Can a nurse cut patient's hair without consent?

[runslikeanose]

I'm a nursing student and my professor was performing a bed bath, linen change, and wound care with our class on a patient who was unresponsive and obese. It was difficult cleaning and moving the patient, and the patient wasn't alert. It took 6 of us because of the patient's size. Problems with this patient: when lifting a flap of the patient's fat to clean, a bug jumped out which surprised us, and the professor immediately put us into PPE. The patient also had impaired skin integrity of the backside because of her size, inability to reposition on her own, and incontinence. The patient's hair was supposedly extremely matted and dirty and uncombable, and the professor got a bandage roll scissor and started cutting the patient's hair off, without consent of the nurses or the patient. The patient had near shoulder length hair and it ended up chopped up to about three inches in length. I did not personally see the condition of the patient's hair because there were 6 of us and I was at the end of the bed. I proceeded to ask the professor why she was cutting the patient's hair, and another student shushed me. I was confused and waited until post-conference to ask the professor. Another student said that I shouldn't say out loud next time because the patient would hear me. I felt frustrated because isn't it the right of the patient to know any treatment, regardless medical or cosmetic done to her? Isn't going behind her back violating her autonomy, despite her lack of alertness? This was a med-surg unit.

[tyvin, BSN, RN]

I have to agree with you. How long had the patient been at the facility? Why didn't the regular staff cut her hair if it was that bad? Perhaps they knew something your instructor didn't?? I would be interested in how she charted that...

Always question when you don't understand or agree; as for the hush...I would have went up to my instructor and asked her why she was cutting the patient's hair without consent of anyone...calmly and professional of course. As for the husher; don't follow that example, or you'll end up being one of those nurse who doesn't advocate for the patients. We are there for them.

[guest769224]

when lifting a flap of the patient's fat to clean, a bug jumped out which surprised us,

This part made me laugh! Nasty, yet imagining that scene is funny.

Yes, nurses can cut a patients hair. We did it all the time in the trauma unit I used to work in. Sometimes in preparation for an intracranial bolt. Sometimes because there was so much foreign debris, dirt, ect., that could not be removed no matter how hard we scrubbed and washed.

It could be interpreted as a violation of the patients own wishes…in your case, (or ours), but the mindset here is cleaning the patient, reducing risk of infection from bacteria that could be found in hair, and helping the patient become presentable and cleansed. What other choice is there, leave it matted and disgusting? I don't know if I consider that good nursing care.

[blondy2061h, MSN, RN]

I've cut hair before, too. I work oncology. We would start chemo on people, then sometimes by the time their hair would start to fall out they'd end up sedated on a vent, and we'd give them a shave.

[crazin01]

Before we changed ETT collars, to a more friendly type, we often would shave a male patient with a full beard soon after intubation in ICU. Rather than have nasty tape pulling hair out, or getting all disgusting from sweat and secretions, it was very beneficial to be proactive and prevent the disgusting ness before it occurred.

While somewhat different than hair upon the head, I agree if it is that matted or dirty then it is warranted. Although it may be a shock, I think most would agree a little cut job is better than spreading infection.

[ArtClassRN, ADN, RN]

Yes..

[brownbook]

I have cut patient's hair....they're on a vent, their hair is a matted mess. I do have it stuck in my brain that technically it is not permissible without their consent but don't know where or why I got that idea? Probably wrong....why does wrong information stick in my brain like glue and things more critical or pertinent to patient care I can't remember!

Once after I cut a patient's hair a co worker was helping me turn her and noticed hair on the linen, she said, "She is really doing poorly, her hair is falling out!" I didn't say anything!

I'd love to see a court room drama, legal battle, about a family suing a nurse because their loved ones hair got cut! The crazy things people sue for....it probably could happen!

[amoLucia]

I once cut an extremely agitated & violent dementia pt's hair. It was soooo wild and in straggles - she was pitiful to look upon. She was like something out of a horror sci-fi movie.

It was the only time I ever did so - it was an improvement. I would hope that if such a situation ever befell me, someone would take it upon themselves to try and provide me some measure of dignity. Even if I couldn't consent.

[Spidey's mom, ADN, BSN, RN]

I've seen it done . . . homeless folks who come in with matted filthy hair and lice.

I can see how this is an iffy proposition but medical care has to come first.

Good for you for asking the question!

[verene, MSN]

Though I personally am someone who will try to salvage people's hair if I can (and have the time to do so), I don't have a problem with the hair being cut - particularly if it is an infection and/or comfort issue for the patient. However, I do think that the professor should have told the patient that it was being done. Even if the patient seems non-responsive it is amazing what can still be taken in and understood.

[la_chica_suerte85, BSN, RN]

Consider if it were pubic hair that kept wrapping around a Foley. Would you bust out a quick trim?

[Anonymous865]

I would be one of those family members that would raise hell if you cut my family member's hair without consent of the patient or the POA unless there was a clear medical necessity.

Matted hair is not a medical problem.

Even if it were a medical problem there was no urgency. The patient's POA could have been contacted for permission.

Hair has religious and cultural significance to a lot of people.

Cutting someone's hair or shaving someone's beard is not respectful of a person's values, culture, religion, or their autonomy.