How clean is a "bathed" patient?

  1. 19
    What is a bath? When you say you "bathed" someone on your shift, what should I expect was done?

    I'm getting frustrated. Being a tech is frequently an icky job, but don't we have an obligation to get people clean? Going after some techs when I change a diaper, it's very clear that the patient's bath wasn't thorough. Dabbing at someone's armpits with a wet washcloth and calling it a day just isn't cutting it.

    If I'm paralyzed one day, I hope someone is reeeeally cleaning me to make sure funk isn't building up somewhere on my body. We recently had an MR patient for almost two weeks on our floor. I first had him as a patient about 10 days in. While in bathing I retracted his foreskin to clean and there was... well, a solid sheet of smegma underneath. It was difficult to even move the skin out of the way in the first place and cleaning it was awful. It had clearly been building up since before he was in our hospital, but why –after 10 days under our care- was it still a hot mess?

    How does this even happen? I asked around on my floor and no one retracts foreskin during a bath, not even our two male techs. Yes, it’s incredibly awkward and distasteful. Yes, I hate doing it, but aren’t we obliged to make sure our patients are clean and sanitary everywhere? If they’re incapacitated and bounced to us from a nursing home, shouldn’t we make sure they’re actually clean?

    It’s increasingly difficult for me to ignore when this stuff happens - like when the patient that was “bathed” still has stool on her perineum and between her lower labia. Sure, it’s horrible to clean that up, but it’s worse to sit like that.

    Just venting. Just angry that it seems like not enough techs that I work with care enough to get under the skin folds, even when they’re in ick places, even when the patient is hundreds of pounds overweight. No one likes doing this, but if I’m a patient care tech, shouldn’t I be really caring for the patient?!!? When I first started I gave techs benefit of the doubt more often, but 8 months in, not so much. After a while you know who does and who doesn't do the job... I have no idea how to constructively talk about this with coworkers. I doubt the tech that's worked nights for 15+ years would be swayed by anything I did or said. Just had to vent. Thanks for reading.
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  4. 29 Comments so far...

  5. 1
    You might want to speak to your charge nurse or even the nursing manager about it so that it could be mentioned in daily meetings(we call them huddles where I work). You might not have to mention the person's name who you think is not doing their job correctly, but eventually the patient or their family may complain and the problem will fall on you. I would bring it up though because it's slowing your work down. I work days and I'm responsible for everyone to get a bath while night shift only has to give 2-3 baths, and sometimes they might not give any on my assignment.

    To answer your question in the OP, in my opinion, a bathed patient is someone is bathed from top to bottom. Unless they are a new admission that came near shift change and they really smell or look horrible, they're getting a full bath because they deserve it since I have 12 hours to spare in my shift. If I don't have time(like near shift change), I would give them a partial bath, making sure I cleanse the spots that tend to smell the most.
    tiredtech likes this.
  6. 0
    As a new cna I don't usually find time in my day for all of the patients to get baths and usually have to rush through it if I do give a bath. However, when night shift comes on and I tell them this they get annoyed because I guess they never do baths. I was on a 1-1 the other day and the patient wanted a bath but when I offered her one she repeatedly refused because she wanted a shower but that wasn't possible due to a couple of reasons.
  7. 4
    Quote from tiredtech
    How does this even happen? I asked around on my floor and no one retracts foreskin during a bath, not even our two male techs. Yes, it’s incredibly awkward and distasteful. Yes, I hate doing it, but aren’t we obliged to make sure our patients are clean and sanitary everywhere? If they’re incapacitated and bounced to us from a nursing home, shouldn’t we make sure they’re actually clean?
    That is just awful. Even the male techs should know better than to leave that up to a female. To be frank if a regular guy misses one day of cleaning that area it smells terrible, and this has been going on for days??? yuck!!! This is totally unacceptable. Granted CNA and techs are now watching too many patients, if you have to rush, you got to at least clean between the legs and under arms at a minimum. Unfortunately when one is "new" in any job,you are right, noone ever listens. Sometimes that sort of pressure would make you want to just follow with the crowd and do a half way job like everyone else. I don't work in your field but I always remind myself to be the best I can be no matter what the job is. I applaud you for trying to stand up to this inhumane treatment. Keep on pushing the others to do their work properly.
    nurse671, CrufflerJJ, jjrodriguez, and 1 other like this.
  8. 0
    Quote from man-nurse2b
    That is just awful. Even the male techs should know better than to leave that up to a female. To be frank if a regular guy misses one day of cleaning that area it smells terrible, and this has been going on for days??? yuck!!! This is totally unacceptable. Granted CNA and techs are now watching too many patients, if you have to rush, you got to at least clean between the legs and under arms at a minimum. Unfortunately when one is "new" in any job,you are right, noone ever listens. Sometimes that sort of pressure would make you want to just follow with the crowd and do a half way job like everyone else. I don't work in your field but I always remind myself to be the best I can be no matter what the job is. I applaud you for trying to stand up to this inhumane treatment. Keep on pushing the others to do their work properly.
    I completely agree with you that we are watching too many patients but I try to do the best that I can. I work on a tele monitored med/surg floor and sometimes, the nurse doesn't feel comfortable with the patient being off tele so a bed bath is all that can be done. If it's a nightmare shift, I usually try to get the most stinkiest ones a nice thorough bath or shower. For bed baths, I like to get a couple of bath blankets under them, a couple of warm blankets on top, have my basin with washcloths/warm water ready and get them soaked, scrubbed, wiped and dried. Totally not how I was taught in CNA school nor nursing school but I feel like it gets them cleaner. I haven't met one patient that didn't have that look of total bliss after feeling squeaky clean, top to bottom. For the ones that are a little more mobile, I like to encourage them to do as many ADLs as possible so if they can bathe or shower themselves, have at it! I just set them up with the supplies. Some patients might refuse a bath or a shower but I always document if that happens for CYA purposes. Recently, I had one patient refuse because she swore up and down she was going to go home any minute despite all of us trying to convince her that keeping up her hygiene was a good thing. Any who, good article!
  9. 0
    A girl I know in her 20s attempted suicide by jumping from a building and had a long hospital recovery. Her boyfriend had to really fight ad advocate for her to get good pericare/ baths. Because she was young (and suicide?!) people kind f forgot she was total care. Unacceptable!! (a year later she walks with a permanent limp but is otherwise ok and enjoying life)
  10. 8
    Also, your managers should be very motivated to change this laziness as UTI prevention is really important for hospital rankings and funding.
  11. 6
    Even if you have to "rush" through is.....every patient that cannot wash their privates deserve meticilous P&P care (pits and privates) face and hands......mouth care.

    To not perfom these tasks is negligence, I'd go to your manager and voice your concerns.
  12. 0
    I at least try and get pericare done on every patient when I work. What you've described is unacceptable and gross, gross, gross. I abhor doing bed baths but it really is for the best interest of the patient so I suck it up and get it done.
  13. 1
    We are taught to clean under foreskin during baths and after an incontinent BM, if time is a problem for getting a full bath in, I'm sure it could be done while you are already cleaning up the BM.
    iconian likes this.


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