Do you have time to give baths?

Nurses General Nursing

Published

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?

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.

furthermore, i was referring to the dynamic where i work where nurses are OFTEN found sitting around doing NOTHING and will spend more time looking for a CNA than it would've taken them to answer a call light. unless you're a nurse who would do such a thing, my comment shouldn't offend you.

0 Votes

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

Not jcaho certified? Well if anything this thread has made me appreciate the value of being JCAHO certified and that it can have direct impact on the kind of basic care a hospital provides. I appreciate this new appreciation :yeah:.

0 Votes
Specializes in Med-Surg Nursing.
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 givin 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.

I have taken plenty of my own patients to the bathroom, filled their ice pitcher, etc....all those things that the nurses YOU work with are above. One hospital I worked at, the CNA's LOVED to work with me because I was one of the few RN's who did answer call bells, etc as the previous place I worked, we didn't have the luxury of a CNA so I did do it all myself. I am not one to pawn off work nor do I think I'm better than you because you are just a CNA.. I'm in my patients room A LOT and have no problem assisting her to the potty or getting her a warm blanket.

I take issue with you automatically assuming that I am another one of your lazy RN coworkers. Seems like you need to take their laziness up with your boss.

And I'm with you in that most nurses in a nursing home wouldn't be caught dead doing ADL's or helping the CNA's with the residents...the ones I worked with all had a bad back and couldn't help me lift Mrs Jones off the toilet but could tell me that Mr Smith needed to go to the bathroom......Poor Mr Smith had to wait because I'm just one person and the LPN was too lazy to help.

0 Votes
Specializes in Med-Surg Nursing.
Not jcaho certified? Well if anything this thread has made me appreciate the value of being JCAHO certified and that it can have direct impact on the kind of basic care a hospital provides. I appreciate this new appreciation .

Not all hospitals are JCAHO certified and sometimes NOT being JCAHO certified is not necessarily a bad thing.

I on the other hand am CCRN certified and I take great pride in that as I am one of two nurses in my entire hospital who IS certified in their area of specialty.

I also work straight night shift and most of the time, I leave the bath's for the day shift folks. Because IMHO, that's when the pt SHOULD be bathed .

Do you have a link where daily baths are a JCAHO requirement? If so, then a LOT of JCAHO nursing homes are in trouble!

0 Votes
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.

i realize they aren't nursing degrees and i'm reaaaally not "bitter." yes, it does tick me off that nurses think CNA's are "beneath" them just like it ticks me off that someone eating out would drop something on the floor and say, "oh well, they get paid to pick up trash."

there's a difference.

i'm working as a CNA because i WANT to - because i WANT to be there. i WANT to turn a patient - i WANT to experience a combative patient. i LIVE to help hold a patient when a nurse starts an IV or starts a catheter. at the same time, there are CNAs who have reached their height in life. that's where they are and they'll never go any further. nurses treat those CNAs like second class citizens. most of the nurses I work with don't treat me that way and there was an OBVIOUS change in the way they treated me once they knew I was a nursing student and that I was already educated.

just like you've expressed in this post - you think you are ABOVE a CNA because you went to school. don't assume, my friend. next time you meet a CNA, don't talk to them slowly or assume you are "better or smarter" than they. they might just have you fooled. don't assume that just because someone is a CNA and doesn't have their work done that it must be because they are "slow" and probably stupid. consider for a moment that they aren't finished because they were caring for patients PROPERLY and picking up your slack. if you're sitting on your butt and looking at google or taking a lunch break while your "assistant" is workng, that's an obvious sign that you've failed as a nurse.

just saying.

0 Votes
Not all hospitals are JCAHO certified and sometimes NOT being JCAHO certified is not necessarily a bad thing.

I on the other hand am CCRN certified and I take great pride in that as I am one of two nurses in my entire hospital who IS certified in their area of specialty.

I also work straight night shift and most of the time, I leave the bath's for the day shift folks. Because IMHO, that's when the pt SHOULD be bathed .

Do you have a link where daily baths are a JCAHO requirement? If so, then a LOT of JCAHO nursing homes are in trouble!

Hey don't take it personally, it's not your fault the hospital doesn't give you appropriate staffing! And I seriously mean that!

I tried to find a link but so much of joint commission stuff isn't available online it's only available on e-dition which isn't available for free.

I'm not sure when I heard this but my boss was telling and showing me about standards and the difference between hospital standards and LTC standards and the bathing thing was an example of a difference. In the hospitals the standard is daily bathing and in LTC the standard is 3 times a week or every other day. The rationale being that in the hospital infection control is at an increased importance but in an LTC you have to worry about things like elderly people having dry skin.

0 Votes

Well the rationale/EBP is that infection control > dry skin when hospitalized. I'm not currently qualified to go over the research and make an opinion on it but from my experience and what I do know the principle seems sound.

I know at my facility in the ICU we go above the standard and use chlorhexidine glutamate (chg) baths Q Daily as part of an on-going study to gather EBP on which cleaning method reduces MRSA infections. And then based on the results of that study we'll probably do whatever has the greatest cost/effectiveness ratio.

Your patients should be bathing regularly, anything less is not high quality care IMHO. It's pretty easy because most people will want to do it themselves or have a loved one do it, but even that should be assessed daily, IMHO.

Also your SIRs (sedated, intubated, and restrained) pts can be cleaned when you're doing your thorough skin assessment, which you'd be doing anyway.

Like I said before if it's not something that can be done during any one shift, there's that magic time between shifts when you have redundant staff. That's a great time for team efforts.

0 Votes

I work float, I'm a pct at a medium sized hospital.

When I work ortho most of those people can bathe themselves, except for the fresh fractures.

On medical it's a mix between selfs, assist, and totals. The guideline is that day shift does self and assist and night shift does the totals.

On the ICU there is more fluidity between when pts get baths, everybody helps out as much as they can. The most important thing to me though is that the pts look presentable during visiting hours. When they're clean it makes me feel good because it's a visible easy to see sign to the families that we do care and we're taking good care of their loved ones. We've been known to postpone visiting times as we scramble around cleaning people up.

I don't do L and D much because I'm a man, but I think most of their mommies can bathe themselves and the initial baby bath is used as a teaching experience.

The standard is similar for peds as everywhere else, but the parents usually help out a lot.

On the geriatric psyche ward the night shift does the bathing, they have a shower room they can bring the pts in and it makes it kind of easier. There's too much going on during days, meals, recreational therapy, social worker groups, family visits, etc. So bathing is done at night or very early morning still during the night shift.

0 Votes
Well when it's a choice between doing stat meds...entering those meds into the computer because pharmacy leaves at 8pm...calling those results to the Dr....bathing a pt takes a backseat to that.

Well sure but does that happen so often that it prevents you from bathing your pts on most days? I don't think anybody is saying that bathing is more important than those other things, I'm saying that baths should still happen some time someway. The fact that they happen daily should be somebody's responsibility, and I wholeheartedly believe that it's something worth staying late for.

The norm should be that the pts get bathed daily and the variance should be that they didn't get a bath. Sure there will be variances, it happens, but like I said that should be as rarely as humanly possible. IMHO.

0 Votes
Specializes in Med-Surg Nursing.

I don't work day shift so I can't speak for what they do or don't do. I believe that alert and oriented patients should be bathed on day shift.

0 Votes
I don't work day shift so I can't speak for what they do or don't do. I believe that alert and oriented patients should be bathed on day shift.

However that belief doesn't prevent you from giving a bath to a AAOx3 pt that didn't get one during day shift right?

You assess when they last had a bath and then ask if/when they want one and then do everything you can to make that happen? I'm sure you do that because, like you said, nursing is a 24 hour thing.

0 Votes
Specializes in Nephrology, Cardiology, ER, ICU.

Back to the topic at hand please - thanks.

0 Votes
+ Add a Comment