Forced Baths and Patients rights

[Health-Nut]

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?

[allisonhillary]

No, I would never wash people while they're sleeping!!!

Sometimes I approach the situation saying "it's time to take a shower" rather than asking because they will allow it with that sort of attitude. If I say that and they still say no, I tell the nurse they refused. They have every right to refuse. And it's not right that you should have to fear losing your job because you're adhering to patients' rights.

[Beverage]

I suspect this "rule" was created by mgmt to hold the CNA's feet to the fire. It's easy to say "the pt refused a bath", when none was offered.

[Batman25]

Why are so many refusing baths? Are they competent to bathe themselves and if yes, are the CNAs having the patient wash what they can and assist with what they can't? Is mental incapacity an issue with the patients refusing? In some instances you would need to step in and keep the patient clean to protect their skin i.e. dementia patient that soiled themselves. Bathing shouldn't be done when the patient is sleeping. Patients of sound mind do have a right to refuse. I would find out why they were refusing and work from there if they were in need. If you have no success get the nurse involved.

[jeweleebleu]

I have to agree with some of the previous posters if the patient is alert and able to decide their own care then there is not much that you can do! May be a little more assertive be if the question is asked "Would you like to take a shower? 99% of the time the answer is going to be "NO!"

But above all DOCUMENT!, DOCUMENT!, DOCUMENT!, what you said and what the patient stated word for word, how many times you offered throughout the shift, if a bed bath or what alternative was offered, what reason the patient refused, and note that you did notify the charge nurse and have her sign next to your name for confirmation that she was made aware.

We have to remember as well if the patient is alert and able to make their own decisions there is that thin line that we are walking because it is a violation of the patients rights to refuse care!

[Cthebigguy]

A facility in the area I work had a similar issue. One of the CNA's charted res. refused bathing (this resident will go WEEKS w/o so much as a wipe down). I can't go into too much detail, but the CNA was written up, and then later terminated (resident still refusing). Well, the CNA lawyered up, and the facility was hit with a nasty fine by APS, the former DON has a mark on [insert gender neutral noun here]'s licence, had to apologize to resident, and was in civil lawsuit that dang near got the place shut down. The DON got canned, and the CNA got a very hefty judgement (even after lawyer fees).

You can NOT force a resident that has not been declared incompetent to undergo any medical treatment, showering included. That said make sure to CYA and document, document, document. Unless the resident has been declared unable to make decisions for him/her self, you can not force them. Even then it is tricky.

Long story short, get your Ombudsman (or resident's rights specialist) involved, and document.

That story is second hand, but you still can't force a mentally competent person into a shower if they say "No"... it will come back to bite you on the rear.

[martymoose, BSN, RN]

i would also question these "nurses" integrity that youre working with. They seriously told you to wash the pt's while they are sleeping, or else you get written up? sounds like they are looking for an excuse to can the cna's. that just plain stinks. i'd go find a job where i was more appreciated. not all cnas are treated this way.