How did you get through your first bed bath?

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I am a clinical instructor for a group of students who will have to do bed baths on "real" folks next week. They have practiced on each other, but of course did not wash breasts or genitals. They are expressing how freaked out they are about this. I'm not so out of touch as to not recall my own fears, but what I wonder is how you as students managed your first time? Was there anything your instructor did to help (besides allowing them ample time to discuss their fears)? Part of me feels they just need to jump in and do it, sink or swim sydrome, but I want them to have a successful experience, so to that end I would appreciate your input.

Not really on topic, but let me tell you about my first bed bath, many many moons ago.

Two of us - I was assigned peri care on a 90 something lady in a Catholic nursing home (I'm a guy).

She was aphasic. She squinched those knees together and fought tooth and nail. After, oh must have been 10 minutes of my partner and I trying to 'spread em', so I could give care, the patient finally mustered up the words 'geeeeeetttttt ooouuuuuutttt!'

So I went to the crustidy nurse (a nun) and told her the pt refused my care. Her response: 'you get back in there and do your job!'

But, I replied, we were taught that if a pt refused care, we couldn't force it.

Reply back 'she did not refuse, go bathe your patient'

My response 'she said, "get out" ' - fortunately I had a partner to back this up.

Nurse Nun: 'this pt told you to get out?'

YES

"Praise to God, Sister Mary hasn't spoken in 8 yrs!"

Unless you plan on your male students doing peri care on retired Nuns, your students have a leg up on me, if you'll excuse the awful pun.

~faith,

Timothy.

:roll :roll :roll

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Thanks everyone for your ideas and stories. What is interesting is that the hospital we are at is a VA type, so the odds of coming across a female patient are very very low. So I would not be able to match students with same sex individuals, except of course for my male student...

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Thanks everyone for your ideas and stories. What is interesting is that the hospital we are at is a VA type, so the odds of coming across a female patient are very very low. So I would not be able to match students with same sex individuals, except of course for my male student...

But thats not a bad thing. We all have to learn and having my first patient a male made all the other female patients that much easier.

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Specializes in Neuro trauma ICU, Flight Nurse.

My experience is that when you are new to a procedure, you are too nervous to idly chit chat over a patient.... It's when you become experienced that talking over a patient becomes an issue. I'm not a big fan of the "get over it" style of nursing training. You get more than enough of that attitude when you get out there in the real world. Just a thought.... :D

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Specializes in cardiac/education.
Not really on topic, but let me tell you about my first bed bath, many many moons ago.

Two of us - I was assigned peri care on a 90 something lady in a Catholic nursing home (I'm a guy).

She was aphasic. She squinched those knees together and fought tooth and nail. After, oh must have been 10 minutes of my partner and I trying to 'spread em', so I could give care, the patient finally mustered up the words 'geeeeeetttttt ooouuuuuutttt!'

So I went to the crustidy nurse (a nun) and told her the pt refused my care. Her response: 'you get back in there and do your job!'

But, I replied, we were taught that if a pt refused care, we couldn't force it.

Reply back 'she did not refuse, go bathe your patient'

My response 'she said, "get out" ' - fortunately I had a partner to back this up.

Nurse Nun: 'this pt told you to get out?'

YES

"Praise to God, Sister Mary hasn't spoken in 8 yrs!"

Unless you plan on your male students doing peri care on retired Nuns, your students have a leg up on me, if you'll excuse the awful pun.

~faith,

Timothy.

:lol2: :roll

Oh man, that sounds aweful!! I bet you were so embarrassed. Actually, same thing happened to one of the CNA's I shadowed at a long term care facility. I was just in the room and was uncomfortable. But, I am a student...:wink2: Hope things have gotten a bit easier for you....:lol2:

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Specializes in OBGYN, Neonatal.

I think we paired up for our first bed bath experience. It was good becaues we were both nervous but we got the job done. If you know the students strengths try to pair the more experienced ones up together and the least experienced ones together so that nobody has an upper hand and could lead the show.

After that though I think we did them all by ourselves. My first one was really not much becuase he was capable and did most of it himself, but after that I did one by myself and I just had to remember the basics, talk to the patient, give them control by asking what they wanted to do, keep them covered, and move swiftly so as to not give them a chill.

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That was funny, Timothy. You should post that in the Humor forum. I hope you see it that way now. Thanks for sharing.

Back to the topic, I'd say bring some food and pair them up. However, only for the first time.

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Specializes in Telemetry, OR, ICU.
...My first one was really not much becuase he was capable and did most of it himself, but after that I did one by myself and I just had to remember the basics, talk to the patient, give them control by asking what they wanted to do, keep them covered, and move swiftly so as to not give them a chill.

:yelclap:

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Specializes in Float.

We were paired up for our first bed bath. I was sooo glad because our pt was restrained for fall risk and she was older and disoriented. Being our first bath... we were NOT organized. I bet I ran to the supply room 10x so I was glad my partner was able to stay with the pt. Now we have a partner but our own pt and I usually do not see my partner, but she is who I ask if I need an extra hand. Believe it or not I have NOT had a male pt yet so that will be a different experience.

Ya know I have been just moving my pt's gown around as I wash and then at the end I lay the new gown over them, and remove the old gown. But I guess I should remove the old gown first and just leave the sheet over them? What do you all do?

Also, I am trying to get their backs when I change the bed. I'm on med surg and many of them have abdominal type surgeries and can't sit up straight, so the only way I can access their back is lying down. Any other ideas to be more efficient?

All my pt's always say they feel SO much better! It makes me feel glad. I must admit I've yet to wash anyone's hair. Most people are in for only like 2 days and we only are with them about 3 hours. I have to do a pretty in depth assessment and do vital signs at least twice so I feel pressed for time. I don't think any of the other students are washing hair either...hmmm....

Also I'm still trying to coordinate a respiratory assessment. I guess I need to listen to posterior breath sounds while I have them laying down and turned on their side. I usually am feeling bad at this point that I am making them move so much because even though they feel better after a bath they usually are in increased pain from having to roll and turn etc. But I know I need to be getting those posterior breath sounds.

How do you find a flow to provide more efficient care? :(

My teacher gets irritated with us for feeling like we are disturbing the pt. She got peeved because I waited for my pt to finish breakfast to get 8am vitals. She said I had to get them to get them charted and that I shouldn't feel like I'm interupting the pt. I guess I feel a little shy too because our assessment is pretty much just for our learning purposes. I hate making the pts move around for me to listen to lung sounds etc. We have to check pretyt much all pulses bilaterally etc. How do you learn without feeling like your pt is a guinea pig? LOL

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I remember my first time as a CNA student, I paired up with my peer and did a bed bath on a client who recently had a stroke, totally alert, and in pain whenever we moved her. So it took us almost an hour.

Always, a couple of habit is that I get a pad/chuck and put in under both legs and feet (hey, I'm not doing laundry)...soap it down...and thoroughly wash esp the toes....get the basin of clean water and pour it slow to rinse it.....they love clean legs and feet. And last, a back massage when applying lotion ....But most important is therapeutic communication esp if your a guy like me...

By the way, my first bed bath was five years ago and I did advice the charge nurse about the pain at touch. She told me "she was medicated about 30 mins ago." I can still clearly recall how difficult it was as a nursing assistant student.

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One thing that surprised me as a student was how most patients assumed I knew what I was doing! :) When you are caring and interested and do your best I think students will be surprised how natural it all feels -- taking care of sick people is very natural. I certainly felt awkward at first, but when I realized that my patient was trusting me, my confidence really increased. I can't count the number of patients who have told me how MUCH BETTER they feel after a bath!

for the students on this board---

Some tips (others have mentioned some great ones, so I don't want to repeat them): If the patient has pain with movement, I medicate them at least 30 minutes before a bath that will require them to move a lot. I always find that you cannot bring too many wash cloths into the room -- if you think you'll need 5, bring 10 (unless your unit doesn't have enough to go around)! Also, it's nice for pt's who get cold easily to put the lotion bottle in the basin with the tub water before you even start the bath -- they love warm lotion! Those are just some ideas.

for the OP--

I agree that pairing up to start out is much better for new students. Once they get the feel for what is going on, they will have confidence to provide care on their own. I think if you tell them the negatives (talking over pt's, experienced students doing the "hard parts") they will take heed to avoid those pitfalls and get a good experience out of it. You sound like a great instructor!

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Thanks everyone for the great advice. My students despite their fears did great. In the end I decided to just see how things went and didn't pair them up on purpose. As a result some of them did the bathing on their own. Some ended up pairing up as all the patients didn't want or need personalized care. I had to hunt down other patients we weren't working with and found a few gems that gave the students a real sense of accomplishment and who greatly enjoyed the attention. One elderly man asked if his student would be back - she was so delighted- I thought the smile on her face would slide off either end it was so big!

One thing they noticed about themselves was how nervous they were in entering the rooms - they felt they were disturbing the patients - well by the end of the day they were in and out and feeling much better about that issue.

In post conference they were filled with the stories of the folks they had worked with, what they had seen and insights on what worked and what didn't. Needless to say I'm very proud!

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