What part of pt care gets overlooked most often - page 4

Ive noticed oral care. Last night I went in to check on a patient I heard moaning (not my patient, but was concerned). She was half in bed/half out, O2 off her face (sat 72), slumped in bed, leg... Read More

  1. by   smarter
    The most overlooked part of Patient care is oral care. Nurses, CNA, techs, don't even think about doing it. Patients become uncomfortable when they have dirty mouths and teeth.
  2. by   smarter
    The most overlooked part of Patient care is oral care. Nurses, CNA, techs, don't even think about doing it. Patients become uncomfortable when they have dirty mouths and teeth.
  3. by   JBirdAngel

    Im not a nurse, and i dont understand what everything is like foley's etc. but im wondering a couple things.

    1) people have mentioned back rubs and someone said that doing that helps the skin not to deteriorate or something i think? what are the main reasons for back rubs / massages? is the reason for these due to effects of laying in bed for extended periods of time?

    2) what all is meant by bowel movement regime, does this just mean keeping track of when they go number 2? and then that information would help provide better care to see what problems might be arising from or what current treatment might be causing due to the timings of b.m.'s?

    3) this is all just for my personal info, and as im not decided as to what im going to do yet, aside from changing tubes it sounds like most things that get most neglected a cna could do, is this correct?

    thanks - jason
  4. by   burn out
    1st staff breaks 2nd oral care 3rd education
  5. by   nursesaideBen
    The thing that gets me are nasty, dirty fingernails. Let's face it, a lot of our pts play in their feces, their foley's, and it's all under their nails for when they eat or drink anything.
  6. by   Marie_LPN, RN
    aside from changing tubes it sounds like most things that get most neglected a cna could do, is this correct?
    Could, yes, however, a nurse or a CNA should.

    IOW, being a nurse will not get you out of doing the dirty work.
  7. by   NotReady4PrimeTime
    Providing oral care to an intubated toddler being forced to "sleep" sitting up on top of a roll of linen with their hands tied to the bed is one of my least favourite tasks. They're sedate enough not to hear you when you tell them you're going to clean out their mouth, but not sedate enough not to go ballistic the second you touch their face. Then you've got yourself a wrestling match worthy of the WWE, trying to keep them from extubating/pulling out their lines/falling off the bed as they arch their back, slide down over the roll-of-linen seat and turn their head away from you while discovering that their hands will now reach their tube... Diaper changes on intubated kids comes a close second. With the VAP police making their rounds a dozen times a shift, with their angle-of-torso goniometers, ensuring that the HOB and AOT are kept at 45 degrees and their rabid insistance that the only time the HOB can be lowered is for x-rays, it's at least a three person job. Ah, the joys of basic nursing care.
  8. by   bethin
    Quote from TheCommuter
    In addition to the oral care, I think backrubs are badly neglected.

    Who, in all honestly, gives their patients the classic backrubs we all learned about in nursing fundamentals many moons ago? Patient care would be so much more pleasurable if we could all squeeze in the time for a good 'ole 3 minute backrub once per day.

    I do. I don't really have time for it but if aides don't do it we will be written up for it. My second day working med/surg I failed to give a back rub and got reamed for it. Never mind that it was my second day working in a hospital, I had 22 patients and I was the only aide - no one was training me.
  9. by   muffie
    dating and changing iv tubing and sites
    paper bag on bedside table for personal tissues
    kleenex at bedside for pts
    central line dressing changes
    shaving men [this not being done really burns my posterior]

    etc etc

    if it needs to be done---- do it !
  10. by   RN BSN 2009
    Quote from chenoaspirit
    I can honestly say that 2 nights ago I gave one of my patients a back rub. She was in with a bowel obstruction and had a colectomy and had chronic back probs. Lying in the bed so long had made her back hurt, pain meds didnt touch the pain. I applied heat packs, which didnt help. I finally eased her up in the bed and gave her a back rub with baby lotion. The look on her face was priceless. And it did help.
    IV's are definitely one at our hospital too that gets overlooked, they do not get changed when they need to be. The previous nurse will say "I didnt because it looks good and has good blood return". Well, if they are a HARD stick, maybe. But not when they have veins that look like garden hoses. We are sooooo short-staffed and overworked, we honestly dont have time to do the things that need to get done. Last night, we had ONE assistant on the entire floor. How on earth was she supposed to be able to provide care to everyone. Its horrible. The ones who decide to short staff will be the ones in that bed one day and then they will see what these patients are going through. Its sad.
    Wow.. seems like in addition to the physical it was the TLC that helped
  11. by   gentle
    oral care. finger nails.

    Oh, how many times have I asked little old ladies to keep those nails clean or get rid of them.
  12. by   Warpster
    I noticed a big difference when we went to 12 hour shifts. When we did the 8 hour evening shifts, especially, we were generally organized enough, assessments done, orders checked and meds passed, to do HS care, part of which was oral care. Sometimes, since days were so busy, it was the only oral care the poor patient got unless there was a disease process going on there.

    Coming on duty at 7PM and needing to do full body assessments, new order checks, med passes and everything else we needed to do in the first 4 hours, we seldom had time to chivvy the ambulatory patients into the bathroom to do their own oral care, much less do it for non ambulatory patients. HS care was reduced to pain meds and sleepers, with an occasional back rub for a post op patient who'd overdone it during the day. We didn't settle down enough for oral care until midnight, and by then they were all trying to sleep.

    Chalk the lack of consistent oral care up to decreased staffing, longer shifts with badly timed shift changes, and the need to set priorities in order for patient safety and not comfort.
  13. by   hecete
    I Work In Ltc, Everyone Is On Some Kind Of Bowel Prep. Tubing Is Changed Every Sunday On 11-7, We Only Have Picc Lines, Dressings Are Changed Once A Week If Opsite Is Used, Everyday If Insertion Site Covered By A 2x2. If These Are Not Done We Have The State Crawling Up Our Butts. We Use Oral Balance For Oral Care And It's Great. I Guess Trimming Fingernails And Toenails Is Our Downfall.
    We Just Started A Program Where The W.cn. Assistant Will Do Nails. Usually, The Np Will Do The Diabetics.