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.
Specializes in Med Surge, Tele, Oncology, Wound Care.
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.
Sorry OldNurseEducator :) I did read the entire thread, but I took what you said out of context.
Thanks for pointing that out kakamegamama :)
I empathize with the OP and it just ruffles my feathers to think that just because she does not have time to give a patient a bath because she is so busy (and probably has no time to eat, drink or pee) she is seen as a nurse no one would want to have caring for them.
Not saying you cannot do both, but:
If I was hovering over the proverbial "drain" would I want the nurse who was worried about my neighbor getting a bath or the one who is busy trying to get me off to the ICU?
When I was a nursing assitant (many moons ago), EVERYONE had their sheets changed, either a full set if sheets were really soiled, or top and tailed (top sheet goes on the bottom, new sheet on the top). 2 nurses or nurse and NA were assigned to do all the beds - I remember getting about 60 beds done in 10 minutes. One RN usually did all the meds, breathing treatments whilst the other RNs were getting people out of bed, baths done, etc. And the old RNs made sure EVERYONE had a bath, all the rooms were ship-shape, rubbish taken off overways etc, and everyone's bed was changed and clean, ready for the day to start.
Those days are long gone now. Team work was the key. I miss those days sometimes. And it won't get any better, it will only get worse.
I'm a student and the floor we are on now loves the students haha. We will bathe and change the sheets for the CNA's and the RNs. If we have "nothing to do", theres always a bed that needs to be changed!
I'm a student and the floor we are on now loves the students haha. We will bathe and change the sheets for the CNA's and the RNs. If we have "nothing to do", theres always a bed that needs to be changed!
You know, I continue to read this thread and am still not finding any answers. Furthermore two more post make it a point to say what a 'priority' it is to get a bath, that baths 'make a patient feel so much better', and that if I were a good nurse who really WORKED then I'd have time to do baths.
In this ENTIRE thread I have not once read that someone is not willing nore does not see giving baths as something that needs to be done. I have not read anyone posting that baths are not theraputic and helpful to the patient. However as in all aspects of nursing it is where does it fit in on the priority scale on your list of a million things to do.
Will I stay after work to give a relatively clean patient a bath unless they asked for one earlier? No. And I'm sure I've got people roaring that a patient would even have to ask for a bath.
And guess what, I say this as a nurse that regularly stays after an hour to do charting. That rarely sits down at work. That eats on the go and might get to pee a couple times in a shift (however I've gotten more picky about peeing more often as I got a BLADDER INFECTION because I wasn't peeing often enough.) Oh and let me throw another mind boggleing fact in there...I'm working nights right now to boot. (I've worked all shifts for a year....I was just as guilty of thinking night people didn't do anything....if you think that you are very wrong.)
Do I feel like my co-workers are not 'helpful' or don't do teamwork well? No. If I need help most of the time all I have to do is ask and the same goes for them. Heck, I'm even proactive and ask them if they need anything on the handful of occasions that I've been able to 'get ahead'.
This whole attitude of 'you need to make time' is silly. Accusing others of not actually working is uncalled for. I've been a janitor, a waitress, worked in fast food, and did telemarketing before I was a nurse. I knew how to bust butt BEFORE I ever became a nurse and I'm still not able to do more than give the pt's that request or absloutly need a bath one.
Do I want my patients to feel like they are an inconvience to me? Of course not. But the fact is that until the patients start complaining to the hospitals that we we weren't able to get in there and do these things for them, then I don't see an end to this. It is not okay that we REGULARLY do not get to eat or pee. It is not ok for us to stay after our agreed working hours on a regular basis to get everything done. Sure, even in my other professions I knew there would be times that I'd have to put in some extra time...on occasion. I do it EVERY time I go to work, it is more the exception that I get to go home 15 to 20 minutes late and I can safely say that in my 3 years of nurse I HAVE NEVER EVER LEFT ON TIME. Heck even when I get low census I don't get to leave on time.
I just don't think there is a debate about the fact that two people that have a good hour or so of time can get a large amount of people clean. The question is when you have two people who have a long list of higher priority things to do and no alloted time for baths, how do they get it done?
We all agree that it is important and all we are arguing about is how important it is. How do you get it done? That's all I want to know. And any answer that is along the lines of, 'you just make sure you do' or 'you don't quit until you do' or 'you need better time management skills' is not acceptable. I've been to classes on time management. I've tried sever different ways to organize, I still can't do it.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
. . .I'm just trying to be reasonable... this isn't 1950. Nurses have sooooo much more responsibility now then they used too. We're like a balloon that you keep filling and eventually burst. My point is simply this: If you NEED a bath or you ask for help cleaning up, etc... you will get it, at some point, during my shift. If you go a day without one?... well, you won't die from it.
I can't speak to what was going on in 1950, but I read this so often it's as if people think all nurses did 30, 40 or 50 years ago was dab a patient's forehead with a cool washcloth and scamper out of their chairs upon first sight of a doctor. I know that because the length of time someone spends as an inpatient has dropped quite a bit, patients are "sicker", but we/they didn't have RT on demand, and all the time-saving gadgetry to take vital signs, know immediately what someone's oxygen sat is, and many others. Hardly anything was disposable, either.
It's upsetting to me that once again we're turning on each other because somebody else is screwing all of us over. I was thinking of pointing out that the patient feeling comfortable is at least in the ballpark of importance of charting - I always recall patient's accounts of not having mouth care done while in a burn unit - the patient/nurse said her mouth was full of grit from the fire and the taste/smell of smoke for days, but she was unable to communicate that. I understand if you could do it you would.
It sounds like your floor is ridiculously understaffed - not your fault! I'm sorry it has to come down to a choice like that. Old school nursing put a huge premium on baths and linen changes because not getting them can increase discomfort or even pain. It was assumed that anything cleaner was less prone to infections that had not been clearly identified or had an effective antibiotic treatment. BTW - lol at "bezoars" I posted a picture of one here a while back !!
Mrs. Sparkle Pants...I don't think this thread is "my life is harder than your life" I think it's just about the frustration of not feeling like we have time to give more personel attention to the patients.
Put the patient first is and should always be done, but no one is giving any answers on how to get it done. Everyone is just saying you should. How is that helpful?
Of course I'd stop what I was doing and go to a patient who seemed in distress and/or uncomfortable. However that seems to be all that I have time to do. Stop caring for one patient to go care for a patient that is more in need. I think there would be a greater reduction in discomfort and patients who turn critical if we got to spend time giving our patients true one on one care. Heck there are even articles about it.
As it is all it seems that I...or any other nurse I've met...gets to do is catch the juggeling balls from one shift to another and desperately hope that I don't drop one.
I've been hospitalized a LOT. The last time I was in was a week long stay several years ago to get IV abx for a highly resistant UTI. The floor was staffed by CNAs, although I don't know how many.
In seven days, not once did anyone ask me if I'd like to use the roll-in shower on the floor (I use a wheelchair), or offer to help set me up with towels and a filled basin so I could wash myself up in bed. Not once did anyone even bother to find out if I'd had a shower or washed up that day (i.e. no one asked me, and I may be wrong, but I seriously doubt anyone went looking through my chart to see if there was a mention of getting cleaned up in there).
Being a seasoned hospital veteran and strong self-advocate, I asked every shift for help getting a bath And I got the same answer every time by nurse and CNA alike: "If I have the time, I'll see what I can do."
In seven days, I never did manage to take a shower and wash my hair. I did get someone to bring me a basin filled with water, towels, and pull the privacy curtain for me so I could take a bird bath once. The rest of the time I used wet wipes a very sweet nursing student scrounged up for me to keep myself as clean as I could manage.
I get that nurses are run ragged by high patient ratios, emergent situations, tasks that only they can perform, paperwork/charting/lab reports, etc. and that sometimes a bath or a linen change just can't get done.
But here's something I ask you to think about.
If you're so swamped that you're unable to help me bathe or at least straighten my linens out while you're taking care of me, there's a very good chance that the nurse assigned to me on the next shift, or the next day, won't have time to do it either. If every nurse makes the same choice to skip a bath or linen change, and justifies it to themselves by saying, "Well, it's just one day", patients can end up going without for a long time.
leslie :-D
11,191 Posts
i agree, that a nurse needs to prioritize their duties.
i just happen to think that even a partial bath, IS priority...
if we are to consider the pt and their healing process, from a holistic approach.
nothing worse than feeling like a grub...
and even though it's not critical to clean your pt, psychologically it makes a difference as to how they face their day.
if sheets aren't visibly soiled, i won't do total bed change, but will change pillowcase and top sheet daily.
maybe they won't get total bed bath, but i will wash their face, comb their hair, shave a woman's whiskers, and set up so they can brush their teeth.
i do ask family, to shave the male pts, or, leave it in report that so and so needs a shave.
it isn't petty.
being and feeling clean, is a basic elemental need.
if i end up staying late, so be it.
i couldn't feel that great about myself, if i didn't do the aforementioned.
seriously, cleaning your pt, shouldn't have to be a privilege.
just sayin'...
leslie