do you make sure your pts

[juzme]

Hello fellow nurses;-)

my DH and I went to visit his mother in the hosp today...this was her 2nd day, dx dehydration. she is pleasant late 80s with pretty severe dementia. Very nice hospital, quiet,,,no one rushing around...(not like the hospital I use to work at;-) staff at desk talking amongst each other.. anyway, MIL with crust all around her lips, mouth very dry, hence the crust(no swabs around) eyes crusty, hair not brushed and has matted(she has never looked like that.EVER.)it was a somewhat of a shock for my DH to see her like that.. her heels right on the bed(not propped on a pillow)so the heels do not break down....this was at about 5pm. My husband was so angry..he said if they all have time to stand around and talk why hasn't someone cleaned her up?

Anyway..I do not want to bash any other HCP, but i do see his point..we were both just so exhausted, when her nurse strolled over to the room from the front desk we didnt even ask why she wasnt cleaned up..I just did it and was happy to do it for my dear MIL. I know when i was tons busy, running my butt off I still made sure either myself or the aide did the care...hair brushed, face washed off, mouth care(esp. with dementia pt who didnt drink much, would go in and swab their mouths...constant rounds on the floor, esp. when things were quiet..time to catch up and whoever needed some things..got them.

So fellow nurses, my question..do you make sure your aides(if you have them)or you, yourself, make sure your pts are getting at least some minimal grooming done? Thanks.

[Ayvah, RN]

Thank you, wooh, you nailed it :)

[dudette10, MSN, RN]

I've been thinking about this thread a lot. I have mentioned on this board about my back-to-back nights that were so different. The first night (the shift from hell), I didn't have time to attend to my patients the way I would have liked to. The next night, with most of my patients from the previous night assigned to me--and no emergencies to deal with, unlike the first night--I did have time.

I worked again last night, received six new-to-me patients (including one admission), but I had no emergencies. What I realized is that, barring any time-sucking emergencies, that hygiene care can be done if you pair up with the CNAs. Last night, we had two CNAs on the shift that are always great in coordinating times for care with me. Turning, cleaning, oral care, etc. goes so much faster when there is another pair of hands. If some needed item is forgotten, you don't have to waste time lowering the bed and doing a safety check...one of you can easily leave, retrieve the missing item, and come back, while the other moves on to another task for the same patient.

I love working that way, and it also makes the work more pleasant with a partner. Just a tip. :)

[wooh, BSN, RN]

barring any time-sucking emergencies,

The big problem is, management creates staffing grids that give you the bare minimum staff to handle the floor without those time-sucking emergencies. So without a time-sucking emergency, you're stuck running, and with a time-sucking emergency, you're sprinting.

[dudette10, MSN, RN]

The big problem is, management creates staffing grids that give you the bare minimum staff to handle the floor without those time-sucking emergencies. So without a time-sucking emergency, you're stuck running, and with a time-sucking emergency, you're sprinting.

Maybe the answer is for night nurses to take attend to what the other shifts can't do. As I get better at this time management thing, my non-hellish shifts allow me more time for the care my patients deserve. I've worked 3-11, and I know how crazy it can be. Admits, discharges, unexpected orders still coming, family visits and calls, etc. I totally get why the PM and day nurses aren't able to do what they want to do.

But, my point was the idea of teaming up with the CNAs. Not all the nurses on my shift have created a working relationship with the night CNAs, but I have, and the patients benefit.

One of the CNAs that I love working with told me last night, "Go ahead and check on your other patients. I can finish here; I know how you like them to look in the morning." That statement didn't happen because I'm super nurse (which I'm not), but because I've worked side by side with her on my total care/heavy patients, and she knows what I expect from myself and for my patients. Plus, we like each other a lot, and we work seamlessly together.

I can imagine that some night floor nurses are fuming at me right now. Look, we have our hellish nights, and we have a goodly number of not-so-hellish nights. However, you can't argue the fact that we don't discharge at night, doctors are usually not coming in writing orders that cover three pages, and families are mostly absent. Those things are time-sucks for other shifts that we don't have to endure.

[anotherone, BSN, RN]

I can imagine that some night floor nurses are fuming at me right now. Look, we have our hellish nights, and we have a goodly number of not-so-hellish nights. However, you can't argue the fact that we don't discharge at night, doctors are usually not coming in writing orders that cover three pages, and families are mostly absent. Those things are time-sucks for other shifts that we don't have to endure.

cant argue the fact that many of these patients refuse to be washed up WHEN I HAVE TIME at 3-5 am.............. the totally confused ones who are up can get washed up at this time.

[Ruby Vee, BSN]

:)mindlor i would give a years salary to be a fly on the wall with a video camera to record your first year as a staff nurse. it should be a riot!

i predict "my preceptor hates me" and "nurses eat their young" posts.

[Ruby Vee, BSN]

well funny you mention that. that is certainly my goal once i get a few years exp under my belt.

and guess what, there will be far fewer lazy, inefficient, uncaring, cruel nurses that have jobs

i'm thinking you missed the sarcasm . . . .

[dudette10, MSN, RN]

cant argue the fact that many of these patients refuse to be washed up WHEN I HAVE TIME at 3-5 am.............. the totally confused ones who are up can get washed up at this time.

Good. I'm glad you understand my point, then.

[nursel56]

I only have my experiences,

I think you've hit on something there -----

Just a semi-irreverent comment, :)

on my last shift here at the VA we had 24 on our unit (med/surge) and zero were total care.......

I am sure there may come a day when we have 24 of 24 total care.....variable yes?

Yes. It's variable from unit to unit, shift to shift and person to person. Too many variables to speculate about what other people have time to do. Mouth care and cleaning poop and pee off are non-negotiable I'd say, though.

The way I was taught to do a bed bath - if you followed every step to the letter - would take at least 20 minutes which is a decent chunk of time with all the higher acuities and complexities of nursing care today. It used to be you'd keep your post op patients for several days of shuffling around the hallways in a plaid robe smiling at everyone with wife beaming by his side. Sighhhhh. . .

[RNnbakes]

I think we need people to have RN or LPN to their name before they can post on actual working conditions of real life nurses. We are not talking of NCLEX hospital here. I am sure when most student nurses graduated they were aiming to do the best for their patients but when you start working as a nurse and are responsible to a million things, you learn to make sure your patient is breathing at the end of the shift.

I just worked 3 days in a row and I dont want a student graduating in 5 minutes telling me about how they could have done my job better.

[wooh, BSN, RN]

^I had a shift from hades Friday, and 3 of my patients were barely checked on during the night because I was so stuck dealing with one patient. And a lot of dealing with that patient was sitting in the nurses station dealing with a bajillion phone calls and would have appeared to be "doing nothing." But please, non nurses, feel free to judge away... And realize, in a few years, it's going to be you in the hot seat, at least if you make it that long before you've gone on to greener pastures.

[Ruby Vee, BSN]

i think we need people to have rn or lpn to their name before they can post on actual working conditions of real life nurses. we are not talking of nclex hospital here. i am sure when most student nurses graduated they were aiming to do the best for their patients but when you start working as a nurse and are responsible to a million things, you learn to make sure your patient is breathing at the end of the shift.

i just worked 3 days in a row and i dont want a student graduating in 5 minutes telling me about how they could have done my job better.

seriously? they've been in the hospital as students in clinical so they know allll about the actual working conditions of a licensed nurse. when they get that license they'll do a much better job than all of us . . . . or so they say.