All About Abuse?

[sleepingdoll]

I'm curious, when is it abuse? I hear this a lot. Staff always complaining about patients refusing to take baths or refusing to be checked and changed and the terrible body odor. So tell me, how do you approach this when you are told you can not ask because it is abuse, for your patient to take a bath so they will feel refreshed and smell clean?

[roser13, ASN, RN]

It is abuse when you force a patient to perform any task or submit to any treatment that he/she does not consent to.

It's very clear.

[brownbook]

Asking is not abuse????? If you have the time, can get the patient to talk, ask open ended questions, you may find out why they are refusing.

[JKL33]

I believe the way to approach this is to find a place of employment where they are interested in being therapeutic with patients (as mentioned by brownbook) instead of threatening staff.

[sleepingdoll]

Yes we have no problems with that, but now the way staff ask, they were told when asking, omit anything else, do not say it's bath time, you will feel refreshed and smell clean, cause it is saying they smell bad. And telling someone they have a strong odor is abusive.

[sleepingdoll]

I enjoy where I work, but some things management handles takes time to get use to. lol..

And therapeutic would be great here.

[RNperdiem, RN]

I remember reading about this in a book for caregivers of people with dementia.

Rather than asking "do you want a bath?", the book recommended setting up the washbasin, warm water and washcloths and handing a warm washcloth to the person and saying politely that it is time for a wash.

There is still the possibility for the patient to refuse, but often they don't. For a person who is confused, the approach you take matters a lot.

[Meeshie]

So where I work there is a mandatory daily CHG bath. If the patient refuses to bathe it gets escalated to the nurse who explains about infection prevention and bacteria and all that fun stuff. If the patient still refuses it goes to the charge who does the same. Then the floor manager and educator. And finally infection prevention gets in on it. The level of harassment is.... a lot and it's hospital mandated.

The advantage here is that you can discuss baths based on infection prevention measures and not body odor. The negatives.. well.. Im sure you can see the negatives.

[JKL33]

I remember reading about this in a book for caregivers of people with dementia.

Rather than asking "do you want a bath?", the book recommended setting up the washbasin, warm water and washcloths and handing a warm washcloth to the person and saying politely that it is time for a wash.

There is still the possibility for the patient to refuse, but often they don't. For a person who is confused, the approach you take matters a lot.

Excellent point. This is the type of suggestion that could help both patients and the care staff who work with them. Just telling staff what they can't do (and using scary language to do so) helps literally no one in an instance like this.

[edmst]

It is abuse when you force a patient to perform any task or submit to any treatment that he/she does not consent to.

It's very clear.

So let them lay and sleep in their urine and feces? Great nurse!....