Bed Bath

[kittyn, MSN, NP]

My clinical instructor stresses the importance of giving a bed bath to our assigned patient every morning and wants it done before 0900. This task has not always been easy for me to accomplish. Many times in the past, my patients refused whenever I asked them or offered one. Some bluntly said "no" while others said such clever things like "Maybe later," or "Not right now." Other times they are scheduled early morning for something important (i.e. physical therapy, meeting with their doctor) or are too sleepy to do anything. All of this resulted in either 1) no bed bath provided on the day of my shift or 2) providing a bed bath at the last minute before the end of my shift. It is rare for me to perform a bed bath on a patient on time. I usually get scolded by my clinical instructor whenever I report this to her. I feel like as if I am doing something wrong here, although I know that patients have a right to refuse care, and that there is always something in the way and never go as planned. I need strategies on how to accomplish this task and on time without any delay. How would you convince your patient to get a bed bath? What is the best way to do this? What is your method? How would you approach this if you were in this situation? Any help is appreciated and thanks in advance!

[curlilockz]

Is this your first semester of nursing school? That sounds like something a Fundamentals instructor would do. If a patient says no, then you can't give them a bath. You could always try to convince them, but with some people, it's just not going to happen. One thing I do with patients to help them bathe is instead of asking, "Would you like to bathe today?" is saying, "It's time to get cleaned up. What do you need help with?" This way, it promotes independence, and if they are just adamant about it, they can refuse.

I think most instructors are like that because a lot of students try getting out of giving a bath. It's not really fair when the patient refuses though. Sometimes you can convince them to get a bed change, and get them a warm washcloth to wipe off their face. Maybe that will help.

I used to be really nervous about giving baths my first semester, but after working as a tech in the summer, you just get used to asking.

Good luck with nursing school!

[peacelovestar]

Im a first semester student and have been to...6 clinicals so far. On my first clinical day, I ASKED a patient if she wanted a bed bath and she said no. I realized I shouldn't have asked, rather have said "I'm going to get you cleaned up now!" Of course, I leave the door open for refusal but when you're confident and in control they're less likely to say no to you.

You have to be assertive. Of course, they can ALWAYS refuse a bedbath and there is nothing you can do about it. You can ask them why, and I like to say how good it feels to be clean. But, really, it's their choice. My clinical instructor was a little mad I didn't give a bath on the first day but she understood. Even another classmate came in to try and help me convince my pt (and this classmate ironically works in the same hospital and is a pct-she would be the best help) but nothing worked.

I suggest not asking the patient and being in control, saying this is what we're going to do. But, again, if they refuse don't force them. I'm not sure how fair it is to require you to have your bed bath done so fast. We get on the floor at 730, then breakfast is there, then VS, Meds, and then Assessment/with bed bath. I figure as long as it gets done by the end of your shift, it should be okay.

Try not to let a patient say "later" because, as I'm sure you know, things come up.

[AOx1]

If your patient still refuses, you might say "Instructor x, my patient refuses a bath. Is there someone else you would like me to help in giving their patient a bath?" This shows you are not attempting to avoid work, just that your patient has declined.