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.
I agree with most of the posts here as well...even though you may not have time, if you can help the patient feel a little more comfortable by taking 5 minutes out of your day to help them at least clean up, it really does make a world of difference to them.
Somewhere on the boards is a thread asking if basic nursing care is a thing of the past. This thread pretty much answers the queston. It also answers my questions as to why, at my last facility job, easily 75% of our admits from the local hospitals (low ratio union hospitals btw) admited to us with skin break down and/or yeast infections.
Basic hygiene is a nursing task, that is why it's one of the first things taught in school. It's also the best time to do a through physical assessment.
If you feel that if any loved one of yours is recieving the best care they can recieve if they were on the recieving end of your care then that is OK for you.......................it wouldn't be OK for me or my family.:twocents:
I may get flamed for this but I think this is where private nurses should come into play. People need to realize how unfair the hospital system can be towards the nurse. So many nurses do not have the time, support, and resources to deliver the type of care that ALL patients deserve. Management is not going to implement adequate staffing ratios anytime soon so if people expect to be bathed and pampered everyday then they need to bring out money and purchase those types of services.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Bathing isn't "pampering" and I don't think we need to be adding yet one more way those without means get the short end of the stick. There is an expanding market for concierge practices, 5-Star emergency rooms and deluxe surgi-centers to cater to that market - but it would be a disgrace to leave people dirty who couldn't afford to pay a private nurse to give them a bath. But that's not a flame!! Just my thoughts.
Specializes in Med Surge, Tele, Oncology, Wound Care.
Thechair1- I wont flame ya, I kind of agree :)
My manager went around the other day telling us how much we spend on linens and how we are way over our budget on the use of them.
Then the next day that good for nothin manager went around telling us how according to Press Ganey we are doing horrible because we are not offering baths to the patients.
Well what does she think we are doing with the linens? I am not using them for myself although, maybe I will on those days where I don't see a toilet for 12 hours (to make a diaper out of them).
Management is not going to implement adequate staffing ratios anytime soon so if people expect to be bathed and pampered everyday then they need to bring out money and purchase those types of services.
this has to be one of the saddest and most pathetic statements i've yet to read...
that expecting to be bathed (which is not pampering) is considered a luxury.
pay to be bathed???
time for me to hang it up...as i never want to be that type of so-called nurse.
this has to be one of the saddest and most pathetic statements i've yet to read...
that expecting to be bathed (which is not pampering) is considered a luxury.
pay to be bathed???
time for me to hang it up...as i never want to be that type of so-called nurse.
leslie
You must be Houdini and Florence Nightengales love child. I have read in numerous posts about nurses being forced to prioritize care due to lack of support and time, and expressing guilt about not having time to give baths. What is sad is your naivete because in a lot of facilities expecting to be bathed IS a luxury. I think this is wrong but no one wants to hold management accountable... Why doesn't the public cry out with outrage and force those selfish suits to change things up? Of course thats not going to happen because management still deserves to make their large profits right? The people who actually have to take care of the ill better just find a way to make it all just magically happen right? Get real or sit down.
Everyone better just focus on eating well, excercising, living a healthy life, and staying out of the hospital if at all possible because at the end of the day its all about money. We as a country have the mindset of survival of the fittest and "every man for himself" anyway so save your snarky "lack of compassion/care" comments for someone else. This shouldn't surprise anyone especially considering the fact that most americans seem to be against universal healthcare. You know who gives the patient a bath in most other developed nations? The Family! I didn't say we need to further alienate the poor or that people do not deserve to be bathed. I just know that that is not going to happen so a possible solution would be for people to pay for personalized care in order to ensure that they receive that level of care since holding the hospital accountable or expecting families to help pitch in is out of the question. Until robot nurses are created and trusted to care for the sick, we are all stuck with human nurses who deserve to be treated as humans too! Now there is some food for thought.
2 nurses or nurse and NA were assigned to do all the beds - I remember getting about 60 beds done in 10 minutes.
That's 6 beds per minute, or a bed every 10 seconds. I believe you were fast, but I don't think I believe you were that fast. Though if you really can change a bed that fast, they need you at OP's hospital!
I give my patients the very best care that I am able to, every time I am at work. I answer lights, potty patients, provide them with assist to wash, etc, etc. I care about my unit. But sometimes, I work with people who apparently have a different philosophy.. so, they get all their charting finished, get out on time. Some of our CNA's disappear, so I get the lights. Sometimes the nurses I work with are a little "hard of hearing," so I get the lights. Sometimes, I happen to notice if a patient needs help, and has for a while, so I help them.. and sometimes, it just gets frustrating to see everyone leave on time, while I am still charting.. I don't adhere to the "not my patient" thing, when it's obvious they need assistance, but sometimes, I wish that my ears were not as sensitive, and my vision was not so clear, and my heart was not so soft. I wish that I could share those things with my co-workers.
If you're working a Med-Surg floor, a fair number of your patients have surgical incisions. Do you change the dressing and clean around the incision? The bath lowers the amount of bacterial on the skin, making it less likely that an infection will develop. The bath makes the patient move, even if it's just from one side to the other, allowing for checking the skin for breakdown.
Many patients will speak of how they acquired an infection in the hospital because they are told in the media that workers "give" them infections. Many times, the bacteria is already on the patient's skin, ready to jump in when there is a decrease in the immune system, and opening in the skin, and poor hygiene. Good bathing and clean linens keep infection away from surgical sites.
Basic care-bathing, changing linens, taking vital signs and acting when the vital signs indicate change for the worse-are key to good nursing care. It's better to prevent infection that to treat it and less expensive for the facility. Think about it.
The bed and bath teams that many home health/hospice care companies have seem to be pretty dang efficient. Even many of our traditionally cheapskate third party payers reimburse outpatient B&B teams with minimal pushback. Hospitals have dedicated IV teams, phlebotomy teams, rapid response teams etc etc..... maybe the time has come where something like an inpatient bed and bath team should be considered. If you did that , it might hold individuals more accountable for their work, minimize the "disappearing acts" and decrease the likelihood of patient's ending up with pneumonia.
Here's one idea: when I have been REALLY pushed for time, or when the patient's shared bathrooms have been chockers (full up), I've said to patients will you wash here at the bedside? So I get a big bowl of warm water, clothes and towels, and one towel to stand on. The patients are usually happy when I explain I am getting behind with showers, and I get another bowl so they can brush their teeth etc. They sometimes grab a comb as well, dip that in the water first and do their hair. Most people don't want to wash their hair I find cos they are too ill and don't care about it.
I've always wondered why people just can't shower in the afternoon when there is double staff on around handover. Why do all showers all have to be done in the mornings, which are frantically busy? I mean, you can give people a washcloth to do their face and hands before breakfast, but hospitals are just so rigid when it comes to bathing at certain times.
:twocents:
SammiJoRNBSN
49 Posts
I agree with most of the posts here as well...even though you may not have time, if you can help the patient feel a little more comfortable by taking 5 minutes out of your day to help them at least clean up, it really does make a world of difference to them.