Is this an acceptable way to bathe patients or am I overreacting?

[Cherrydrop]

I am a nursing student and an agency CNA, working in nursing homes. Yesterday I worked a shift in a nursing home I hadn't been to before.

I was allocated patients to bathe at the start of the shift and I was told by the RN that I should be able to manage on my own and I would be able to turn the patients with no assistance. I tried to turn a patient and was not able to, so pressed the call bell for help, which took some time.

I had managed to bathe the front half of the patient but there was no way I could turn them to change the pad and wash their back. I told the RN afterwards about what happened and she said it's normal for staff to try as much as they can and then call for help if needed. I do not think this is acceptable.

The other CNAs said the majority of the patients always need 2 members of staff to bathe them properly. I feel that making the patient wait for another staff member to turn up is undignified, as they feel vulnerable being bathed and for some the process of being bathed is very distressing and I don't think they should have to wait any more than they have to. I also feel it's not fair or safe on the staff to strain their backs trying to turn a patient on their own.

Every other place I've worked if a patient has a history of needing 2 staff members to bathe then 2 staff members always go into the patient in the first instance. I called my agency as soon as I could who told me to email them my concerns to have it in writing, which I did.

Am I overreacting or is this acceptable?

[canoehead, BSN, RN]

Keeping two people around for the entire bath might feel wasteful, especially if they need someone out on the floor to cover bells. You could do the bath from the front, then during one of the regular turning schedules, or when they get up to the bathroom, do the back when its exposed.

[K+MgSO4, BSN]

Both models are acceptable. Some places do doubles from start to finish. Some places you start and a colleague comes into assist with the parts you can't do, or inverse start the double bit and then one person finishes off.

[Here.I.Stand, BSN, RN]

First, thank you for being so mindful of the residents’ dignity! ?

I’m an ICU nurse and this is a very common occurrence; unless the CNA is very efficient and/or has a lighter work load, I will do the bed bath to the extent I can without help. Then when I’m ready to turn/change sheets/wash the back I’ll have a CNA or another RN come and help.

As previous replies state, it’s not always feasible to have two CNAs completely off the floor at the same time... especially thinking back to my LTC CNA days, when we only had 3 of us and 1 RN or LPN for 30 residents.

Cover the resident with a clean gown/bath blanket, raise the HOB or anything else they need to be comfortable while you summon help. (Actually regardless I will cover a patient’s body with towels while washing other parts... even if there are two of us and the process goes faster no sense in exposing nudity unnecessarily)

[Sour Lemon]

4 hours ago, Cherrydrop said:

I am a nursing student and an agency CNA, working in nursing homes. Yesterday I worked a shift in a nursing home I hadn't been to before.

I was allocated patients to bathe at the start of the shift and I was told by the RN that I should be able to manage on my own and I would be able to turn the patients with no assistance. I tried to turn a patient and was not able to, so pressed the call bell for help, which took some time.

I had managed to bathe the front half of the patient but there was no way I could turn them to change the pad and wash their back. I told the RN afterwards about what happened and she said it's normal for staff to try as much as they can and then call for help if needed. I do not think this is acceptable.

The other CNAs said the majority of the patients always need 2 members of staff to bathe them properly. I feel that making the patient wait for another staff member to turn up is undignified, as they feel vulnerable being bathed and for some the process of being bathed is very distressing and I don't think they should have to wait any more than they have to. I also feel it's not fair or safe on the staff to strain their backs trying to turn a patient on their own.

Every other place I've worked if a patient has a history of needing 2 staff members to bathe then 2 staff members always go into the patient in the first instance. I called my agency as soon as I could who told me to email them my concerns to have it in writing, which I did.

Am I overreacting or is this acceptable?

In an ideal world, you'd be correct. In the real world, staffing often doesn't allow for such "luxury".

You must keep in mind that baths are not the only thing going on in the facility. And while baths are important, other tasks may be higher in priority and unable to wait in line behind baths.

The place I work in is typically well-staffed, but I still find myself alone (or the CNA alone) for at least part of many team efforts. I'm pretty surprised that you haven't encountered this before, but maybe employers have been "easy" on you since you were not regular staff.