Did you get their bath done? Seriously?

carolmaccas66, BSN, RN · Mar 23, 2011

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 !!

So true! When I was a student, I worked with a CN who always harped on re the importance of getting the creases out of bedsheets. TBH I used to think she was a bit of a cow, I used to think how important can it be? She explained one day re bedsores and showed me how it leaves creases in the patient's skin. I wonder if new nurses are taught this in nursing school? Then we gave this bed bound lady a big back wash and rub.

But I do agree with other posters when you have extra patients or some who are critically ill, you just don't have time for this stuff. I always try to make time - I used to always go in half an hour earlier for my shift and have hardly ever left on time, just so I could do the little things that matter or get my charting finished in a comprehensive manner. But now I'm tired of doing that, I don't think anyone in management appreciates it except perhaps the patients - and even then they're not always thankful - they just say 'Well, that's your job isn't it?'

CapeCodMermaid, RN · Mar 23, 2011

I've been on both sides of the bed pan, so to speak. I work in subacute/skilled nursing. We have 20 patients each or more. Our CNAs are expected to do bed baths twice a day and showers once a week. They have 10 or more patients each. One little old lady asked me one day, 'Honey, do you take 2 baths a day? They want me to get washed twice a day and all I do is sit here!' Everyone sees this from a different angle.

I've been a patient on a med surg floor 3 times in the past 2 years. Two different hospitals. At neither hospital was I offered help with bathing. At one hospital, the nurse literally threw a face cloth and towel at me and said 'There'. At the other, at least they gave me a wash basin, but it was empty and left on the other side of the room. These nurses had 5 or 6 patients each and I was the sickest one.

nick adams · Mar 23, 2011

Hits home. I had a very unstable, difficult, ICU, patient last night. Finally she started to turn around. In handoff report the oncoming nurse literally started asking about the patients car. "She's 90 and going to leave in a few days. Do you EVEN KNOW if she drives?WHAT she drives? Do you know if it's been washed? If she drives out of here and plows into a minivan killing a family THAT'S ON YOU!

chevyv, BSN, RN · Mar 23, 2011

I was a pt for a couple of weeks and I have to tell you all that I really just wanted my pain to go away, someone to empty my bed pan, and the occasional sticking your head in the door to make sure I was still breathing. Other than that, I wanted to be left alone. Perhaps it was the nurse in me that made me want to do as much as possible for myself, but nobody was going to bathe me. I took a few pta baths and even managed a safety razor to my uninjured limb.

The hospital was so busy and I just wanted to heal enough to get home and really heal. We come in sicker and leave sicker than we used to. As a nurse, I do the very best that I can with the staff that I have. Sometimes I'm very happy when I go home and no codes were called. Other times I'm happy that I actually had the time to give a hug to someone in need. I have the best coworkers who know how to work as a team. I know how to thank everyone at the end of the shift for their hard work, and really mean it. Management tells us no ot so I need to have my charting done. Unfortunately, that means I have less time on the floor. I've learned to delegate what I can and dive in when I can as well. It's never easy, but it's also never boring.

enchantmentdis, BSN, RN · Mar 23, 2011

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.

Right. And there is no way i will lose my job because of poor documentation because i spent all my time doing a CNAs job. If i wanted to be a CNA i would have stayed one. The occasional bath during the day is fine but bathing 4-6 when you have no assistants or lazy assistants, well, time to find a job where you don't have to be a glorified nursing assistant. It's a shame it took me nearly 15 years to realize it was never going to change in the big hospitals. Hospice is great! No baths, no CNAs, no pills to choke down the patients, and management not pestering you over documentation and requesting you kiss the orifice of impudent family members... Would rather put my arm in a meat grinder than return to acute care.

General E. Speaking, RN, RN · Mar 23, 2011

I'm in ICU now. Some days the patient is too sick to even think about bathing. Too busy just trying to keep their b/p up. On the less hectic days, I will do all that I can do to clean my patient by myself- face, trunk, front of peri- area, legs. I have all the supplies ready (linens, water, etc...) We do not have CNAs so when I'm finished, I will call the charge nurse, co-worker nurse or secretary in to help me turn so I can do the back, bottom and sheets. Most of my patients are on a vent, so Q4 hr mouth care is standard.

Floor nursing was different. I usually prioritized the bed bound ones to get a bath. On the days that I had numerous bed bound patients, I chose the ones who were more "ripe" than others. Usually, they had incontinence issues anyway so scrubbing a few more areas wasn't a big stretch. I would try and squeeze in helping the walkie-talkies in between.

I think that if every single day you go to work, you are unable to help the patients with at least some basic hygiene, it is a management/staffing issue.

It is hard to get everything done. We are our own worst enemy. We should be supporting each other, not nurse-bashing.