Ethical/Legal Question!

[paris2]

We had a patient the other day, he looked quite dirty and was smelling. Not had bath or wash for days.

Nurses asked him numerous time to have a bath/shower but patient refused even after giving explanation that it is important for him to have bath before surgery. He said he is ok. But this was not fair on other patients who were in same room.

My question is, forcing patient to have a bath is an assualt?

[suzanne4, RN]

The surgeon would have every right to refuse to operate on this patient as he did not follow protocol, as well as orders to have a shower before his procedure. And if not clean, that usually means a bad outcome from the surgery. At extremely high risk for infection and full-blown sepsis.

Can you force someone to shower? No, but if the surgical team will not operate on the patient, then they are free to leave the facility. Remember that no one is holding them there against their will.

Things are easier to understand for the patient when they have it explained to them like that.

A mental health evaluation should also be required for a patient like this.

[XB9S, BSN, MSN, EdD, RN, APN]

Paris we had a situation just like this last month, as a managment team we sent this patient home as unfit for surgery because of the infection risk. TO be honest the smell was really unpleasant and the other patients in teh 4 bedder complained about it but he would not have a pre-op bath so we explained what would happen, he still refused so he was discharged as unfit with a recall to the out patient clinic to discuss it with the surgeon. THis was a nursing managment decision we didn't even involve the consultant just the juniors and directorate managment

[english_nurse]

we sometimes encounter this problem on medical wards especially wit patients who are abusing drugs or drink.

When they are in the very confused state of early withdrawal sometimes it is easier to 'persuade' someone to have a wash and get changed by gently guiding them to the bathroom and 'helping' them out of their clothes however you have to get the timing right :roll

I would have thought that many things we do in nursing are probably on a fine line between assault, for example, sedating an aggressive patient, with the assistance of the hospital porters, i know its for the safety of all concerned but, it doesnt mean i dont feel like a ***** after ive done it.

With regards to surgery, the surgeon is right, after all it puts other patients at risk of infection too not just the patient to be operated on, plus its not nice for the other patients, trouble is, cancellations mean money wasted, maybe patients should be informed in the booking letter that they need to be reasonably clean when they come to hospital?

[karenG]

In the bad old days.. we just bathed them! I remember bathing patients who protested at being bathed.. the consultants would refuse to see the patient until they were clean..

scary really though i remember finding a woman with fungating breast ca.. she didnt want to be bathed because she knew we would find it.. and she was scared what it was. Another lady took 3 baths to get clean.. ugh. she was lovely.. eventually.

and another lady of 65 told me in no uncertain terms that she would tell her mother that i bathed her and her mother would tell me off. I remember saying yes, you tell your mother.......... and her mother did indeed visit and did tell me off.. the mother was nearly 90!!

now.. guess its different.

dont suppose you have the fun of undressing patients and watching the maggots drop to the floor because they have an open wound infested with maggots......

Karen

[english_nurse]

i found maggotts in a belly button once and it wasnt that long ago!

eww