Baths!

[Nursingschoolzombie]

I've been off of orientation for a few months now as a PCA in an acute care unit. I usually have 9-12 patients. We have a pretty heavy workload, including bladder scans, ekgs, blood draws, etc. We might have 5 or 6 bed bound patients each at a time, and we have shared showers. In orientation, my trainee said she will usually give 3 or 4 baths a day and leave some of the bed bounds for night shift. I bathed 7 people one shift and left 3 for night shift and the night PCA jumped my case and reported me. This PCA also reported me b/c a ice pitcher didn't have new ice in it and the trash was halfway full at shift change in two rooms. Now, I'm being hovered over by our charge nurse and I hate my job already. There were a few pts one day I didn't bathe b/c they had bathed the previous day and they were not dirty, so I just provided peri care with soap and water. I got reported for that too. I think overwashing when not dirty leads to more skin breakdown? There are no guidelines where I work on this issue. What are some of your policy's on baths at your facility? Between rounding, procedures, and everything else, I don't even take lunch in the 12 hour shift, so bathing everyone is impossible it seems. I just don't want to get in trouble.

[LCinTraining]

Wait, why is night shift not doing any bathing? Some days in my facility, nights are the only people that give baths. We all are to work together, but sometimes the day is too crazy, or sometimes the night is too crazy. I have multiple complete cares, some that like to crap out in the middle of the night. I'm not bathing people at 2 a.m. and most days get started at 5 a.m. with baths. Between that and the fifty million toilet runs I make I'm lucky to get 2 patients bathed. I try to make it the ones that are overdue for a bath, or the tough ones, like spinal cord injuries that take an hour to get done, to make it easier on days, but it's got to be a give and take. If all the next shift cares about is who is bathed and who is not, then they have bigger issues than I care to deal with.

[duskyjewel]

That is beyond unsafe for patients. And I'm not saying that you're not good at your job, but there is NO WAY any person can give proper care to that many patients. Doesn't matter how amazing you are. You guys are being overwhelmed with work and your patients are being denied proper/sufficient care. Sounds like a recipe for disaster. I can't believe that you guys don't have an astronomically high fall rate.

Everything you just said is why I left my first job after 7 months. And it took me three months after finishing CNA school to get that job. I'll tell you the dirty little secret: my unit did have a terrible fall rate, and yet somehow my hospital was named one of the safest in America by US News and World Report. Don't ask me how or who got paid off for that one..... To give you an idea how bad it was, I usually had 13 high-need tele patients (full unit was 26 with 2 aides and usually only 5 nurses), and mostly less-than-helpful nurses. I learned to cherish the ones who were willing to help do the "dirty work" and to just suffer through the shifts with the ones who weren't. We once had a near fall where the patient's light had been going off for TWELVE minutes. She gave up and got up on her own. I and the other aide were both busy caring for other patients. The nurses, including the charge, were all either busy or just ignored the light (and I know for a fact that at least one could have answered it). When I told my charge what had happened, after the patient reported it to me, her answer was, "Maybe we should put a bed alarm on her." Um, no dip****, maybe someone should answer her fricking light before TWELVE minutes have gone by!

I refused to be part of it any longer, for my own physical, spiritual, and mental health, and now work for an amazing hospice company. I work night float full time in their inpatient units, and man, does a paradigm shift make all the difference in the world. I am so much more satisfied with my job, and the scandal is.... these people who are dying get astronomically better care than the ones acute care is supposedly trying to heal. At least here, they get treated like human beings and not just a list of tasks!