Do you have time to give baths?

Nurses General Nursing

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Hi,

I usually have 4 patients and rarely have time to give baths. If they're a walker-talker. Its easy to get them to the shower. I give partial baths to total care patients if they're soiled but just don't have time to give baths/change linen (especially with so much charting to do!). Any one else have this problems?

Specializes in Medicine.

Where I work we have no help or CNA's, 5 patients (mostly fully dependent) and I give full baths plus everything else hectic that goes on but that's probably why i'm exhausted at the end of every shift. Bath time allows me to do my full assessments and gives me time to spend with them since I'll never get a chance unless it's educating them.

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Specializes in MICU/SICU/CVICU.

I'm a night-shifter in mid-level acuity ICU with no CNA's. We have to do nightly baths on all our patients, every night. Day shift on my unit is pretty good about cleaning up the patients during the day if they're getting really gnarly, but usually the spa treatments fall to us. While I don't mind doing it because I feel it's an important part of their care (especially our vented/sedated patients), it's still physically very hard on me to do every night. In addition, we have no turn teams or such to help, so every nurse has to help their neighbor when it comes time to turn and change linens. Many of our patients (at least 1/3 to 1/2) are morbidly obese and require multiple people to turn. Factor in these people being on lactulose (we get A LOT of cirrhosis patients), and I'm essentially bathing/turning at least 4 times (twice for my 2 and twice for my neighbor's) a night, usually more if everyone is pooping. No wonder I'm 29 and my back and knees are KILLING me.

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I'm an RN in a hospital. All of the above mentioned are the responsibilities of a nurse. Nursing assistants are there to help us with our responsibilities. That being said, I find it interesting that you asked if I worked in a nursing home because I've found that nurses in nursing homes don't do any ADLs.

Well, I asked because although I work in a hospital and the ADLs are the ultimate responsibility of the nurse (with the help of the CNA) the nurses don't really do any of them - ever - in the hospital where I work. Even if the CNAs are running around like chickens with their heads cut off - the nurses will chill out at the station, take lunch breaks (hours before the CNA even if the clock in time was the same, which it is), and even wait for a CNA to pass by in the midst of their chaos to ask them to take a patient some ice.

I've never worked in a nursing home, but I'd assume that hospitals have more money (which would mean more employees) so I figured you might work at a nursing home if you're helping with ADLs bc I've never seen nurses do them where I work - a hospital. I don't think they'd even know HOW if their life depended on it.

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The difference between a total bath and a partial bath is a very small time investment that reaps huge benefits to your patients.

As far as walky-talkies go, I'm not sure I follow what you mean. In my book if somebody is a walky-talky but can't get in the shower then the most they need is to be set up for a self sponge bath. That takes all of 5 minutes to set them up with the basin, soap, and tooth brush.

I guess I disagree with you on two points:

1. It doesn't take that much time

2. Daily bathing should be a top priority, something that "has" to be done and time allot for. Not something that may or may not get done that day.

If you are genuinely too busy to do baths on your shift then another shift should do them.

Isn't daily bathing and ADLs a Jcaho standard for acute care? Helps prevent infection when done properly.

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Wow, that's sad. Every patient deserves basic care, whether they're in acute care or a SNF.

well, i'm not saying they don't get basic care - i'm just saying that MOST RN's won't perform basic care. the CNA's have to do it. if the CNA's can't do it for whatever reason (short staffed, etc) then it usually isn't going to be done because thats the "CNAs job."

nurses often forget that CNAs are there to ASSIST and get caught up in the "my job/your job" mentality.

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Specializes in Med-Surg Nursing.

I used to be a CNA in an LTC before becoming an RN. I was abused by the nurses on a daily basis...they would all tell me how they can't lift because they had a bad back...so because of that I NOW have a bad back. I'd have to lift 150lb dead weight LOL's all by myself. So I know how overworked most CNA's are. I would never ask my aide to do something that I couldn't do myself...but it's called delegating. The CNA can take a set of vitals for me, check a blood sugar...give a bath....they cannot do my charting for me, pass my meds, call the Dr's.

When I worked LTC...the residents got showered twice a week...once on day shift and once on evening shift. In between they got the PTA bath(Pits, t*ts and A**). Elderly people do NOT need bathed every day..it's drying to their skin.

After I graduated and passed NCLEX-RN, there was no nursing shortage...so I didn't have a hospital job but still worked as a CNA in that LTC. They paid me the MAX they could pay a CNA which back in 1997 was $10/hr!! When I got hired as an RN perdiem at a local hospital a few months later...I was only making a few dollars more than that....sad, huh? I've always thought CNA's were underpaid...that's why there is always a demand for them. It's a good experience to get if you are contemplating nursing school.

I actually think that ALL RN and LPN candidates be required to work as a CNA prior to being accepted into nursing school!!

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Specializes in Med-Surg Nursing.
I'm a night-shifter in mid-level acuity ICU with no CNA's. We have to do nightly baths on all our patients, every night. Day shift on my unit is pretty good about cleaning up the patients during the day if they're getting really gnarly, but usually the spa treatments fall to us. While I don't mind doing it because I feel it's an important part of their care (especially our vented/sedated patients), it's still physically very hard on me to do every night. In addition, we have no turn teams or such to help, so every nurse has to help their neighbor when it comes time to turn and change linens. Many of our patients (at least 1/3 to 1/2) are morbidly obese and require multiple people to turn. Factor in these people being on lactulose (we get A LOT of cirrhosis patients), and I'm essentially bathing/turning at least 4 times (twice for my 2 and twice for my neighbor's) a night, usually more if everyone is pooping. No wonder I'm 29 and my back and knees are KILLING me.

I worked in an ICU where there were no aides at all....Days bathed half of the patients and nights did the other half....the vents were split up between the two shifts...all shifts were 12 hr shifts...we worked in teams....after labs and am CXR's were done....we'd go in and just start bathing...as a team it took less than 45 minutes..of course we never had to do more than 4 baths...it was usually less than that.

I don't think that ALL of the baths should ALWAYS fall to night shift because it's "less busy"!! Not where I work! Not when I'm respiratory and houskeeping! And night shift usually has to perform 24 hour chart check to make sure all the orders written on a pt in the last 24 hours were carried out! That takes time too! I've had my share of running a pt down to CT in the middle of the night.

Day shifters automatically think their shift is so much busier than night shift...not necessarily. There is usually less staff in the building. So if you have a 600lb pt to turn...it takes a while to get 4 other people from 4 other depts down to ICU to help turn said pt.

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Specializes in Med-Surg Nursing.
2. Daily bathing should be a top priority, something that "has" to be done and time allot for. Not something that may or may not get done that day.

No, I disagree with you. When I am the only RN in an ICU for up to three patients,bathing is NOT a priority. Titrating vasoactive drips, giving blood, weaning pt's from ventilators, entering orders in the computer because we do not have a unit secretary nevermind an Aide, passing medications, administering pain meds, reporting abnormal lab values to the Dr.....THOSE are priorities!!

Then I have to chart all the care I did get to give to my patients. My day shift coworkers LOVE to skip bathing...honestly, I think most patients SHOULD be bathed on days(with the exception of sedated/ventilated pt's so long as said pt is stable).

I don't know about JCAHO requirements because the facility I work for is not JCAHO certified...we are AOA certified.

Backatit...if you are so busy NOT doing ADLs because it's the nurses responsibility then what ARE you so busy doing? Any hospital I've ever worked at, that was the primary responsibility of the CNA? Being an assistant to the nurse, is to help him or her with the things that the CNA can do, like vitals, blood sugars, ADL's...if I have to do that PLUS my other duties, like passing meds, charting, calling Dr's....I'd NEVER get done with my duties!

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I used to be a CNA in an LTC before becoming an RN. I was abused by the nurses on a daily basis...they would all tell me how they can't lift because they had a bad back...so because of that I NOW have a bad back. I'd have to lift 150lb dead weight LOL's all by myself. So I know how overworked most CNA's are. I would never ask my aide to do something that I couldn't do myself...but it's called delegating. The CNA can take a set of vitals for me, check a blood sugar...give a bath....they cannot do my charting for me, pass my meds, call the Dr's.

When I worked LTC...the residents got showered twice a week...once on day shift and once on evening shift. In between they got the PTA bath(Pits, t*ts and A**). Elderly people do NOT need bathed every day..it's drying to their skin.

After I graduated and passed NCLEX-RN, there was no nursing shortage...so I didn't have a hospital job but still worked as a CNA in that LTC. They paid me the MAX they could pay a CNA which back in 1997 was $10/hr!! When I got hired as an RN perdiem at a local hospital a few months later...I was only making a few dollars more than that....sad, huh? I've always thought CNA's were underpaid...that's why there is always a demand for them. It's a good experience to get if you are contemplating nursing school.

I actually think that ALL RN and LPN candidates be required to work as a CNA prior to being accepted into nursing school!!

just so you know - you were getting paid a lot more as a CNA in 1997 than i make NOW - 15 years later.

albeit, nurses are paid very little where i live compared to other parts of the country. i have a bachelor's degree in another field and i'm looking forward to making $18 an hour when i get my RN BSN which by the time i finish will be 6.5 years of college for me (and two degrees - three is you count my associates).

i see you said you were a CNA abused by the nurses. what's funny is i think nurses "abuse" CNAs because they think they are superior - specifically in terms of education. i internally find it humorous when a LPN who went to college for a whole year doesn't realize that i'm more educated than her, but i can tell by how slow she talks that she thinks i'm stupid. lol. sometimes i want to say, "i have a bachelors degree from ______ - where did you go to school?" lol.

seriously, there are a few nurses (very few) who WORK even if it isn't "their job" with "their job" meaning they can put it off on someone else even if they aren't busy - but for the most part, CNAs are treated like crap. i fully expected this when my educated ass took on the role of a CNA, but it was still an eye opener. i think i will be a much better nurse and co-worker (as i'm sure you are) by gaining experience as a CNA first. just know that CNAs appreciate you and the time you spent wasn't in vain.

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No, I disagree with you. When I am the only RN in an ICU for up to three patients,bathing is NOT a priority. Titrating vasoactive drips, giving blood, weaning pt's from ventilators, entering orders in the computer because we do not have a unit secretary nevermind an Aide, passing medications, administering pain meds, reporting abnormal lab values to the Dr.....THOSE are priorities!!

I don't disagree that it is something that can be further down on the totem pole than the things you mentioned, and on nights when you're the only RN then sure I can see that. But I do think it should be something that should be done more often than naught. At some point the pts need to be bathed, period. If that means that the day shift needs to stay an extra fifteen minutes and team bath some people with the night shift, and viceversa then so be it.

I totally understand what you're saying, but I also think that it needs to be worked into the schedule somehow. A pt not getting a bath in a 24 hour period should be a variance and not the norm.

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Backatit...if you are so busy NOT doing ADLs because it's the nurses responsibility then what ARE you so busy doing? Any hospital I've ever worked at, that was the primary responsibility of the CNA? Being an assistant to the nurse, is to help him or her with the things that the CNA can do, like vitals, blood sugars, ADL's...if I have to do that PLUS my other duties, like passing meds, charting, calling Dr's....I'd NEVER get done with my duties!

wait, when did i say i'm so busy NOT doing ADLs because it's the nurse's responsibility? i said:

"I'm surprised because although I work in a hospital and the ADLs are the ultimate responsibility of the nurse (with the help of the CNA) the nurses don't really do any of them - ever - in the hospital where I work. Even if the CNAs are running around like chickens with their heads cut off - the nurses will chill out at the station, take lunch breaks (hours before the CNA even if the clock in time was the same, which it is), and even wait for a CNA to pass by in the midst of their chaos to ask them to take a patient some ice."

i also said:

"I've never worked in a nursing home, but I'd assume that hospitals have more money (which would mean more employees) so I figured you might work at a nursing home if you're helping with ADLs bc I've never seen nurses do them where I work - a hospital. I don't think they'd even know HOW if their life depended on it."

that phrase was in RESPONSE TO:

me asking the question,

"do you work in a hospital or LTC? i work in a hospital and our RNs would laugh if they were asked to do any of the above mentioned."

and APRIL
RN
answered my question by saying:

"I'm an RN in a hospital. All of the above mentioned are the responsibilities of a nurse. Nursing assistants are there to help us with our responsibilities. That being said, I find it interesting that you asked if I worked in a nursing home because I've found that nurses in nursing homes don't do any ADLs."

Therefore, if you could read and comprehend, you would know that I was SURPRISED by the fact that a RN did ADLs because where I work most nurses (and I'm certain you'd be one of them) would NEVER be capable of doing such a thing as giving a patient something to drink or god forbid taking them to the bathroom - which is why I was surprised that this particular NURSE (April) did her own ADLs for her patients.

by the way - i applaud you, april. i know it's hard work to do those things on top of your regular duties.

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Specializes in Med-Surg Nursing.
just so you know - you were getting paid a lot more as a CNA in 1997 than i make NOW - 15 years later.

albeit, nurses are paid very little where i live compared to other parts of the country. i have a bachelor's degree in another field and i'm looking forward to making $18 an hour when i get my RN BSN which by the time i finish will be 6.5 years of college for me (and two degrees - three is you count my associates).

i see you said you were a CNA abused by the nurses. what's funny is i think nurses "abuse" CNAs because they think they are superior - specifically in terms of education. i internally find it humorous when a LPN who went to college for a whole year doesn't realize that i'm more educated than her, but i can tell by how slow she talks that she thinks i'm stupid. lol. sometimes i want to say, "i have a bachelors degree from ______ - where did you go to school?" lol.

When I was making that $10/hr, I already had passed my NCLEX-RN and was a full fledged RN but working as a CNA because that's the job that was available to me at the time. That was the MAX rate my LTC could pay me in the CNA role because I was really an RN but they didn't have a position available for me at the time.

In most cases, Nurses ARE superior to CNA's as far as education goes. We are LICENSED to do what we do. A CNA is not...there is a BIG difference between a license and a certification!!! If a pt is going to sue who are they gonna sue...not the CNA who might've screwed up...but ME, the RN with the LICENSE!!! BIG DIFFERENCE!

Backatit..you are an enigma in that yes you ARE more educated than the nurses you work with. You are the exception, not the norm...you seem bitter that you aren't using those 3 or 4 degrees you already have. The thing is...none of those degrees are in nursing...not yet anyways. SO yeah while you may have a bachelors in art therapy/mechanical engineering/photography, they aren't nursing degrees.

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