ICU and Bed baths? - page 2
I have worked at a couple different units and each had their own policy on bed baths. Where I worked last we did baths at 4am. Days said they were to busy to do them. Just wondering what the... Read More
May 14, '03In our unit we do baths at night. For A&O patients, I try to do it right after 9pm visiting hours. If both of my patients are A&O, I try to get one done right after my first assessment and do the other at 9:30. If the you-know-what hits the fan though, I just do it whenever I can.
Day shift does NOT do baths and will write up night shift if they are not done, unless you chart that A&O pt refused or can show by VS/interventions done that the patient was too unstable to be turned on one side to wash back and change sheets.
The only exception is fresh open hearts are bathed as soon as their temp is back up to normal (assuming the patient is stable enough) even if it happens to be on day shift.
I had a patient a couple of weeks ago, motorcycle accident, admitted at 9:30 AM, who was absolutely FILTHY, that the day nurse did not bathe. I was upset because if I get a dirty patient in the middle of the night (rules say if the patient is admitted after midnight you don't have to bathe him), I always bathe him. Sometimes I'll bathe them as soon as they roll in (traumas especially, usually covered with dirt, leaves, bits of glass, blood, betadine if they went to surgery) and it makes me mad if the other nurses don't do the same.
May 15, '03Originally posted by MandyInMS
In our CCU half of the pts get done AM shift/other half PM...we usually do the harder/total care folks @ night ,saving the more alert pts for days.
OOOHH was I mad! I NEVER ask the NA's for help unless I'm swamped or need help, ie turning pt's q 2 hr's. So, what I wanted to ask her then what Is a priority around here? The NA's in my ICU are extremely lazy and yet they run to the NM as tell her that us RN's treat them like dirt! Yet some manage to find PLENTY of time to sit and talk on the phone for 40 minutes or surf the internet for hours or do crossword puzzles all night! HELLO!
OK, I'm done venting now...
May 20, '03if they are on a vent or getting aprocedure/surgery before noon then I do it on nites other wise the day babes!
Oct 9, '03newest from the queen of bosses: nites has to bathe everyone, alert or not, (this is soooooooooooo not holistic!!! & I rebel!) We have no aide/tech to do this, so all RN's doing everything including cleaning the rooms (which is what I did last nite-since housekeeping did a lousy job of cleaning this isolation room). uuuughghhh!!! I am so pooped I could just nod off right here....zzzzzzzzzzzz
Oct 10, '03Originally posted by Going80INA55
..............whenever staff is able to get to it.
I voted "dayshift", but yesterday found the patients got bathed whenever the "PCTs" got around to it. Those days DO happen, ya know.
Oct 13, '03We usually do baths on the day shift, but we all work together (we have a fairly small ICU staff who are all friendly). If the patient is really dirty, it depends on the situation & clinical status. We really try not to leave the next shift with an icky patient, but in reality, that is occasionally impossible.
One of the most appreciated words during night to day report is "oh, also, I bathed him/her and you have new linens on". Then I say "I buy the next Margarita!!"
Whyo in Wyo
Oct 15, '03I did ICU nursing for five years before nurse anesthesia.....trauma, surgical, neuro, and cardiothoracic (T,S, and Neuro had a lot of overflow among the units, so a GSW to the head with abdominal wounds was not uncommon in SICU). Most of it was as an active duty RN in the air force. I was a stickler for the cleanliness is next to godliness theme. A full, thorough bedbath including soap, water (in separate tubs), toothpaste (just because they're intubated doesn't mean oral hygiene takes a back seat!) and shaving, yes, I shaved the men's beards and ladies' legs, too. Washed hair, too. This may sound excessive, but think about how skanky YOU feel after 24-36 hours without bathing! Cleaning off all those dead skin cells, rubbing the skin and rejuvenating blood flow to the skin revitalizes a person.
OK, this may sound hokey to many of you. Yes, blood pressures circling the drain and kidneys shutting down definitely takes priority. The coronary arteries won't be well perfused if the IABP timing is off. But don't forget the basics of human care. I have actually brushed a patient's teeth in the OR, I was so disgusted by what I saw in the oropharynx during intubation I almost vomited, literally. That basic lack of care is uncalled for.
Nurses are overworked, underpaid, and have way too much to do in the mere 8 to 12 hours they are caring for patients to worry about the little things. The little things need attention before they turn into the big things. Nurses have to waste too much time and energy to get a simple medication. Enter the order into the computer AND fax the order to pharmacy. Pharmacy rounds to the floors are once every eight hours. You need it now? Well, you will have to send someone to get it, can't send it through the tube system because the tube system's down (again). The one aide you had for the entire floor went home early due to back pain. You spend 15 minutes of your thirty minute lunch break running to pharmacy to get the po nifedipine for your patient who hasn't had a dose since yesterday and it is now 2100. Have things changed much in the few years I've been in anesthesia? Believe me, I am empathizing, not criticizing.
Jul 9, '11Here is the rule....all vented pts should be bathed during the night shift.
Non vented pt who is alert and oreinted can be bathed during day shift...non vneted pt sho is out can be bathed early during the night shift prefrable b/w 8-10pm...the ideal reccemendation is dont wake up a elderly pt at 12MN or 0400am for bath...disruption in sleep wake cycle is the one of the most leading cause for ICU delirium....
Jul 10, '11Except for rare nights I bath all comatose or vented and sedated patients at night.
I offer alert patients a bath if they are awake and bathe them if they want it.
Jul 10, '11In our ICU we try to split the bathing duties evenly between day shift and night shift because we have the exact same staffing for day and night (we only use 12 hour shifts, no 8s). Vented patients by default are night shift, usually. The only time vented people should be a day bath in our unit is if A) something happened and they had to get a bath! like a code brown (: or B) if the entire unit is vented, we will split evenly between shifts.
I agree we do NOT wake up people with dementia or bathe disoriented individuals in the middle of the night. Because we get a large portion of our patients up to the armchair in the morning for pulmonary toileting, often times an awake patient or a confused patient is offered a bath/bathed before getting into the chair, so we can start their morning nicely (: