What part of pt care gets overlooked most often

[chenoaspirit]

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 stuck between mattress and siderail and hanging off bed. I straightened her up and was putting her O2 back on her face when I noticed her mouth looked awful. After her sats went back up, I did oral care over and over and over to remove the gunk in her mouth. I pulled out this huge CHUNK of stuff that was like hard plastic approximately 5 cm in size! She had thick slime all over her gums and her lips were cracked. That gets overlooked at our hospital with about 95% patients.

[GrnHonu99, RN]

Oral care esp for patients on vents! We are pretty good at changing our tubing, but I admit that on occasion I have forgotten to do c-line dressing changes!

[Lorie P.]

Everyone,

Yeap oral care, foley care, and not changing IV tubings. But then again I do what I can when I can. Taking care of 6-9 total care patients on a med/surg floor can be quite overwhelming at times.

But I have found that when I go into to my assessments, I take the time to do most of the above tasks. This way I am getting several things done at once, assessing my patient, looking out for any changes, and providing them with the basic care they need along with medical care.

I attitude is the paper work can wait, but telling a patient that his/her dry crusty mouth can't wait is a big no no!

I am only one nurse, I put all my effort into making sure my patients comfort levels are met to the best of my ability.

[Marie_LPN, RN, LPN, RN]

From what we get, mouthcare is what we see that's not done.

As in, we have to do mouthcare, get the gunk and crust out, because the mouth is so filled, that the MDA can't even begin to find the back of the throat, and can't even pass the ET tube through.

Foleys with brown gunk all down the tube, dried BM either all over the skin, or in an obvious place that someone can see to clean. Pts. that look like they haven't had a bedbath in days.

We started writing incident reports on all of these things after we noticed that pts. in this shape were mainly coming from one floor. Some of what we've seen, there's absolutely no excuse for it.

[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.

[smarter]

:nono: 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.

[JBirdAngel]

Hello,

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

[burn out]

1st staff breaks 2nd oral care 3rd education

[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.

[Marie_LPN, RN, 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.

[NotReady4PrimeTime, RN]

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.

[bethin]

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.

[muffie, RN]

mouthcare

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 !