Bathing critically ill patients?

Tweety, BSN, RN · Aug 2, 2007

As far as I know it's still taught the very first semester.

PrincessAnnie · Aug 2, 2007

CNA's do it.

deeDawntee, RN · Aug 2, 2007

We give thorough baths at least daily and often every shift if the pt is diaphoretic or has skin issues or stooling etc. For patients on vents mouthcare is one of the biggest priorities to prevent VAP. We do it at least every 2 hours or more often if there is a lot of oral secretions. The nurses are responsible at my facility. It is beyond a CNA's scope to protect all the lines and the vent with turns etc. Skin care is sooo important.

Don't know what is going on where you work, doesn't sound like a good trend.

truern · Aug 2, 2007

CNA's do it.

To quote my Nurse Educator, "If the CNA doesn't do it, it's YOUR responsibility as the RN!"

Actually what she said was, "If the night CNA doesn't do it, then it's the responsibility of the day CNA, and if SHE doesn't do it, it's YOUR responsibility as the RN!"

Didn't much like how she skipped over the night RN

Regardless, I can't stand stank. I've bathed many a patient that obviously was just getting a spit shine and a promise.

CritterLover, BSN, RN · Aug 2, 2007

i have been out of hospital nursing for about 13 years and now do research in the hosopital setting. my question is when did we stop bathing our patients? do nurses graduate today with this skill? have we forgotten about patient hygiene, mouth care, etc?
what 's up ?
c:nono:

no, they are still supposed to get a bath.

however, if a patient really is critically ill, giving a bath may be the last thing on the nurse's mind. an alive patient is more important than a clean patient.

patients that were once 1:1 are now sometimes the second or third patient in an assigment. it can be tough to get to the bath when you've got to do baths, assessments, meds, titrations, blood draws, etc on two or three fairly sick patients, esp when one of them is very sick.

most nurses i know still make a huge effort to get the bath in.

in fact, some of the icu nurses i have worked with were "bath obsessed" to a fault. they made the bath their priority, even if there were other things that needed to be addressed. like blood pressure. or oxygenation. or icps.

i've also seen some icu patients that really were too unstable for a full bath. of course, they usually could tolerate having the top cleaned up, but didn't do so well to be turned for the rest of the bath/linen change.

i've seen more than one patient code when being turned for a linnen change.

nursemary9, BSN, RN · Aug 2, 2007

For the most part, bathing is usually done by the CNA's.

However, We occasionally also do baths.

In our ICU's, the RN's usually do all of there own care.

On our floor, we may do 1 or 2 baths a week, if that.

Mouth care is often done along with the AM cares, however, on very ill pt's & sometimes even not so ill pt's I might do mouth care several times a shift; for instance an NPO pt, a trach pt. Someone along those lines. I know my CNA's do the mouth cares on these people, but I like to do it in between.

My pet peeve is nurses who don't feel that a back rub has any place in care. We learned to give back rubs, especially with bedbound pt's with AM cares & also at bedtime. RN's today refuse to give back rubs---

"I didn't go to school to rub someone's back!!"

Apparantly, this is beneath some nurses. However, I can't tell you how many pt's are so happy with that back rub & say they sleep better & feel so much better.

\

Good Luck

fultzymom · Aug 2, 2007

I think our community hospital has forgotten how to. I work in LTC et some of the patients who come to us have a major stink about them et they will say, "I have not had a bath since I have been in the hospital." YUCK!!! :nono:

Grumpygs, MSN, RN · Aug 2, 2007

When I did my CNA clinical training, we did full bed baths and showers if the patients were able to be moved to the showers. But I was amazed at the lack of mouth/oral care that the residents received. We made it a point to make sure that we did mouth/oral care throughout our time in the facility, but I don't think that the regular staff of CNAs did any oral care on a regular basis. I actually took care of this one resident and her teeth were brown nubs - it was really sad.

RNperdiem, RN · Aug 2, 2007

In the past nurse managers paid closer attention to details of patient care. Miss a couple of baths on your patient and you would hear about it. The emphasis is becoming more on clean and polished paperwork that would look good in a chart audit. Concerns about getting your restraint consent forms filled out correctly compete with patient care.

Luckily where I work, we are well staffed and have high standards of patient care.

nursewannabee · Aug 2, 2007

For the most part, bathing is usually done by the CNA's.
However, We occasionally also do baths.
In our ICU's, the RN's usually do all of there own care.
On our floor, we may do 1 or 2 baths a week, if that.
Mouth care is often done along with the AM cares, however, on very ill pt's & sometimes even not so ill pt's I might do mouth care several times a shift; for instance an NPO pt, a trach pt. Someone along those lines. I know my CNA's do the mouth cares on these people, but I like to do it in between.
My pet peeve is nurses who don't feel that a back rub has any place in care. We learned to give back rubs, especially with bedbound pt's with AM cares & also at bedtime. RN's today refuse to give back rubs---
"I didn't go to school to rub someone's back!!"
Apparantly, this is beneath some nurses. However, I can't tell you how many pt's are so happy with that back rub & say they sleep better & feel so much better.
\
Good Luck

I am an LNA and I fully agree that a back rub is a wonderful and caring thing for the patient but there is usually not time to give back rubs. I would love to give all of my patients back rubs but there are so many other things that need to be done that it is not a priority. I run from the minute I step onto the floor till the minute I leave. It is just chaos. If the hospital would allow another aide on the floor budget wise backrubs might be accomplished. So sad that money talks and patients suffer because of it while the bigwigs go home to their 14 room mansions. Just my 2 cents.

Altra, BSN, RN · Aug 2, 2007

I have been out of hospital nursing for about 13 years and now do research in the hosopital setting. My question is when did we stop bathing our patients? Do nurses graduate today with this skill? Have we forgotten about patient hygiene, mouth care, etc?
What 's up ?
c:nono:

It's possible that what you are encountering is pure and simple laziness. It's also possible that nurse assignments are routinely overwhelming where you work, meaning that keeping 1-3 critical patients breathing and perfusing is taking up all the available time, leaving none for bathing.