ICU: Nurses Wash Patients + Make Beds?

Hoozdo, ADN · Sep 17, 2007

Just curious: In my hospital, ICU RNs wash their patients, make their beds, draw bloods, & do EKGs, while RNs on med-surg floors have Assistants who do these tasks (and of course the RNs on med-surg have far more patients). Is this structure typical throughout the hospital industry? I work at a NYC teaching hospital and wondering if this is standard practice.... Thanks for any input.

It is in my hospital, and the previous hospital I worked at. There are no nursing assistants.......though we could certainly use one. At least an orderly to help lift patients that are sedated and pure dead weight!

deeDawntee, RN · Sep 17, 2007

Yes, in my hospital, the nurses do the baths on at least one of their two patients on their shift. (which includes changing linens as well) We draw blood if the pt has lines, but don't do EKG's, our RT department does those.

Keep in mind, that ICU patients often are vented, have lines, (including hemodynamic lines) and bathing them and changing sheets requires personnel that can manage the vents and lines with turns. Also, skin care is so important in ICU patients given the degree of immobility and fragility, that the RN her/himself should be monitoring skin frequently. Often if a patient is diaphoretic, and has potential or existing skin issues, full bed baths and linen changes are done more than once a day, all this really requires the primary RN and not the supportive staff to be managing the lines and the skin care. Does that make sense?

Good question.

nyforlove · Sep 17, 2007

Yes, in my hospital, the nurses do the baths on at least one of their two patients on their shift. (which includes changing linens as well) We draw blood if the pt has lines, but don't do EKG's, our RT department does those.
Keep in mind, that ICU patients often are vented, have lines, (including hemodynamic lines) and bathing them and changing sheets requires personnel that can manage the vents and lines with turns. Also, skin care is so important in ICU patients given the degree of immobility and fragility, that the RN her/himself should be monitoring skin frequently. Often if a patient is diaphoretic, and has potential or existing skin issues, full bed baths and linen changes are done more than once a day, all this really requires the primary RN and not the supportive staff to be managing the lines and the skin care. Does that make sense?
Good question.

Thanks!--that makes sense...and thanks again to AllNurses for the terrific forum it provides the profession :)

CHATSDALE · Sep 17, 2007

as above, many of these pts are in icu because they requrie extrordiary care..frequently there is a roving cna who will hold a pt over during baths, empty cath bags, give the unit clerk a break by answering phones and help with houskeeping but basically icu is a one on one and the patient requires trained care

Ariesbsn · Sep 17, 2007

In addition to the baths, linen changes, and blood draws, nurses in the ICU where I worked (have been in ER now since May) are also responsible for stocking the rooms and emptying the trash and linen bags. The fun part about stocking is that all of the linen has to be refolded to make it fit into the cabinets.

deeDawntee, RN · Sep 17, 2007

In addition to the baths, linen changes, and blood draws, nurses in the ICU where I worked (have been in ER now since May) are also responsible for stocking the rooms and emptying the trash and linen bags. The fun part about stocking is that all of the linen has to be refolded to make it fit into the cabinets.

You've got to be kidding? You would think it would be a wiser use of nursing dollars to hire someone else to do those essential, yet non-skilled jobs.

Susan9608 · Sep 17, 2007

In addition to the baths, linen changes, and blood draws, nurses in the ICU where I worked (have been in ER now since May) are also responsible for stocking the rooms and emptying the trash and linen bags. The fun part about stocking is that all of the linen has to be refolded to make it fit into the cabinets.

We do this in my ICU as well. And the nurses are responsible for counting the equipment in the emergency carts (airway cart, procedure cart, neuro cart, crash cart, heart cart, etc.) Now some things in the carts, like the instruments (in the procedure cart only) may require a nurse to identify them, otherwise, it's just basically counting the equipment to make sure the correct number is there. There's a list on the top of the cart. A tech could surely do this.

We also have to clean our own equipment, like IV pumps, poles, cables, etc. A tech could do this as well.

Occasionally we have an "equipment tech" to do this stuff, but not often.

NursingAgainstdaOdds · Sep 17, 2007

Just wanted to add-in that I work med-surg, and while we do have aides we still do a great deal of the personal care and so forth. If it's messy, clean it up, no matter how much alphabet is after your name...

deeDawntee, RN · Sep 17, 2007

We do this in my ICU as well. And the nurses are responsible for counting the equipment in the emergency carts (airway cart, procedure cart, neuro cart, crash cart, heart cart, etc.) Now some things in the carts, like the instruments (in the procedure cart only) may require a nurse to identify them, otherwise, it's just basically counting the equipment to make sure the correct number is there. There's a list on the top of the cart. A tech could surely do this.
We also have to clean our own equipment, like IV pumps, poles, cables, etc. A tech could do this as well.
Occasionally we have an "equipment tech" to do this stuff, but not often.

Holy Crap!! That is truly unbelievable! Do you really have time for all that?

HealthyRN · Sep 17, 2007

If there is no tech to help, are you expected to bath patients and change linens by yourself? Or do you take turns helping other RNs? I am interested in ICU nursing, but it is the physical component that is worrying me. It's not that I feel that I am above bed baths or anything, but I just don't know how I could handle this without any help. My back hurts as it is!

fultzymom · Sep 17, 2007

I am in Southern Ohio. I know that our ICU nurses do total patient care. There are not any STNAs on that unit. The nurse/patient ratio is usually 1:2 depending on the patient. I have never worked their but did do some clinical days there and they told me it has always been like that.