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.
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!
Well, all the other nurses had got the patients out of bed, and I tell you, the RN I was with - she was SO FAST! I have never seen anyone make beds like that - and we had mitred corners then as well (my old hospitals had sheets with elastic around them). I believe it was about 10-15 minutes, cos I rememeber we just raced around that ward like you wouldn't believe - I was out of breath! She said if we took more than 10 minutes, we were TOO SLOW. Plus we top and tailed some of the beds, and you can make a bed like that in about 10 seconds flat if you have 2 people. And all the sheets are pre-folded - makes them easy to whip onto the bed and get tucked in.
Maybe it was only 50 beds, but I remember it was a huge ward and it was full at the time. Also I wondered if she had been in the army at all - cos she was VERY efficient indeed. There is something to be said for the old style of nursing I must say. This was a long time ago as well - about 25 years or so, so I suppose speed isn't seen as a priority now.
I remember working with a nurse who was trying to lose weight to get back into the army. She told me you HAVE to be efficient in the army what with packing stuff up and maneouvres etc, and making beds fast was one of the skills. She told me if the bed wasn't made in so many seconds, it had to be stripped and re-made until the major nursing officer was satisfied - and that might be 10 times over or more!
I miss those days actually, we seemed to work harder but there was more camraderie
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I used think the old nurses were a little daft wanting to do a full bed bath on every single patient every day - especially the elderly - those no rinse soap/shampoo solutions or just warm water with a couple of squirts of lotion in the areas of need would be the minimum and those that cansdoes!! I keep reading about ambulatory patients who want the nurse to wash their pits etc. . .
Wise Woman RN you sound like somebody I would love to work with. :)
What is scary is that we are now not given bath basins anymore. We have to use premoistened wipes in a bag. Due to 'infection control issues.' Gross. Give me soap and water and all will be happy. I mean have you ever gone home to not a shower, wash cloth and a bar of soap but a wet wipe? seriously.
Also yes med - surg is certainly busy. You say you are 'in the trenches' but we are ALL in the trenches. Try having 7 or 8 patients. I am not trying to one up the OP but to make it sound like your job is the hardest job in nursing is naive. Sorry. I know what you meant but it rubbed me the wrong way.
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.
i just wanted to re-hilite what you said. "workhorses of the hospital...no one can argue with that....we're in the trenches..." wasn't sure if i remembered it quite right in the previous post, but here it is. so i guess i am the one 'arguing with that.'
What is scary is that we are now not given bath basins anymore. We have to use premoistened wipes in a bag. Due to 'infection control issues.' Gross. Give me soap and water and all will be happy. I mean have you ever gone home to not a shower, wash cloth and a bar of soap but a wet wipe? seriously.
Also yes med - surg is certainly busy. You say you are 'in the trenches' but we are ALL in the trenches. Try having 7 or 8 patients. I am not trying to one up the OP but to make it sound like your job is the hardest job in nursing is naive. Sorry. I know what you meant but it rubbed me the wrong way.
Try looking after 65 patients like I had to one night! It was an absolute NIGHTMARE. Never went back to that facility! (and before you start going on about it, yes I did have some carers to help me but NO Enrolled Nurse - the EN just decided not to turn up that night!)
I don't like those wipes either. How can that replace lovely warm, soapy water and a nice, fluffly facecloth and a nice towel? Only good thing is for Aussieland is that they DO save us water in our drought.
What is scary is that we are now not given bath basins anymore. We have to use premoistened wipes in a bag. Due to 'infection control issues.' Gross. Give me soap and water and all will be happy. I mean have you ever gone home to not a shower, wash cloth and a bar of soap but a wet wipe? seriously.
I HATE those dang wipes and I won't use them unless I have NO choice!
I am new to allnurses.com and registered also just to reply to this post. I too am a new graduate, and I see this OP as venting about her unit issues. Honestly you need to do something about the condition of your unit before you burn yourself out. Yes you have to get charting, etc done, but you also have to think about your own health in order to care for your patients, if you're feeling this overwhelmed after a year I can only imagine you after 10. Please do something now. I do also agree that you're a great nurse doing the best for your patients and that is your priority is your patients and I know you would do that bed bath or linen changes if needed. Good luck! :redbeathe
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.
After reading many of the posts here after mine about someone "needing a vacation"...I think I finally get it! The OP was upset because she was doing her best to get it all done...and still couldn't. I totally understand and empathize. There is no answer to the original post. Every day in nursing is different. Most days are extremely busy and occasionally (very rarely!) we have a day where everything gets done on time and we all go home when the shift ends. There is NO way to get it all done everyday. So the answer is....there is no answer. It depends on the facility, the staffing, the patients' condition, blah, blah, blah...
I think we would all agree on a few issues:
1. Bathing and clean linen has a purpose...it can make a patient feel like a human being again, and prevent infection.
2. Staffing has gotten worse in most (if not all) facilities due to the economy.
3. We all want to give excellent, professional, compassionate care.
4. We just can't do it all everyday...even though we want to.
Let's act like the professionals we are and quit bashing each other. (Threads like this drive me nuts!!!):smokin:
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.
Who knows where we are headed? And yes, at some point, something's going to give.
You're too young to know this, but believe it or not, what you are suggesting is actually how it used to be with TV's. TV's were in all the hospital rooms but you had to pay to turn them on. Anyone else remember the TV ladies that came by every day to collect money from the patients? I think she was known as the Sylvania lady. That's going waaaay back :)
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.
honey...you need to chill.
my post wasn't directed at you specifically, but at the state of nursing today.
you're right...i haven't worked at a facility where expecting to be cleaned up, is a luxury.
but i certainly have been stressed to the max, barely being able to take care of 2 (dying) pts...never mind 5.
for ME, cleaning a pt is just as much priority as any other nsg task.
perhaps it's r/t the population i work with (hospice), but i've always considered basic hygiene, nsg 101...and giving pts the best environment to recover in.
TV's were in all the hospital rooms but you had to pay to turn them on. Anyone else remember the TV ladies that came by every day to collect money from the patients? I think she was known as the Sylvania lady. That's going waaaay back :)
I remember it from being hospitalized in the mid-70s, and from Harper Hospital in Detroit in 2006! Only difference between the two was how payment was collected -- cash for the TV Lady then, and credit card over the phone now.
I probably didn't bathe anyone the last several years of my bedside nursing career. There just wasn't time. No, we didn't have secretary, techs or CNAs. It was a critical care unit and I'd frequently have 3 critical patients on my own, and also be responsible for 10-12 tele pts. If I had had the time, I'd have done it, no problem. I assume they got a bath on med-surg or at the funeral home.
:smokin:
carolmaccas66, BSN, RN
2,212 Posts
Well, all the other nurses had got the patients out of bed, and I tell you, the RN I was with - she was SO FAST! I have never seen anyone make beds like that - and we had mitred corners then as well (my old hospitals had sheets with elastic around them). I believe it was about 10-15 minutes, cos I rememeber we just raced around that ward like you wouldn't believe - I was out of breath! She said if we took more than 10 minutes, we were TOO SLOW. Plus we top and tailed some of the beds, and you can make a bed like that in about 10 seconds flat if you have 2 people. And all the sheets are pre-folded - makes them easy to whip onto the bed and get tucked in.
Maybe it was only 50 beds, but I remember it was a huge ward and it was full at the time. Also I wondered if she had been in the army at all - cos she was VERY efficient indeed. There is something to be said for the old style of nursing I must say. This was a long time ago as well - about 25 years or so, so I suppose speed isn't seen as a priority now.
I remember working with a nurse who was trying to lose weight to get back into the army. She told me you HAVE to be efficient in the army what with packing stuff up and maneouvres etc, and making beds fast was one of the skills. She told me if the bed wasn't made in so many seconds, it had to be stripped and re-made until the major nursing officer was satisfied - and that might be 10 times over or more!
I miss those days actually, we seemed to work harder but there was more camraderie