Did you get their bath done? Seriously?

[Bezoars]

Okay, can I just talk about a personal soap box of mine? After reading the thread about proper bed-making, I had to laugh... I graduated a year ago and, yes, we were taught proper bed-making. Yes, they still teach it... that's great... but all my patients usually have SCD's so it means nothing to me. Anyway, here's my issue:

General Med-Surg today is what ICU was 20-30 years ago. The acquity of patients on the floor these days is high and we as nurses are expected to do now more then ever. We need to chart completely and precisely, do procedures, admit and discharge, assess properly at all times, teach, counsel, and be a walking info hotline, all while keeping a smile on our faces and a spring in our step. So here's my view on giving baths and changing sheets. If you stink and are visibly soiled, I will bathe you to the best of my ability in the five minutes I have to do it. Otherwise, I assume the opinion that you did not come to the hospital for a bath... and really, you didn't. Rarely do I have my time divided to where a bath is top priority. It never is. And as far as sheets go... again... are we visibly in need of a change? Because I can tell you that I don't change my own sheets every day. If you're not sitting in a pool of blood, and I have time to change 'em... I will.

With all the pressures of our job.... I will never go home beating myself up over (or even thinking twice about) the fact that my patient didn't get a bath or their sheets changed. If you are medically better off when I leave then when I came (or at least not worse), I feel good.

[gettingbsn2msn, MSN, RN]

At many hospitas you will be fired for not doing the paperwork which takes oodles of time. Not to mention if you are called in on a lawsuit. I totally get what the OP is saying. Is it the OP's fault or the hospital administration for cutting CNA positions to save cash?? One person can only do so much.

[Bezoars]

the op is just saying that it isn't a top priority. i work on a med-surg floor where it's me and the 6 to 8 patients. no aids, the other nurses have their 6 to 8, and i just have more important things to do. she's not saying that she wouldn't like to do it, it's not a priority. frankly i wouldn't want a nurse who made my bath more important than being safe in passing meds and checking orders. family needs to pitch in; in todays nursing you are seriously disillusioned if you believe that we actually get to take holistic care of a patient.

k makes a good point here with family pitching in. i am aware that not everyone has family to do this but if you have to go to the hospital, you better circle the wagons. i always tell everyone i know... don't go to the hospital without a friend or family member who can be a serious advocate for you. i certainly wouldn't. things just fall through the cracks... always. if you're lucky it's just a bath.

remember, you're talking to med surg floor nurses here.... we're the workhorses of the hospital and nobody can argue with that. we're in the trenches and can use all the help (from family) and support (from peers) we can get.

[kakamegamama]

My response was not made from a position of being on a "high horse" to quote KalipsoRed, but as a response to what I saw in the OP's comments. She sounds tired, frustrated, and truly at risk of burnout. Been there. Done that. Don't want to go again. And--I DO know how rough the floor can be. I am unable to care for adult patients at the bedside because of that very thing---a bad back is very preventative. Anyway.... And, I agree with OldNurseEducator---KalipsoRed--if you can get a vacation or any time at all for yourself, please do so. You really will benefit from it, as will others you work with.

Guess I'll go put my horse out to pasture now

[KalipsoRed]

Cinquefoil,

You said what I wanted MUCH more eliquently...good job. I think that it's pretty obvious that the OP WANTS to give the kind of care we learned about in RN school, but who ACTUALLY gets to do that? Yeah, teamwork would be great...I don't feel as though my coworkers AREN'T being a team player. Its a numbers game. We have a MINIMUM of 24 patients that all need help because they are post surgical and can't move very well. There are 4 of us. Without interruptions, having things higher on the priority list to do, and could all be free at the same time to bath patients, at a MINIMUM of 5 mintues a patient it would take us an hour and a half to do all the baths. Not to metion that in and ICU most patients are gorked out of their minds so you can bath, lotion, tuck and roll then move on. Mine are awake and responsive and pull stuff like: Thanks for the bath now I'd like some water. (Come back with water.) Oh, and can I have some pudding too? So I'd really say that 'bath' time would take and average of 10 minutes per patient which is a MINIMUM of 4 hours to do all baths....and thats if we had our MINIMUM patient load of 6 patients to one nurse. (We have no aids.)

[Cinquefoil]

Guess I'll go put my horse out to pasture now

Please don't! Or at least, not for my sake. I appreciate your concern for the OP, and thank you for the clarification:redbeathe

[Bumashes, MSN, APRN, NP]

Sheesh. Simma down now! I think the OP is just venting about a common problem I used to experience on med-surg before I escaped to the ER. Our aides were terrible (not that some of the nurses weren't, too.) With no support from management and 5-7 pts all to yourself, you were pretty much stuck doing 100% of everything for them. It was very frustrating to do all the post-op ambulating, I&O's, med passes, charting, dressing changes, PRN pain meds, calling pharmacy and lab, notifying drs about things they forgot, admits, DCs, coding one and sending them to the ICU, etc. Then, at the end of the day, someone gets snippy b/c you didn't have time to bathe someone...

I'm sorry, but I feel the OP's pain. I do believe that a bath is beneficial to hurting/sick pts. However, I don't think it will kill you to miss a bath if you are in for an appendectomy and will go home the next day. I would usually pinpoint my 1-2 most dependent pts (quads, very elderly/frail) and try to get their baths/changes done. The rest, I would set up for bathing if I got a chance. It doesn't matter at the end of the day that you missed lunch to do PT CARE and had to stay 1-2 hrs over to finish PAPERWORK. All that matters is that a bath got missed or a sheet has a speck on it. Damned if you do and damned if you don't. A sheet, a bath, fresh towels, etc. Something always gets missed in an understaffed environment like med-surg, and I would much rather someone miss my bath rather than my ABX. So glad I got out of it. Kudos to those who can do it! And as I said, I think the OP is just attempting to vent a common frustration of the "no time" factor encountered on med-surg. As usual, though, it gets seen as a personal affront, and they get attacked and judged. Whateva. Y'all play nice now, ya hear?!

[nurse_1234]

Hello everyone! I have been lurking here for over a month, but for some reason, this thread made me register to join so I could reply!! I really can see all points of view here, but there is one thing that I haven't seen brought up yet. I have read many threads on this board as to how nurses are not being seen as professionals, and we have all bought into the "nurses are martyrs" syndrome, how we just swallow our anger at being unjustly treated by administration because as nurses we are super compassionate and our needs come last, and if we are abused by patients, family and administration alike we are just supposed to suck it up and deal with it.

When I read the original post, I really felt the poster was laying herself on the line, stating her true feelings, and maybe looking for some support amoung her colleagues. I was surprised by some of the replies, especially the "you need a vacation" one. Seemed pretty snarky and unhelpful to me. The OP was expressing her frustration at feeliing the need to document to protect her license superceded the care she is expecting to give to her patients. I have been a nurse for 25 years, and I can honestly say I have never seen so much expected of nurses in the hospital setting, and it is only getting worse. I just find it kind of amusing that when one of our own infers that she may be less than a "perfect" nurse, she is met with criticism. ( "I hope you arent' my nurse" I hope you arent' my family member's nurse" " A bath can really make you feel better" and "you need a vacation")! I am sure she knows all of this!! She is NOT saying that she wouldn't give someone a bath or change their linens if she had the time, she is just trying to prioritize! She also said she would not leave anyone who really needed bathed or their bedding changed, it would get done!!

[rkitty198, BSN, RN]

I think you need a vacation:clown:

That really bothers me.

Not only does management harp on us for our overwhelming usage of linens, we also get harped on because patients complain that they did not get a bath.

It comes from many directions. Instead of harping on the OP (and the other posters who agree with the OP)

Why don't you offer suggestions on how YOU get it all done, including baths?

If you can give every patient a bath and get your charting done and eat and use the bathroom share your secrets...I will be glad to listen.

[kakamegamama]

Cinquefoil--thanks.....she's not put out there....yet :)

[kakamegamama]

rkitty198--I think OldNurseEducator was responding to another poster's comments when she said "I think you need a vacation", not the OP. She actually made some very caring and compassionate comments, validating the OP's angst/concerns.

[thinkertdm]

So...it's just nurses who have to do more with less? Who have to prioritize on a daily basis? Have increased expectations of them by supervisors? Who work for an organization that has to make a profit to keep everyone employed?

If you think that, I have a teeny tiny violin here playing for you.

There are few jobs where you can work at whatever pace you want and still be hired.

Believe it or not, this has been going on forever. Economics, unfortunately, does not take a backseat just because you are "saving lives".

I understand you are busy. That's just too @#$@ bad.

The original post had a definite "I have too much paperwork/answering questions/etc too bother with you" attitude. Anyone who has a job understands that the bean counters want things done as cheaply as possible. Everyone has boxes to check off and deadlines to meet.

Now, just because you may do procedures expertly, and document your ass off, and do whatever, that doesn't make you a good nurse. It makes you a good factory worker, churning out product day after day that no one really cares about as long as it's done. And that is fine. You are just a little cog in a great big machine, and unfortunately, no one is going to say, "thanks for saving a million dollars", or "thanks for making that big machine turn". Nope.

What makes a good nurse is that they understand the end product. They know they are working for a higher cause, not just turning their little mouse wheel over and over again.

And you know, people do know, and thank you for, that work.

Thanks for helping my father pass away with some dignity.

[3dayRN]

When I'm sick I always feel better after I have a shower. I understand as a nurse this is important but if I have to decide, for instance, between passing meds and giving a bath then they will not get a bath. There's only so much one person can do. I had a manager that mandated nurses and/or aides to stay over to gives baths. That is a bit extreem in my opinion. Bathing is important but something has to give if you run out of time. Now for sheets. I don't think these need changed daily unless soiled with sweat, urine etc.