do you make sure your pts

[juzme]

Hello fellow nurses;-)

my DH and I went to visit his mother in the hosp today...this was her 2nd day, dx dehydration. she is pleasant late 80s with pretty severe dementia. Very nice hospital, quiet,,,no one rushing around...(not like the hospital I use to work at;-) staff at desk talking amongst each other.. anyway, MIL with crust all around her lips, mouth very dry, hence the crust(no swabs around) eyes crusty, hair not brushed and has matted(she has never looked like that.EVER.)it was a somewhat of a shock for my DH to see her like that.. her heels right on the bed(not propped on a pillow)so the heels do not break down....this was at about 5pm. My husband was so angry..he said if they all have time to stand around and talk why hasn't someone cleaned her up?

Anyway..I do not want to bash any other HCP, but i do see his point..we were both just so exhausted, when her nurse strolled over to the room from the front desk we didnt even ask why she wasnt cleaned up..I just did it and was happy to do it for my dear MIL. I know when i was tons busy, running my butt off I still made sure either myself or the aide did the care...hair brushed, face washed off, mouth care(esp. with dementia pt who didnt drink much, would go in and swab their mouths...constant rounds on the floor, esp. when things were quiet..time to catch up and whoever needed some things..got them.

So fellow nurses, my question..do you make sure your aides(if you have them)or you, yourself, make sure your pts are getting at least some minimal grooming done? Thanks.

[Lovely_RN, MSN]

Can it be run w/o nurses? Plenty of units with no techs...none w/o nurses. I get along very well with the techs but they shouldn't delude themselves into thinking all work will cease w/o their presence. I give respect and expect to get it in return. I encounter a few with a huge chip on their shoulder like you're supposed to kiss their butts every minute of the shift. You get paid to do a job and you're just as easily replaceeable as I am. Also this judgdemental attitude...we need more nurses like you....mind games and manipulation.

let me clear one thing up. The floor cannot run without techs. When I am a practicing nurse, I WILL team with the techs, I will respect them, help them however I can and never under any circumstance take them for granted. Their role is crucial.

[mindlor]

Can it be run w/o nurses? Plenty of units with no techs...none w/o nurses. I get along very well with the techs but they shouldn't delude themselves into thinking all work will cease w/o their presence. I give respect and expect to get it in return. I encounter a few with a huge chip on their shoulder like you're supposed to kiss their butts every minute of the shift. You get paid to do a job and you're just as easily replaceeable as I am. Also this judgdemental attitude...we need more nurses like you....mind games and manipulation.

Ahhhhhhh I sense you need a hug this morning lovely_rn!!!!

*BIG GIANT HUG*

[mindlor]

Obviously the flooe can run without techs if they staff up with more nurses......

There may be the rare 12a-7a shift that has no techs yes?

But where else? I think in modern hospitals a floor with no techs is rare indeed

[vashtee, RN]

Seriously? Maybe you are being a little dramatic here?

I have been on many units and seldom have I seen more than 20 percent of patients being total care...

I am sure they exist, but as you said, I dont know ***** lol

I work on a DOU floor that also takes *all* CVA patients. There is a very high patient turnover rate, and the majority of our patients are total care, or close to it. People hate floating to our floor because of the pace.

I would LOVE to take 2 patients (even total care) and not have any CNA at all. Then yes, I might have time to brush their hair, but for now, I am more worried that my patients are eating, because we have a LOT of feeders (and CVA patients take a LONG time to eat because of impaired swallow and high aspiration risk), and turned q2 so they don't get bedsores, and not sitting in their own excrement or urine.

Is grooming important? Yes, but not as important as other things, and you will see that at times, you too, will have to learn to prioritize.

Most nurses *I* know want to provide high quality care, but are limited by high patient loads and poor staffing. You'll see.

[deftonez188]

Prioritization is a basic principle of nursing care. These nurses deemed the care needed was not a priority. It's great to have a big heart for humanity, but let's not confuse what we wish to be with reality.

Also, those not nurses yet commenting on how things 'should be,' walk a mile buddy, walk a mile.

[mindlor]

No doubt that nurses WANT to provide the personlized care. I certainly understand the staffing issues and what not on a busy unit...

However, many times I see patients not receiving proper care while the staff stands around for 15 minutes looking at videos of so and so's new puppy on the hospital computer....

[dudette10, MSN, RN]

I have been on many units and seldom have I seen more than 20 percent of patients being total care...

The other night, I had six patients, five of which were incontinent of urine and stool. Three of those five needed two people to turn because they were very stiff and/or unable to help turn themselves for a clean up. One was a complex patient that I spent about 45 minutes at the beginning of shift and 30 minutes at the end of shift to do a thorough clean up w/ early am med pass. The sixth patient was the only one who was alert and oriented x 4, but she was up w/ assist.

My unit has very, very few self-care patients. About three-quarters of the time, the one who wants to go to the bathroom by himself really shouldn't because of a high fall risk, so those are assists, also. Some of them have impaired judgement so you have to keep a close eye on them while in the bathroom or on the commode.

Looks can be deceiving when it comes to safety and the amount of time and diligence necessary to ensure it.

[Lovely_RN, MSN]

Ahhhhhhh I sense you need a hug this morning lovely_rn!!!!

*BIG GIANT HUG*

Thanks but no hug...I need a chill pill and the winning mega numbers more than a hug. More and more I feel like Sisyphus during each shift and the constant criticisms toward nurses irritates to no end. Yes there are lazy nurses but the constant merciless criticism from non-nurses and nurses alike grates after a while. Its always woulda... coulda... shoulda....I'm (or I will be) a better nurse than she is. Unless you were the nurse for that shift you have no idea. Yes we have to cut corners due to staffing and if folks are mad now just wait. This country's health care system is getting worse...where's the money going to come from? Soon we will have third world style hospitals.....one nurse for many patients even in acute care. See if mamma gets her bath then. Hospital patients will need family to bring food and supplies if they want more than the lowest quality bare minimum. Sounds kind of like most nursing homes right now doesn't it? Hospitals have been cutting everything and are next on deck for very steep cuts in Medicare and Medicaid dollars but of course its always because the nurse is lazy and too big headed. God forbid a lazy nurse sip water, take a break, or chat in front of her peers,pts, or family. We need to work every second of every shift and then some to not be considered lazy and even then someone will find something else to knock you down for. Fellow nurses do your best and make yourself scarce if you get 30 seconds of peace or people will hound the life out of you. It's truly never enough.

[fakebee]

:)Mindlor I would give a years salary to be a fly on the wall with a video camera to record your first year as a staff nurse. It should be a riot!

[vashtee, RN]

I truly wish there was some way to diplomatically tell family members they should be participating in their loved one's care if they want them to be shaved or have their hair fixed if they are a patient anywhere besides ICU, and that I have as many as seven other patients who believe they are more deserving of my attention than your parent. Of course, the hospital would fire me if I gave the impression that we are understaffed. :/

I don't mean this to be sarcastic... I wish this with genuine concern for my patients. My own child was a brain surgery patient, and there is no way I would rely on overburdened hospital staff to take care of her basic needs... because I have no idea what her nurse's other patients needed.

Caring for the sick should be a collaborative effort between staff and family members.

[mindlor]

:)Mindlor I would give a years salary to be a fly on the wall with a video camera to record your first year as a staff nurse. It should be a riot!

I think you would be impressed.

I had my clinical evaluation yesterday and do you know what she said?

She said she would be honored to work side by side with me on the floor and I told her the same thing.

Will I make mistakes? Of course I will.

Will it be a riot for the viewer? No I dont think so as I take my work very seriously.

You don't know me so your comment seems a little inappropriate.....anyway, I have no problem with a little levity at my expense.....

[mindlor]

I truly wish there was some way to diplomatically tell family members they should be participating in their loved one's care if they want them to be shaved or have their hair fixed if they are a patient anywhere besides ICU, and that I have as many as seven other patients who believe they are more deserving of my attention than your parent. Of course, the hospital would fire me if I gave the impression that we are understaffed. :/

I don't mean this to be sarcastic... I wish this with genuine concern for my patients. My own child was a brain surgery patient, and there is no way I would rely on overburdened hospital staff to take care of her basic needs... because I have no idea what her nurse's other patients needed.

Caring for the sick should be a collaborative effort between staff and family members.

You are spot on in my opinion Excellent point!