What is so darned difficult about oral care?

  1. A local dentist and some of his staff did an inservice today about oral care. Very informative. It wasn't mandatory, and we didn't get paid. Who showed up? All the CNAs who already DO oral care and are interested in learning. Not the ones who swear they do it only their residents have chunks of chewed up chicken in their mouths. Or the ones who say the resident "refused" oral care, except his toothbrush is still sealed in the package with the charge stickie on it. Why do some CNAs find it SUCH a bother to do oral care? It seems some aides think as long as the butt is dry, they've done a good job. I guess this is just one of my soap box issues.
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    About lovingtheunloved, RN

    Joined: Oct '04; Posts: 925; Likes: 584
    RN; from US
    Specialty: 12 year(s) of experience in LTC, home health, critical care

    31 Comments

  3. by   Marie_LPN, RN
    I hated oral care, but i did it.

    One thing that made it difficult was my first day back after 2 days off. And during those 2 days of, none of the residents i was assigned to had any mouthcare, so it wound up taking three times longer to do when i did it to dig the stuff out.
  4. by   Maxs
    When facilities are fully staffed, then CNA's will have time to do oral care.

    Maxs
  5. by   Antikigirl
    My caregivers really know the value of oral care, and will report when they see oral care not being done by other shifts! It doesn't help if you do oral care and no one else does! That happens too darned often! It is just gross and can be dangerous!
  6. by   lovingtheunloved
    Quote from Maxs
    When facilities are fully staffed, then CNA's will have time to do oral care.

    Maxs
    I may get flamed for this, but that's a cop out. We're always short lately, but we manage to get it done. It has to be a priority. Bad oral hygeine is linked to cardiovascular problems, lung infections, and just think, that wad of food that someone didn't have the time to clean out may wind up lodged in the resident's windpipe.
  7. by   Marie_LPN, RN
    Quote from lovingtheunloved
    I may get flamed for this, but that's a cop out. We're always short lately, but we manage to get it done. It has to be a priority. Bad oral hygeine is linked to cardiovascular problems, lung infections, and just think, that wad of food that someone didn't have the time to clean out may wind up lodged in the resident's windpipe.
    EXACTLY!
  8. by   unknown99
    Quote from Maxs
    When facilities are fully staffed, then CNA's will have time to do oral care.

    Maxs
    This is true, but the patients should not have to be neglected because of it.
    Recently, I got a patient on the surgical floor who had fallen at the local nursing home and broke her hip. When I went to take her teeth out, I had to pry them out. Once out, the dentures was covered in green mold towards the back, the roof of the patient's mouth had black eschar from the pressure, as did the bottom gums. The odor was so bad that I had to go and vomit! I can tolerate alot, but that was awful!!!
    We did blood cultures on thei lady, due to the mold, and guess what??? They were positive for MRSA, VRE, and another one I cannot remember. This lady was in bad shape because of it. Her surgery had to be put off for 72 hours.
    That was outright neglect AND abuse!!!! Short-staffed is NO EXCUSE!!!
    Last edit by unknown99 on Apr 3, '05
  9. by   VivaLasViejas


    I'd be willing to bet it's not just laziness or neglect........some people really don't do well with oral care because it's so GROSS. :stone I've always turned green when handling dentures and cleaning out peoples' mouths---doesn't mean it's ever OK to neglect this chore, but I know I have to think about something else while I'm in the process or I WILL get sick. Bleaaaaaahhhhhhhh.
  10. by   Shastalee99
    Quote from Maxs
    When facilities are fully staffed, then CNA's will have time to do oral care.

    Maxs
    I agree. I do oral care as much as possible, even when my fellow nurses are tugging at me left and right to get a pt ice for their coffee, or a blanket for another. I know everyone is busy, but when I have 15 pts who need somthing every second, it would be nice if a nurse could get the blanket themself instead of passing the buck to me. I'm an RN student and learned how to make a bed and do ROJM, but many of my pts have contractures so bad I can barely T&P them. I believe in team playing, and frequently ask the nurses "Can I get you anything?" "Is there something I can do to help?"
  11. by   lovingtheunloved
    I'm fortunate to work with nurses who trust me enough to let me do my job and not follow me around irritating me.

    And if oral care is too "gross" to do, don't become a CNA. If a person can't handle what the job requires, do something else.
  12. by   Shastalee99
    Quote from lovingtheunloved
    I'm fortunate to work with nurses who trust me enough to let me do my job and not follow me around irritating me.

    And if oral care is too "gross" to do, don't become a CNA. If a person can't handle what the job requires, do something else.
    Yes, I agree with you on that one. That is what the job entails, and cleaning up is one of them. I know I'm not in the most glorified position, but I really am grateful to do it. No matter how gross it is to me, I am glad to do it. Patients rely on us, they depend on us to take good care of them and make good judgements about their care. I'm grateful that I'm able to be with them and help in every way possible. I used to waitress before I switched to a nurse's aide. I knew it would help me while getting my RN, and would aleviate some stress of a new environment. I make a good living waiting tables, but I hated it. I had to rely on patrons for income. Now patients rely on me to be responsible,caring, and sensitive while they are recovering. I'd rather clean dentures and rear ends anyday.
  13. by   lovingtheunloved
    Quote from Shastalee99
    Yes, I agree with you on that one. That is what the job entails, and cleaning up is one of them. I know I'm not in the most glorified position, but I really am grateful to do it. No matter how gross it is to me, I am glad to do it. Patients rely on us, they depend on us to take good care of them and make good judgements about their care. I'm grateful that I'm able to be with them and help in every way possible. I used to waitress before I switched to a nurse's aide. I knew it would help me while getting my RN, and would aleviate some stress of a new environment. I make a good living waiting tables, but I hated it. I had to rely on patrons for income. Now patients rely on me to be responsible,caring, and sensitive while they are recovering. I'd rather clean dentures and rear ends anyday.
    Amen. I consider it an honor to be able to care for the woman who single-handedly raised 8 kids who all grew up to be doctors, lawyers and teachers, or the World War II veteran who risked his life so that generations after him could know freedom.
  14. by   CoffeeRTC
    I totally agree staffing shouldn't be an excuse, but yesterday am..we had 3 aids for 48 residents (2 that were mandated from 11-7)...I wasn't pushing oral care...just satisfied for cleaning, turning, feeding. I did let 3-11 shift know this.

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