Forced Baths and Patients rights

Nurses General Nursing

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I posted the question regarding Forced baths and a few people read my post and they want to know What is APS and who do we contact concerning this bcause I have 4 people here who want to know who to turn to because they've been written up for not giving baths when it is the patient who refuses and they are told it's ok to just start washing a patient if they are sleeping do whatever it is you need to do to wash the patient up. They are told this by management and they nurses are always throwing the CNA under the bus. They all say they are very uncomfortable by this and have been told by several patients that they are very upset that they are bascially forced to get a sponge bath and they are talked down to if they refuse to bathe. They have told the managers on the unit this and they will not listen they always say you have 5 baths to do today get them done. This is crazy if I were the Patient I would be highly upset by this. They are saying they are constantly harrassed about you better get baths done and they are sick of it. Wow is this infringing on Patients rights or what?

What state are you in?

Missouri. This is a Hospital Not a Nursing Home. I have two pt.s that have complained about this they say they were told they have to take a bath today it's been two days and your dirty. This man was offended. The CNA said she does just go in and tells the Pt. It's time to clean up and does not give them a chance to refuse because she has the tub of water and gown etc. Is this Nuts r what. If it were me I would be so angry and to management expects and tells the other to follow suit?? Crazy. You cannot make a adult do anything they are patients in a hospital they have rights. One CNA said she is afraid someone will sue her

Specializes in LTC and Acute.

I had the same thing happen to me while I was a tech in Alabama. I would have patients refuse the bath and I would get in trouble for it. I was told to tell the patient that they were having a bath, not to ask if they would like I bath. I always thought that it was inappropriate because if I was in that situation I wouldn't necessarily want a stranger bathing me. I have been told it's an infection control issue and that it's to reduce the risk of HA-pneumonia and other HA diseases.

Specializes in Cardiac ICU.

The nurses are def in the wrong here. Forcing someone to bathe is like forcing someone to medicine. Every patient has the right to refuse treatment. That's like day 1 of CNA training. If it were long-term care, I'd say contact the LTCO, but it's not. I think it's time to go to the management.

Specializes in Cardiac ICU.

Approaching it like hburatti says can help sometimes, and I don't feel wrong doing it that way. Especially with dementia patients. And bathing is def an infection control issue. But if you walk into someone's room and say "it's time to take a shower", and they still refuse, it's their right.

Personally, I try to get the person to shower 3 times during my shift. If they still say no I just tell the nurse they refused.

Specializes in PCCN.

ultimately the pt care falls on the rn- therefore they are the ones to get sued. if i have a pt refuse care, i document it in a progress note, and also inform family when they come in that the pt refused. If this goes on for a day or two, Dr will be notified also. Maybe they have a psych problem that needs to be evaluated. Dont forget- from the rn point of view- they are legally reponsible for the pt care- they can delegate it to the tech/cna,uap , but ultimately falls on them. If the person ends up with a hygiene problem- they are responsible.

sounds like you guys have a bad work environment- maybe try working in a different area?

Yes I understand the infection control issue. But you do not have the right to bathe a patient who is sleeping, and if you ask 3 times and they refused three times you shouldn't fear losing your job or be told your not doing your job.

Specializes in Cardiac ICU.

I agree. Trying to bathe someone is their sleep is absurd. All you can do is ask multiple times during your shift and report it to your nurse if they refuse. If they want to fire you for being ethical, then it may not be a place you want to work anyway.

To Allisonhillary: Do you just start washing pts if they are sleeping, Do you just enter the room and say it's time to clean up Im not talking about dementia pts. this unit is a step down unit TICU/MICU these people may be on the way home and say I'll shower when I get home or they are leaving. They have the sense of saying yes or no. No mental issues on this unit

Specializes in home health, dialysis, others.

If you have asked twice, and the pt still refuses, contact your supervisor/manager. Sometimes it may be easier to give the pt a choice - I have time to assist you with your bath, and to make your bed. Is this a good time? Or should I come back in an hour or so? I would really like to make your bed this morning - is 9 or 10 a good time?

I realize that this isn't always practical. But by giving them a choice of 'when' there is a presumption that it will be done.

Yes people have a right to refuse. But sometimes we really need to see their skin, esp. pressure points, etc.

Again, notify your superior after the 2nd refusal.

Specializes in CNA.

My only experience with this as a CNA is in the Dementia/Alzheimer unit. Often a pt with Dementia will refuse baths and it would take sometimes the entire CNA staff playing good cop bad cop to get them to agree to one.

There is a point, when a pt is covered in their own feces and stinks that it's for their own dignity we give them a bath.. even if they refuse.. especially since they don't know any better..

As far as washing pts against their will, NO WAY! I wouldn't do that.I'd probably go to management and see what I am suppose to do.

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