Did the title catch your attention? Good, I was hoping it would.
I've seen people talk about this attitude on allnurses quite a bit, and I find the reactions fascinating. I'm amazed at the passion, care and professionalism of the nurses on this board and really about every nurse I've ever met.
BUT, everyone-from the most seasoned nurse to the student- knows that nursing is changing and will probably continue to change dramatically over the years to come. There are CNAs and MAs who seem to have an increasing role in the healthcare system and nurses themselves have more responsibility (all the charting etc.) and demanding jobs as new diseases, new medicines and standards of care make their way into our lives.
My question is, do you think their should be a change in what nurses do? Will there come a time when basic hygiene and certain other tasks often done by nurses in the past will be the responsibility of CNAs and others in similar roles? Would this be a good thing for nurses? Is there really anything wrong with nurses who feel that four years of education + all of their other demands and responsibilities should mean that they shouldn't have to do these tasks?
I think families help out because they want to help out the pt. You feel helpless when your loved one is laying there in a coma for weeks, and even a bathbath can help them feellike they are contributing.
Some families help out because I think they're just inclined to help care for their own, and they see how the nurses are overworked and running around all shift trying to keep up with the workload and genuinely want to do whatever they can. Many families, however, I think are stressed out and angry at the ever-increasing copays and other charges their insurance is not picking up and feel entitled to every bit of "service" they can get from the hospital because they are paying through the teeth. But we all know that the nursing staff, (not hospital administrators) who are already run ragged and short staffed, bear the brunt of these demands.
And they are "paying through the teeth".
Regarding direct patient care:
My motto is "Do unto others as you would have them do unto you". It is humiliating to be an adult and to have to have another adult clean up your mess. I have seen many patients go through the tortures of the damned at having to have another adult see them as helpless. I do all that I can to maintain their personal dignity.
Besides...poop I can stand by the truck load :uhoh21: . It's the snot that makes me want to run for the hills! :chair:
Just wanted to add something to my last post. In our hospital (and many magnet hospitals) the nurse to patient ratio is low. Yesterday in the ER we had 4 rooms assigned to us and at any on time we only had 2 patients. The most I seen any nurse have at once was 4. Therefore, there is the extra time to wipe buts and give continuity of care.....each pt has one nurse for everything and they seem to like that.
I agree. I work at two hospitals. At one hospital, I have 7 patients (it's a busy cardiac floor with tele, drips, etc.) and another hospital with 4 patients. At the latter, even though I have a CNA, I bathe my own patients, empty garbage, clean the room, take my own vitals....because I have the time to do it. However, when I have 7 patients, I really rely on my CNAs. I have to prep patients for tests and monitor the ones going bad and do an enormous amount of charting with that many patients. I wouldn't leave a patient lying in feces if the CNA is too busy, but I depend on them to make sure my patients are clean and turned just as the doctors expect me to have my labs drawn and my patients properly prepped for procedures. The nurse to patient ratio really dictates how much DIRECT CARE we are capable of performing.
1) a family member was complaining to the doctor & nurse at the bedside that her husband was at an extended care facility post hospital discharge. she commented on the $$ daily charge. yet her husband was left in bm until she no longer could stand waiting for the nurse & did the hygiene herself. she stated that since "no one wanted to help her husband anyway, i might as well take him home. i'll take care of him myself since the nurses don't any way."
2) a patient had a condom cath that he had pulled. a student nurse was assigned to this patient & was going to place a new condom cath on the patient. she became upset when giving peri care. the patient was crusted with peri discharge that his scrotum stuck to his inner thighs. then when she started to wash his back, she discovered a pressure ulcer. no one had documented any thing in the chart. needless to say, this student was very discouraged about the state of this patient's care.
rns may not be the individual who will personally give patient hygiene but he/ she is still responsible for assessing the patient's over all condition: skin, elimination, hygiene, nutrition, mobility, activity, etc. it's not all about exotic complicated technology. it's respect, compassion, & providing basic care for our fellow human beings.
Specializes in Happily semi-retired; excited for the whole whammy.
I think to a large extent there already has been a drastic shift in the primary role of the nurse as a member of the healthcare team. Increasing technology and shrinking budgets make it more realistic to have auxiliary staff handle routine tasks. However, I don't think the time will ever come when a nurse won't ever need to perform hygeine or other basic tasks. We do what we need to do for the patient, right?
Im not above performing personal care however I think it does somewhat distract the patients view of our ability to asses, and assist in their care plans. if a patient sees us changing their briefs and then admin IVs they tend to doubt our ability
I agree and in some cases I've had this happen as in "Are you a nurse?" when I went to hang an IV immediately after having brought in ice water and changed a brief. I had told her my name and title when I walked in the room ten minutes prior.
Or, after answering a light and emptying trash got "Go tell the nurse I want......."
Specializes in Happily semi-retired; excited for the whole whammy.
what ever happen to team work doesn't it matter?
Of course, it matters. That is why the nurse sometimes has to step in and perform these tasks. However, when it comes right down to it, the duty of all team members simply can't be equal, since not all team members have the training and skills to perform all aspects of care.
I agree and in some cases I've had this happen as in "Are you a nurse?" when I went to hang an IV immediately after having brought in ice water and changed a brief. I had told her my name and title when I walked in the room ten minutes prior.
Or, after answering a light and emptying trash got "Go tell the nurse I want......."
It shouldn't happen but it does.
Sorry, I still disagree. Partly because of the lack of uniformity in our clothes, I may be mistaken for housekeeping if I empty the overflowing trash can, but it does not bother me to say, "I am your nurse, what can I do for you?" I do not feel insulted if I am mistaken for anyone else; if anything it's a compliment because I did that job well enough to be mistaken for a CNA or housekeeper! CNAs may not be licensed but they can do some things better than I can----I had to ask a CNA once the best method for removing crusted stool from the skin, because soap and water wasn't working. Lotion!
And just because you told your pt your name and title, it doesn't mean he/she will remember ten minutes later. It's not only stressful being a pt, how do you know he/she heard you? I once had major surgery and a night shift person came in and told me her name. A short time later I had a question for my RN, and I asked her "Are you my nurse?" When she said Yes I apologized, I said I didn't hear her if she had told me that and I wanted to make sure I was talking to the right person.
I didn't have time to read all of the replies, so sorry if I repeat.
I think that the bottom wiping and ADL kind of things allow a nurse to use her all of her education in assessing the patients status. How are you ever going to know what C-diff "presents" like if you never clean up a patient with it? What about a GI bleed? A UTI? How about assessing your patients peri-area? Checking for sacral pressure ulcers? Hemmorhiods? (sp?) Assessing their ability to properly clean themselves?
It may be my rehab focus, but my duty is to my whole patient, including his/her butt and what comes out of it. RNs are the ones who assess. That task can not be delegated. Unless the techs are going to save bms and urine for my "viewing pleasure" and I'm going to go in and tell my patients to drop their drawers just so I can look at their bums, I think that helping with such things is part of my patient assessment and that skill is a utilization of my education.
Marie_LPN, RN, LPN, RN
12,126 Posts
I think families help out because they want to help out the pt. You feel helpless when your loved one is laying there in a coma for weeks, and even a bathbath can help them feellike they are contributing.