Giving Baths At Night. Agree Or Disagree?

[kmwlpn]

we have recently started giving baths on night shift at the ltc facility i work at....many of the cna's are upset over this because they feel that it is wrong to drag residents up out of bed in the middle of the night to give a bath to them....we are not really short handed so that is not the reason for giving baths....and the residents we give baths to on 3rd shift are disoriented, but still....so question is do you or do you not agree with giving baths on 3rd shift?

i want to clarify a few details to see if the response is any different....but thank you for all your input thus far....

this is a long-term care facility,,,,and the residents, in which baths are given are unaware of the time of day, due to cognitive status......and some are frequently awake at night anyways, but not always........these factors may not change your views...but i wanted to make sure you had all the information........thank you for your response.....

[chris_at_lucas_RN, RN]

I thought it was cruel and unkind when they bathed ICU patients at night when I was an extern. The rationale was that they were doing so much other care during the day, the night shift was the only time the patients could be bathed without interfering with other "more important" care. The patients who were at all "with it" complained, but to no avail.

I think it is absolutely stupid mean and insensitive to bathe nursing home patients (anyone!) in the middle of the night. If they are confused about day and night anyway, why would you want to do something to confuse and stimulate them more? Aren't we supposed to be helping them meet their basic needs, and isn't sleep one of them? And aren't they supposed to do that at night so they can meet their other basic needs during the day (like eating and socializing?)?

My hat's off to the union nurse who slipped the note under the DON's door, and also to the poster who noted that the DOH sees that as a violation of the patients' rights.

One more reason why I do not want to ever be a patient in a LTC or a critical care unit. I believe I'll just stay home with my dogs. (They know when it's time to sleep!)

[cardiacRN2006, ADN, RN]

If it's before bedtime, then it's perfectly fine, .

Well, that's what I said, but it was completely overlooked. I specifically said do it before bedtime and not in the middle of the night...

[VivaLasViejas, ASN, RN]

And we wonder why confused elderly patients get agitated and cranky........I have long been of the opinion that care tasks should NEVER be scheduled for staff convenience alone.

I wonder how "nice" the people who think up such indignities would be after being awakened every 2 hours night after night for years on end, for meds, turns, changes, baths, etc.? :trout: Unless a resident is used to being awake nights---and every facility has a few who worked graveyard shift for much of their lives---their sleep should NOT be disturbed for anything that isn't essential to the continuation of their existence.

This issue is one that is near and dear to my heart as a LTC nurse. I'm a firm believer in personal choice and dignity, as well as the restorative qualities of undisturbed sleep. Phooey on any facility that would drag residents out of bed at night for a shower or bath---why don't they just staff better during the day and evening shifts, so that all the baths can be accomplished in a timely manner?

[burn out]

I thought it was cruel and unkind when they bathed ICU patients at night when I was an extern. The rationale was that they were doing so much other care during the day, the night shift was the only time the patients could be bathed without interfering with other "more important" care. The patients who were at all "with it" complained, but to no avail.

I think it is absolutely stupid mean and insensitive to bathe nursing home patients (anyone!) in the middle of the night. If they are confused about day and night anyway, why would you want to do something to confuse and stimulate them more? Aren't we supposed to be helping them meet their basic needs, and isn't sleep one of them? And aren't they supposed to do that at night so they can meet their other basic needs during the day (like eating and socializing?)?

My hat's off to the union nurse who slipped the note under the DON's door, and also to the poster who noted that the DOH sees that as a violation of the patients' rights.

One more reason why I do not want to ever be a patient in a LTC or a critical care unit. I believe I'll just stay home with my dogs. (They know when it's time to sleep!)

I've worked ICU 20 years (17 of which were 7p-7a) and for the most part the only patients that were bathed at night were the ones on the vent knocked out on versed, fentanyl or diprivan who didn't even know they were being bathed let alone what time of day it was. Or the new post op patients at 5 am got a bath pod1 and gotten up oob if ordered to get them moving--most of them would lay there like slugs unless you put dynamite under them.

I would gladly give all the baths during the day if it meant I didn't have to transport patients all over the hospital for nuc med tests, mri's or ct scans.

Those things never get done on night shift.

[CHATSDALE]

if you have pts in a vegatative state then they would not care if they were bathed at 2am or 2pm

also you have early risers who get up and if they have been incontinent a bath would be good..however at 5am when many of these are getting up the aides are really too busy to give scheduled bed baths

some facilities have a bath team that comes on at 5a to start baths and assist with showers so that the residents can go to breakfast and start the day fresh and clean

[linzz]

Disagree. I wonder if this may make the disorientation worse or speed up the decline in mental facilities. Does this help or hinder those who already don't sleep? Just asking because I had a lady that was very disoriented, she was always dressed for breakfast at bedtime and I think waking her up for a bath would have made this worse. Just my opinion.

[bethin]

I don't wake myself up at 4am so I can give myself a bath. And I curse the person who does that to me when I'm old. To me, LTC is supposed to be their home. If a pt wants to get up at 9am instead of 7am let them. It was stressed in my CNA classes that those in LTC are residents, not patients. Most of these resident's homes are gone, family doesn't come to see them and we have to make the atmosphere as much of a home as possible. If the resident is confused then I'm sure waking them up at 4am or 5am to give a bath isn't going to help matters. But, if they are night owls and are already up in the g-chair I don't see a problem with it.

I do agree with a point cardiacRN made: people will use all kinds of excuses not to give a bedbath. Personally, I like giving them. It's so nice to see fresh sheets, pts hair combed and washed, back rub, room neat and all that good stuff. I feel a sense of accomplishment.

I worked LTC for a few months and we did baths before we put pts to bed. I did do a few night shifts and I was required to get certain pts up. Mind you, I was on a lockdown unit by myself - no nurse! For obvious reasons I left the facility. I had one resident (schizophrenia) who ripped a door off the hinges and threw it at me. But I digress.

I work on a med surg floor now and I give baths whenever the pt wants one. If they want it when I walk in the door at 0630 I'll do it if time permits. If a pt requests a bath at 11p I'll let the evening shift know and they are easy going about it. I'm pretty sure they do it because I will come in the next morning and will ask the pt if they got cleaned up the night before. They always say yes.

[pghfoxfan]

I've worked ICU 20 years (17 of which were 7p-7a) and for the most part the only patients that were bathed at night were the ones on the vent knocked out on versed, fentanyl or diprivan who didn't even know they were being bathed let alone what time of day it was. Or the new post op patients at 5 am got a bath pod1 and gotten up oob if ordered to get them moving--most of them would lay there like slugs unless you put dynamite under them.

I would gladly give all the baths during the day if it meant I didn't have to transport patients all over the hospital for nuc med tests, mri's or ct scans.

Those things never get done on night shift.

I agree with the ICU patients on a vent.

I also agree about the daylight shift having to do the majority of traveling with patients.( I know there are times when an off shift has to go to CT, etc) But again, most tests are done when the departments are open, day shift.

Lastly, most of us have mentioned that there are times to give a patient a bath, when they are still awake. As I said, ya gotta be flexible.

[allantiques4me]

If its before bedtime thats fine.I wouldnt wake them up unless thier incontinent and a mess.

[TheCommuter, BSN, RN]

I agree with giving baths during the evening shifts (2-10pm or 3-11pm), but not during the night shift. Administering baths during the evening shifts helps to evenly spread the workload, so that the day shift staff is not stuck bathing everyone. Giving baths during the night shift, however, would involve disturbing the rest of the patients.

[marjoriemac, LPN]

I think that is abuse. We would never bath residents at night unless they wanted to be bathed by night shift ( I had 2 residents who wanted bathed at 7am by a particular carer every Wednesday/Thursday).

[NextSummer]

The people who created this idea must be people who have never worked a single night shift in LTC!