevices (abdominal folds, under breasts, etc).
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