Bed Baths, I dread giving them.

Nurses General Nursing

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OK, so now I'm going to split my 0.6 FTE on our small rural hospital 6 bed CCU/Stepdown unit half and half, 12 hour days and 12 hour nights, since some rare weekday dayshifts opened up. I'm keeping nights for my weekend obligation. In our unit, baths are done on days. I have never worked days in my 13 years of being a nurse. I told my manager today that my worst fear is giving baths. I have a great manager, btw.

Any tips on giving bedbaths? Really, I'm totally unskilled at giving bedbaths. Anyone else scared of them?

Specializes in Psychiatric, MICA.

I'm an EMT and a student nurse in Rochester, NY. I've been working as a tech since January of 2006 as a way of backing my studies with real-world hospital experience. If you look up the definition of patient care tech in the dictionary, I think it says, "Person who gives bed baths"...;)

I agree that they key is focusing on the patient. Learning the procedure can be a pain, but the real payoff is the patient contact.

Problems to foresee:

Interruptions are #1 on my list. I can't leave a client undressed and half-damp to answer a call from another room, nor can I do baths for six or eight people if I don't allot enough time. So plan your schedule in advance to allow for 20 minutes per bath.

Also plan the bath itself. Nothing is more frustrating than being under the gun in a schedule sense and finding that every swipe of the washcloth spreads feces to a new spot. Or simply running out of rags because you didn't bring enough! Plan to bring more thna you think you'll need and isolate any quantities of messy stuff with a clean towel to keep it from the spots you clean. Figure out the best direction to roll (away from the biggest mess) in advance - take a moment or three to look. Change gloves a lot rather than spread stuff.

If the patient is going to do part of his own work, set him up and then buy time by fitting something else in, whether an interview question or another task elsewhere (like setting up materials for the next bath in line!).

For your comfort, raise the bed. Lower the rail on your side, but be careful of the other side because sometimes rolling can be disorienting and the patient will just keep on going...

Mostly, just be organized. Get a list of steps, sort of a mini-bath protocol, and you'll do fine. Use your best communication face to reduce discomfort and it actually turns into a comfortable and often funny moment with the person you are caring for!

D

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Specializes in ER, Medsurg, LTAC.
Any tips on giving bedbaths? Really, I'm totally unskilled at giving bedbaths. Anyone else scared of them?

Here are my tips garnered at the knees of a most-wise and speedy tech while I was a green nursing student:

Planning! All the tips mentioned before were very good!

If you have no hair washing device then use:

* an adult brief (if they're super absorbent- if not, use several towels)

* a styrofoam cup

* liquid soap (preferably shampoo- but if none available use the liquid soap).

* 6-8 wash clothes

* 3 towels- depends on hair length

* conditioner (if no conditioner use lotion)

Have hot water ready in basin- this should be hot but not burn skin hot (as if you could get it that hot from the faucet- I'm sure someone here can, but I can't where I'm at).

Place brief under patients head to help absob any stray water rivulets that may run under pt's head or down the neck. (can use towels or a combo of both)

Place washcloths in basin. Use one with NO SOAP to get hair damp; for longer hair use the styrofoam cup to pour the water sparingly over hair.

Place SMALL AMOUNT of soap/shampoo on new washcloth and towel through hair (this will get the excess oil off and make the hair smell nice without working up a hard-to-rinse lather).

Rinse with a new NONsoapy washcloth or if necessary with the cup.

If hair needs conditioning, place a very small amount of lotion in your hands and rub it into the pt's hair starting at the ends and working into the scalp (think 1/2 of the amount of conditioner you would use for the pt's hair length).

Rinse with a new NON soapy washcloth.

Have used consistently with bedfast or acute patients with positive results- conserves patient energy, helps them feel really clean and refreshed.

Other tips:

Powder in creases of a bed-bound or obese patient can cause irritation and eventually open sores (think granules of sand rubbing in those sensitive areas).

Make sure you dry the patient's creases well- even under the abdominal flap, breasts, under arms, and double (okay- triple) chins. Otherwise, yeast infections can form quickly.

A quick word about lotion- do not use the whole bottle on your patient and leave it on the skin where it hardens and drys. Lotion was meant to be rubbed onto the skin- you should no longer see it after that. Just pouring lotion on them is not enough :)

Just work quickly and keep your patient covered and warm. Tell your patient you are green at this and to let you know if there is anything they would like you to include.

I hope you enjoy the new shift!

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Specializes in Aide.

I have come on to a shift to find dried BM on patients with delicate skin. Periwash works with LOTS of rubbing. But if you put a little lotion on the washcloth, it softens and comes off much easier. But still thoroughly wash and dry...

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Specializes in Aide.

Oh, I forgot something our instructor taught us:uhoh21:

Wash distal to proximal to promote circulation!

And I just read a post above. An incontinent pad under patient's head and rolled under neck, with a couple of folded towels on top, also works well to wash hair. Use a wash basin of water, and a cup pouring water over hair. Wash hair and then rinse. It actually works better than one of those sink looking things for beds that have drain tubes on them!

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Specializes in Psychiatric, MICA.
An incontinent pad under patient's head and rolled under neck, with a couple of folded towels on top, also works well to wash hair. Use a wash basin of water, and a cup pouring water over hair. Wash hair and then rinse. It actually works better than one of those sink looking things for beds that have drain tubes on them!

If you have to wash hair right in the bed, an empty, double-bagged wastepaper basket and stand in for a drainage pail when using the plastic side-draining hair sink. I owe a veteran RN for that bit of too-obvious trivia!

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Specializes in Psychiatric, MICA.
This is the key: Place like 5-8 washcloths in the prepared water in the basin

Another tip: thick creams like Calazyme become a bit more tractable when the tube is left in warm-to-hot water for a couple of minutes before use...

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Specializes in Psychiatric, MICA.
On people with very dry skin I sometimes put a little lotion on the wet wash cloth, but haven't tried putting it in the water.

I did this with a foot soak for a patient with very dry feet. I would follow it with a nutrient cream after a ten-minute soak. Over the course of four days, the improvement was impressive. Of course, it could have been just the after-bath application or just that he hadn't been doing anything before this care, so I can't support the technique well. It's the only time I've tried it but I'd try again based on this incident.

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Specializes in gynae.
I can't believe that a nurse of any kind is asking how to do a bed bath? am I missing something?

Liz

i am a newly qualified RGn in England and i must say that although i can see the assessment oppertunities in giving my residents (i work in a nursing home) a bed bath i do not always have the time (there are 28 reidents and 1 nurse i also have 4 carers to help) as the morning med round takes nerarly 3 hours! i too dread giving a bed bath especially to the terminal residents that we have as i fear hurting them or not doing as they would wish and they may not be able to communicate that with me.

as a student i spent a lot of time with our NA's at the local hosopital and they were great, my advice would be to work with one of them for the first few days and see how they do it.

good look;)

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Specializes in Psychiatric, MICA.
... And, having to give bedbaths does *not* imply that we must give one every day - I don't know where that comes from. ...

I work in acute (respiratory floor as a tech - I'm a student) and we are required to bath each patient daily on the day shift unless they refuse. Each tech normally gets 11 patients and perhaps half these are total care on an average day. In other words, bed baths instead of just set-ups.

Personally, I shower every day when I get up and again after work in case I've got any hitchhikers trying to colonize my skin. My wife is immuno-compromized because of Embrol (RA), so this is more than an affectation. I like being clean and I have to assume the patients do, too. Those who prefer not to bath daily I will work with, but the nurses require an explaination if I skip anyone. Also, to me, dirty patients just seem out of place in a hospital...;).

I don't scrub people with soap if they don't have visible grime. I use a gentler cleanser, I use location and I dry throughly. Mostly I'm after salt and sweat, food, feces and urine. I've also reported many, many new Stage I sites in time for early intervention!

I'm learning a lot from this thread about how the procedures differ by location. Thank you to everyone contributing!

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Thoughts:

Team up with CNA or another RN from your unit - do her pt., then yours! Helps with the 'uneasy factor" and gets the job done quick.

For best 'best' hints - ask an experienced/helpful CNA - their knowledge is priceless.

Families *love* when their relative and linen are clean and sparkling.

Some patients (my mother) never wanted "someone washing her", she was an elderly, private person, and embarrassed. Give them the opportunity to do what they can themselves - I've seen some just run in, take over, and railroad the patient - mainly because of time factor.. Not good - or kind.

Truth is sometimes it's just not a "priority", esp. in ICU. Do the best you can when you can.

Not often - there are patients that truly need a CAR WASH (always tried to come up with some gagit that would do that - and make me a million bucks! Never happened.

Good luck - all things become easier - the more you do it!!!

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Also if the resident or pt. loved to have a touch of perfume, i would spray it very close in a dry washcloth, and dab on the pt. Spraying in the washcloth kept the mist from traveling on everywhere and everrything, plus it was away to apply it sparingly.

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Specializes in ICU.

These are great tips, thank you.

Do you give a bed bath to a patient who is physically able to bathe themselves? Or do you give them supplies and privacy?

Such a basic question, I know. I've given bed baths to patients who were physically able to do it - but now I wonder if I did the right thing?

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