Advice please

CapeCodMermaid, RN · Mar 17, 2012

If you want my opinion, and I've been doing this for 30 years, you did the absolute right thing. How dirty to people really get?? Was it worth the poor woman being hysterical just to have a shower? No. Can people be allowed to wander around a dementia unit at night? For sure. Don't misunderstand....sometimes drugs are a necessity, but when a cookie, a glass of milk, and a kind word works that's what you should do.

NoahscoopsRN · Mar 17, 2012

Thank you for making me feel like I'm not crazy! I knew I was right but actually hearing it from another nurse is so helpful. When it comes to the showers I say to myself enough is enough, it's not worth it, if I get spoken to about it, so be it. One of the day shift nurses had said (not to me) that if we don't shower them it's "neglect" which I think is such a crock, it's not that these aides don't WANT to shower them it's when they attempt to they freak out obviously because they are scared and don't know what's going on. To continue to shower them when they are that upset, in my opinion, is abuse if nothing else.

Nascar nurse, ASN, RN · Mar 17, 2012

If you want my opinion, and I've been doing this for 30 years, you did the absolute right thing. How dirty to people really get?? Was it worth the poor woman being hysterical just to have a shower? No. Can people be allowed to wander around a dementia unit at night? For sure. Don't misunderstand....sometimes drugs are a necessity, but when a cookie, a glass of milk, and a kind word works that's what you should do.

100% agreed. I've also been in LTC for more than 25 years and both of you are right on the money. Way back in the day I had a little old demented lady that had worked midnights most of her life. She kept me company for 2 years of midnight shifts - she sat at the desk when I was there and she knitted/tatted while I charted. (Does anyone tat anymore - she made me a beautiful spread for a table. She's been gone for years but I still cherish her tatted spread).

CapeCodMermaid, RN · Mar 18, 2012

These days tat more likely means having something inked on one's skin!

Nascar nurse, ASN, RN · Mar 18, 2012

These days tat more likely means having something inked on one's skin!

Alright - showing my age! :)

SHGR, MSN, RN, CNS · Mar 18, 2012

I miss working with geriatric patients on a regular basis...so nice to see that good nurses do choose that field. :) I am a little confused myself here though, why if you work nights are your residents getting showers? Do LTC's really try to shower people in the middle of the night? I would scream too.

Whispera, MSN, RN · Mar 18, 2012

How often do the patients get a shower--how dirty can they get?? Given that their skin is likely pretty dry, having showers too often can be a bad thing on top of causing emotional distress. Do the patients get any say in when they get a shower? Do they get to take part in self-bathing? I think it has to be pretty embarrassing to be showered by someone else. Having some control over life activities can do alot to help people feel they maintain some dignity. I think to force a shower could be considered to be battery. Not only are you doing the right thing to stop the showers, you're doing what must be done.

A person who is calm, and up and about at night, shouldn't be medicated for sleep. People have long-standing sleep habits. Not everyone sleeps at night. It's not kind to force a change to fit a facility's convenience. We should fit things to their need and dignity.

You have done the right thing.

SHGR, MSN, RN, CNS · Mar 18, 2012

OK I have a question for you kind nurses. My LTC career lasted 6 months in a cruel facility. I usually worked days but on the occasions I worked a PM shift some of the very old ladies wanted to go to bed like at 4pm. One would sit and repeat over and over "I want to go to bed." I can still hear her pained voice. The staff would put the side rails up and ignore her. They were so adamant that people could not go to bed in the afternoon or they would be up all night.

The really bad issues I reported to the state and left after even the state inspectors couldn't fix the bad culture of uncaring at that place.

Would you have let this lady go to bed when she wanted?

nurseycheri · Mar 18, 2012

I have worked with Alzheimers patients for over 10 years and it is not easy. The first step to take is How to approach the person, 90% positive, calm and soft spoken voice. it takes a special person to work with dementia/alzheimers patients, Once they get combative, too late for medication. Give the med when they are in a good space. Trust and we have to go into their world, not ours. This is the 10%....

wooh, BSN, RN · Mar 18, 2012

I worked nights as a CNA way back what seems a million years ago. I usually got away with those that were throwing too much of a fit to get bathed by taking advantage of the LOL that was walking at night and getting her in the bath instead. (And what's better than a nice warm bath to get you ready for bed?) As long as the sum of the work left for the next shift was the usual amount, if I couldn't do something, then doing something else would make up for it.

DixieRedHead, ASN, RN · Mar 18, 2012

I don't consider it wandering unless they are trying to get out the door. Why medicated them?

As for the bath, they probably just don't want a bath before 7 am. I wouldn't. Let them wait until later in the day when they might be more ready to participate.

If they want a late night snack, sometimes, well, don't we all?

They LIVE here, let them have what little life there is left for them.

You did a great job. Don't listen to anyone who tells you differently.