I'm in my first semester of a 2 year Diploma/ASN program, and we've been doing clinicals on a med-surg floor. Our instructors place large importance on the psycho-social aspects of care, especially making sure that comfort measures and provided like a bed-bath, linen change, oral care, etc. I don't mind doing these tasks at all, but sometimes trying to convince the patient to agree to these this is exasperating and I feel takes time away from when I could be taking vitals, doing an assessment, or giving meds. Everybody I've talked to tells me that when you're really working as a nurse, CNA's are the ones who do bed baths, linen changes, and putting patients on the bedpan, not the RN's. Last week my instructor said she was "embarassed" that I wasn't able to convince my patient to let me bathe him when he insisted more that I wait to do it until after he had a bowel movement (which he didn't have until I went off the floor). I want to reiterate that I am not lazy and I'm happy to do these tasks, the only problem is that I'm afraid of getting poor marks in clinical because of issues with tasks that it sounds like I won't even be doing as an RN. And we're going to be responsible for the baths/bed making/etc. next semester as well. Is this just the typical way clinical is done in school? Any advice?
I've been thinking about it all last night and this morning, and I think I just didn't fully realize how important it was, but I do now. I have no doubt that I have what it takes, and the importance of these tasks will be at the front of my mind at every clinical day next semester and beyond. I feel like I've been pounced on a little for this, but I can guarantee that my original post was more a result of "deficient knowledge" and listening to heresay than any kind of whining or distaste at particular tasks.
I was there also. At some point, for most, it becomes a aha moment. Thanks to some night CNAs I was able to really improve my ADL skills and am very glad for it.
And again it is a skill that is not always easy to perform. I have watched others and asked for advice. Like I said, if you have problems, bring it up early to your instructor or even other experienced students. "What do you advise, or how should I approach this person."
Good luck, sounds like you have a good head on your shoulders and will do fine. Just so you know what you are experiencing is not unique.
I am being taught that cleaning a patient/ changing the bed is a veyr important task it nursing.... its not nursing assistant work. If you think about it.... when you give your patient a bed bath... you can pretty much complete your head to toe assessment at the same time! For the phsyco-social aspect.... I find it really hard when I (as a student) are learning new skills every day and thinking about what I have to do that..... but the person emotional needs are so important to their health and healing! Depression etc. needs just as much medical attention as an infected hip replacement.
Its hard, and someof it is gross (like changeing the bed pan) but I absolultly hate it when my fellow nursing students are like "OH yaa went the whole term without touching poop". Umm... its a part of life and a nurse should attend to a patients needs no matter what it is!
Maybe ask the patient when they normally bathe. Maybe he is the type that likes to do his hygiene at night and that is his routine. So doing the bed bath may have been more of an inconvience than help in his mind. Who knows. However, yes there are going to be CNAs to help us but how do you expect to ask a CNA that will be working with you to do something you have no experience with? We are all taught the basics in the beginning of nursing school and these basics (bed bath, making a bed, feeding, transfers, ect) are what the CNAs are taught in school.
Nah, I don't think you were pounced on as much as people just really wanting to stress that yeah, we still do these things as RNs (no matter what anyone tells you about CNAs). And it is a marvelous opportunity to assess more than just a dressing or wound.
However, having your instructor get after you for not convincing an a&o adult to bathe on her schedule is unreasonable. I have been the patient, and I'll danged well bathe when I feel like it. As nurses we manipulate people nonstop to get them to do what we think is best for them (which of course it is, being the infallable angels of mercy that we are ). Save the manipulation for things that really matter, like doing that deep breath and cough, and mobilizing after surgery. Don't sweat the small stuff; if I am capable of bathing myself, give me the towels and what little control I have left as a patient.
I have a fair amount of experience bathing, feeding, changing beds, working with bedpans/urinals, and I know I'll get much more as the semesters go by. We all have experience with these things by the end of our first semester, right? I didn't mean to give the false impression that I'd never given a bath before. It was only an issue this one particular time with this one particular patient and the instructor picked up on it. If anybody said they got through a semester without ever needing to give a bath or work with poop (as someone said), I'd think they weren't really in nursing school.
from my experience, yes, you will still be doing baths, linen changes, etc. as an RN. as others posted ahead of me, you may not always have a CNA working on the floor. so guess who has to do the bedpans for your patients? you!
i think it's important you to realize that tasks such as bed baths, etc. are taught in nursing fundamentals 101 (or whatever your school calls it) because they are the foundation of your nursing practice! think about it..giving a pt a bath helps you perform a thorough skin assessment (any pressure sores? breakdown? bruising? how does that wound dressing look?). turning a pt. in bed can give you a chance to listen to their lungs (are they clear? is he taking full breaths?). assisting w/ toileting can give you an understanding of the pt's elimination patterns (is he constipated? when was his last BM? does he need some colace? what do his stools look like?).
sometimes we only have 1 CNA on our floor. our floor holds 30 pts. so if we have a full house, i try to help out our CNA w/ doing any of the cares for my patients myself. the other day, i had 5 patients on my load, 1 was total and 1 was partial assist. the other 3 were self care. of course i did those 2 cares myself bc i knew my CNA was busy with 25 other pts! i think it's important to take care of your CNAs and help them out whenever you can..b/c one day you'll need them to return the favor :)
don't become that nurse who think she's above helping a pt off the bedpan! you don't want to give yourself that kind of rep!
All patients have a right to deny any type of care. You must document the refusal, however. Your professor should be shamed for making you think you HAVE to make your patient accept any care you offer.
Thanks to some night CNAs I was able to really improve my ADL skills and am very glad for it.
). Save the manipulation for things that really matter, like doing that deep breath and cough, and mobilizing after surgery. Don't sweat the small stuff; if I am capable of bathing myself, give me the towels and what little control I have left as a patient.
anon695
267 Posts
I've been thinking about it all last night and this morning, and I think I just didn't fully realize how important it was, but I do now. I have no doubt that I have what it takes, and the importance of these tasks will be at the front of my mind at every clinical day next semester and beyond. I feel like I've been pounced on a little for this, but I can guarantee that my original post was more a result of "deficient knowledge" and listening to heresay than any kind of whining or distaste at particular tasks.