Baths on night shift?

The military man did make an exception for the unstable patient. I appreciate his gung-ho style and sense of work ethic.

Laziness can creep in unless there is an understanding about baths. These patients need turning every 2 hours anyway, they get soiled linen often enough. What is so hard about adding on a bath and fresh linen? In 8 years at my current job, I have only had one patient who didn't get bathed by the night shift, and she was alert to refuse a bath.

Thanks RNperdiem U understood what I had to say.

U don't move a unstable pt NO WAY. I said that clearly. These pts U don't move beside U are to busy with them throught the day/night to bath them for the reason walk6miles mention above.

Wake6miles to let U understand the military. Iraq & Afghanistan nursing U are tunnel-visioned 24hrs a day 7 days wk for 12hr shifts. U get use to that after a 1year :). They still got bushed down. That's a long flight to the states stinking up the plane with others on it who are trying to keep U alive.

And for the record I was a civilan nurse in NYC I now what it's like to saving lives on both ends.

Oh and its Ms. Military to U.

Our unit is pretty relaxed about the baths. I try to bathe people on nights. My coworkers try as well. When we're full (6 beds) we get an aide and it gets done. Sometimes we just team up and go on a "mad bathing spree" and get 'em all done within an hour or so, if they're all stable. It's kinda fun, builds teamwork, no one hurts their back, or if they do, they don't do it alone.

I've also done the style of bath that I call "piddling" where I keep the wipes handy and go head to toe, in between a bunch of other stuff, with a big break for a bunch of dressing changes and emptying drains and stuff. There may not be a bucket of water and it may have taken me all darn night, but they're alive and clean. Weeee! This bath style is reserved for the bedridden, vented, patients who don't realize I've been fiddling with this or that thing all night.

It depends. Try to do it on nightts. Doesn't always get done. And not everybody gets a full bath. Sometimes it's literally pits and slits due to staffing, census and acuity (27 bed Trauma ICU).

This discussion comes up constantly in my unit. I think some nurses are so compulsive that they feel they HAVE to give a bath. Personally, if my pt is awake and alert and can refuse a bath or request then so be it, not too many of them want a bath at 12am, maybe in the morning, but I have found that most just want pits and peri and they feel refreshed. If i have a super sick pt I am not gonna further increase their discomfort by scrubbing them and what not, sometimes I find baths help relax pts, others it just makes matters worse. So really i think the focus should be what is the best interest for the pt. Not the fact that a. it is nites, b. you are the nite nurse and c.all baths must be done on nites. I personally love giving baths, it really helps the pt to feel better and is great for assessment, but sometimes you just need to let that pt rest and clean them up as needed.

I work in a 13 bed SICU, and night shift does 99% of the bathing. All vented/sedated and confused patients are bathed at some point during the night, unless they're unstable. Alert/oriented patients get bathed between 7p and 11p so that they can "sleep". The A/O's rest better when they're bathed early!

Night shift generally has more time to do the "maintenance" type things... and therefore should be responsible for the bathing. There's no clipboard sorts around, the docs are generally gone, there's less traveling for tests, and limited family visitation.

Before I get flamed for my opinion let me assure you that I've worked both shifts for 14 years and I can appreciate what nurses on each shift have to do. Aside from having a crappy night with a super sick patient, there's no reason why nights can't do baths.

Let me clarify too that if someone refuses, I respect that. AND, some people just need to rest. Period. I don't bathe those except on a PRN basis.

I guess what I'm saying is that unless there's a good reason NOT to, that nights should be doing most of the bathing.

I work in a 48 bed ICU and we generally have 2 pts per nurse. There is not a set policy that I am aware of, but since I started there we try to be curtious to one another and the day shift will bathe one and nights bathes the other. It doesn't always work out that way, sometimes you just can't get it done, but we try. If my pts are alert and oriented then by all means, I am going to allow them to rest. And the day shift is generally understanding of this. Hope that this helps....

See, in the ICU where I work......the acuity is generally low. We have a lot of alert and oriented patients who like to SLEEP at night. Circadian Rhythms anyone?

Last night I had a vent pt. PT did get a bath for me.......I MADE the aide come in to help. Tonight the aide got pulled to the med-surg floor. I don't have the vent patient. Pt's a lot sicker tonight than last night and I doubt my co-worker will bathe this patient.

I totally agree that if the patient is sedated and intubated then by all means the bath should be done on night shift. BUT like I said earlier in my initial post.....where I work...there is NO ancillary staff on night shift. And by nights, I mean after 11pm. I consider 9-10pm still evening shift. We have NO respiratory therapy, no unit secretary....nothing!

In an ideal nursing world where coworkers all actually pull their weight, and shifts don't fall apart, all A/O patients would bathe during the day and sleep all night. I'd love it if my A/O patients were bathed on dayshift!! It would make my nights much easier.

However, if I come in and my patient hasn't had a bath since yesterday, then he/she is getting a bath. Period. Am I going to wake him up at o' dark-thirty to wash? Of course not... but I do make a plan with the patient: "Okay, Mr. Patient, I'm going to do my assessments, get some medicines passed, and do some charting. I'll be in between 10 and 10:30 to help you get cleaned up and settled for the night." If the patient refuses, fine. I've done my part in making the attempt. OR, sometimes they want to bathe in the AM... so I give them the option of doing it around labtime (4 am) or right before shift change (around 6 am). Of course this comes with the disclaimer that if something goes awry in the middle of the night I may not be able to follow through with the bath.

Most A/O patients appreciate a bath, even if it occurs on nightshift. Circadian rhythms stay more rhythmic if the patient can sleep, which he is more likely to do if he is clean and not laying in his breakfast crumbs!!

(And BTW, the only ancillary staff we have is a unit secretary on dayshift. Nights, we're on our own! We generally tag team and knock out most baths between 3 and 5a.)

One of the things I noticed NOBODY mentioned was the role of the family in all of this. I always try to involve family in the care of the patient, and one of the things they can do is bathe the patient in those areas that are easily accessed and not injured. I give family members small tasks all the time, and often I find that they become more comfortable with the situation and feel less powerless. The family must be part of the health care team, as well as the patient. Patients who are A/O and fairly mobile get small "tasks" as well. I'll tell them, wash everything that you can reach comfortably and avoid your dressings, I'll come back and help you with the more difficult parts.

I honestly believe this helps the patient in many ways. It gives them a sense of involvement in their care, it gives them a sense of control over their own body, it gives them motivation to help themselves (even if it's just this small way), it establishes a collaborative relationship between me and the patient, and it gives me teaching opportunities. Even the apathetic patients will do it because I tell them that if they can take care of washing the easily accessible bits, I may have time to give them a backrub (always appreciated). We aren't afraid to touch our patients and we should help the family to not be either, and I think we can give the rehabilitation stage of recovery a real boost by getting the family and patient directly involved in their own care ASAP :)

P.S. - This philosphy applies to either day shift OR night shift. I think that assigning a task to one shift only is a mistake. It creates a "task" oriented culture which is NOT what being an RN is all about.