Ethics of patient bathing

[discontentment]

Could someone please help me with this delimna.

First and foremost, I want to start this off by saying.... I dont mind to bathe a patient. I quit one job and took another with a lower patient ratio in order to be able to bathe patients and provide better care for my patients on a daily basis. Herein lies the problem. In working one night recently, i had three patients (work on a icu stepdown unit), one patient was on bedrest till the mornining and didnt want to bathe until he could get up a poop on the commode, he wanted to bathe himself. Another was an 80 yo with PNE, HCAPS she was asked at MN replied it was too late, then asked again at 5 am, replied it was too early. It was explained to her that days may be too busy and would she like to go ahead and bathe now..... still the answer was no (mind you she had had xanax and sonata at 10p before i assumed her care and was quite sleepy) and another patient was a trauma patient, she was tachy, hypertensive, humerus broken in 3 places (not fixed yet) scaplula broken and orbital fractures, and t11-t12 fracture. she was asked multiple times, she was extremetly anxious, she didnt want to be touched, she had a 100% non rebreather on and would desat quickly without it.... wouldnt allow it to be put around her head, she had a washcloth holding it in place. she refused the multiple times she was asked.

all three of the patients were A/O X3, there were no overt signs of filth, infection or otherwise.

the problem? my nurse manager was asking coworkers today if they felt that the patients really felt that way about getting a bath .

I feel that it is unethical to force someone to bath when they do not want to...... AM I wrong???????

Please feel free to be honest.....

I am really perplexed at why you wouldnt just ask the patient if they had been asked to bathe?????

[caliotter3]

I say strongly suggest, ask one more time, but you can never force someone to do it. Just make certain you properly document their refusal and you might gently remind them that eventually they need to bathe.

[southernbeegirl, BSN, RN]

why are baths scheduled on the night shift when pts should be sleeping???????

[mochabean]

I know that me and the other nursing assistants I work with are fed up with patients who want to be bathed late in the afternoon. During that time of day we have vitals, accuchecks, discharges, new admits, etc. We give patients until 11am to get bathed. The patient will be asked at least 3 times if they want to bathe and if they refuse, then that is charted. You can't force someone to take a bath unless they're really funky.

[CoffeeRTC, BSN, RN]

THis is such a big issue in LTC. Management thinks every one must get a bath as scheduled or else. LOL. Hey, you ask, remind them that is is best for xyz purpose or that you might not be able to do it at xyz time then you chart of pt refusal. Heaven forbid you don't chart that you went thru hoops to give them a bath...you might be looked at as being lazy.

[NeosynephRN]

You cannot force a person to take a bath...it is just not right. I do not know why the mngr cannot ask the patients..it is silly just walk in ask how the care has been and if they have been offered to be cleaned up today...big deal right?

[retiredlady]

If it's ltc, ask the patient what time he bathed at home. My father is in one and he gets so mad when they want to bathe him in the morning (usually when Price is Right is on, ha, ha) he always took one in the evening, but now takes one in the afternoon, but not when his favorite afternoon show is on. In the hospital, it should be offered and they can refuse. But, when I have talked to several people who have recently have been in the hospital, it wasn't even offered unless asked. If I am visiting, I will change the bed for them (cause I know that can help) and I always get thank yous.

[rn2bnwi, BSN, RN]

i would have a fit if i was in the hosptial and someone was waking me up all night trying to give me a bath. for goodness sake they need their sleep. i have gone to A LOT Of facilities and have only given a night shift bath once and that was a their request. the place i go to now most has had one pt asking for a night shift spa but we couldn't safely staff the other pts to accomodate that request otherwise we have done it.

[rnmi2004]

I'm thinking the main reason they refused was because it was night shift. You can offer, but they can refuse.

I'll be honest--if I were the patient who had the Xanax & Sonata, and then was asked repeatedly if I wanted to bathe--I'd be pretty irate.

I think that patient's need to get at least a few hours of uninterrupted sleep at night takes precedence over bathing, and it should be done during day hours. I'm not talking about ventilated/sedated patients in the ICU, but those who are with it enough to communicate their wants and needs.

[Batman24]

Asking a patient who takes meds at 10pm who is sleepy if they want a bath at midnight and again at 5am is a waste of time. She's drugged and tired and that is too late and too early unless she's had accident. I agree with her.

Asking an already anxious trauma patient again and again throughout the night if they want a bath when they are afraid of not being able to breathe will only make them more anxious. Let them be.

It's best to let them get their rest and do a little clean up when they are awake especially if they aren't incontinent or smelly.

[inthesky]

You are right! Isn't it technically assault and battery to force a patient into a bath?

[somebodyluvsu]

If a pt. refuses a bath i ask again, and if they refuse again, i just bring a bucket of hot water with soap in and they usually will start to wash up. if they reach for the bucket, i tell them let me know if you want help or to wash your back. it works 90% of the time:)