do you make sure your pts

Nurses General Nursing

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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.

Cleaning the crust off a defensless person's face is basic nursing care. It takes one minute to wash someone's face as part of another task. If care that basic is being skiped it makes me wonder what else is.

And not doing oral care on someone who is dehydrated is just cruel.

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Specializes in New PACU RN.
I don't want this to sound harsh but before I checked that I "check with and make sure that the docs, pharmacy, kitchen, OT, PT, SLP, X-ray, porter, houskeeping, TV, maintenance, security are doing their jobs" I would make sure my patient is clean, comfortable and cared for so I wouldn't have to "feel terrible"....just saying:smokin:

Each hospital/unit is different in terms of type & number of pts, support staff, acuity & staffing available. I don't know what kind of place you work at but sometimes - bedbaths and extra little stuff to make pts comfortable are the the last things on my list: if I have pain, stat/urgent doc orders, procedures etc. covered - then I can have time for the rest. But I can understand your point - I would never leave someone in an awful condition as the poster said - but I find a lot of pts/family members too fixated on the little stuff when I have bigger things to worry about.

(I'm not talking about total care pts)

[Edit to add: our hospital does not provide toothbrushes, toothpaste, combs, deodrant, razor. Pts have to bring them from home. We only have those spongy mouth swaps and non-alcohol rinse. So if someone doesn't bring those basics for the pt- what are we supposed to use?]

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We need more nurses like you Esme :) From what I can tell, these younger nurses tend to think they are all that and that basic human care like brushing teeth is beneath them, or that it is the techs job...and maybe it iss the techs job but sometimes the techs need a little help.

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EXACTLY i do not wash patients because IT IS BENEATH ME. just like all the other young nurses on my floor, we are too busy with mcdreamy m.d, and mcsteamy, d.o. in the clean utility room while the techs and older nurses do everything.....................................................:uhoh3::uhoh3::uhoh3:

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I wish hospitals, nursing homes/LTC facilities, etc., would hire people like me to do things like this. This sounds a lot like what I do for my older relative that I do caregiving for. I would love to brush teeth, comb hair, wash faces, listen to their stories about what they did in the 50s/60s, etc., while your more experienced people do the specialized medical care.

But with all the staffing problems you all talk about on this site, probably won't happen.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Each hospital/unit is different in terms of type & number of pts, support staff, acuity & staffing available. I don't know what kind of place you work at but sometimes - bedbaths and extra little stuff to make pts comfortable are the the last things on my list: if I have pain, stat/urgent doc orders, procedures etc. covered - then I can have time for the rest. But I can understand your point - I would never leave someone in an awful condition as the poster said - but I find a lot of pts/family members too fixated on the little stuff when I have bigger things to worry about.

(I'm not talking about total care pts)

[Edit to add: our hospital does not provide toothbrushes, toothpaste, combs, deodrant, razor. Pts have to bring them from home. We only have those spongy mouth swaps and non-alcohol rinse. So if someone doesn't bring those basics for the pt- what are we supposed to use?]

I hear what you are saying but....there is a person on the other end of those orders, procedures, meds and treaments. thinking breathing, feeling human beings. If someone like you was caring for your Mom and you came in to find her in a dirty bed, crusty mouth and dirty face...how would you feel? If you still feel justified that the personal care of your patient is the last on your list as well as the comfort of your patient (which can enhance the effectiveness of pain meds) then Ok. I am just asking for everyone to realize what's at stake here and that there is a real person underneath all your chores feeling sick, frighten and alone that could use a little TLC.

I tell you what....I have cared for 11 patients with a LPN and rarely an aide (acute care telemetry) that had mostly totals and a few heavy assists. My patients were bathed, cleaned and cared for. It was the EXPECTATION not the EXCEPTION. If I had to do a bath at 2 PM then so be it......but they were bathed. You need to be organized and effecient. Is it hard YES....does it stink sometimes? YES....but I never let my patients suffer for the lacking moralities of the facilty. I would wet face cloths and place them in a baggie and as I passed my afternoon meds or as I passed trays I would offer them to freshen their face and hands. Admittedly it has not gotten me anything material, but I am rich in my heart. Peace.

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It was the EXPECTATION not the EXCEPTION. If I had to do a bath at 2 PM then so be it......but they were bathed. You need to be organized and effecient. Is it hard YES....does it stink sometimes? YES....but I never let my patients suffer for the lacking moralities of the facilty. I would wet face cloths and place them in a baggie and as I passed my afternoon meds or as I passed trays I would offer them to freshen their face and hands. Admittedly it has not gotten me anything material, but I am rich in my heart. Peace.

thank you, esme.

i share your "EXPECTATIONS"...

even if there was emergency after emergency, at some time i'd make sure pts were washed...

even if it entailed leaving late without the extra pay.

to me, a pt's feeling of well being, is right up there with attending a code.

it has nothing to do with being/feeling "morally superior" (yes wooh, i'm thinking of you.:))...

it is how i have defined myself as the nurse i want to be.

i'm glad i'm not alone.

leslie

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Specializes in DOU.
I never let my patients suffer for the lacking moralities of the facilty. .

Lack of moralities? I don't know what kind of people you work with, but none of the nurses or CNAs I work with are "immoral". They are just really busy.

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Lack of moralities? I don't know what kind of people you work with, but none of the nurses or CNAs I work with are "immoral". They are just really busy.

esme wasn't calling the workers "immoral"!

rather, the employers themselves...

for stretching the nurses/aides so thin, with never-ending demands and expectatations.

we are mere workhorses to the top brass...

and get absolutely no respect or even acknowledgment for all we do.

anyways, esme had made a personal and professional decision to ensure her pts were at the very least, bathed.

(esme, correct me if i've misspoken.)

leslie

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Right on the nose Leslie. I didn't call any bedside care giver amoral. I said it was the FACILITIES that lack the morals to ensure care can be carried out effectively. FACILITIES....THE BUILDING...THE ADMINISTRATION. and before anyone comments I have been amongst the "insider group" of upper management and in my personal experience they do lack the morality to care about the patient.....it's all about the bottom line...MONEY.

I made a personal choice, stopped complaining and made sure my patients were cared for....even if it meant no break or lunch. I have been accused of being too unsocial and not a team player because I am always in my patients rooms. As a supervisor and manager I have never passed by a patients room with a light on and I roll up my sleeves with the CNA and get as many patients done as we can when I can....if that's 3 am then it's 3 am. Patients deserve descend treatment that's all.......when did patient care become only an CNA responsibility and the last priority of the day. I know patients are sick, I know it's busy....but if that was my loved one what would my expectation be for them is how I care for my patients.

I'm a relic I know.....but a proud one!!!!

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anyways, esme had made a personal and professional decision to ensure her pts were at the very least, bathed.

And generally I try to as well. But if one patient doesn't get a bath or any of their personal care, it's not for lack of trying, it's generally because I've got other patients that are crumping.

And you know what? I realize there are lazy nurses out there, just like there are lazy anything else. But I'm going to give a nurse the benefit of the doubt until I know better. And none of these posters that come in "I didn't get this, I didn't get that..." have any proof other than, "I heard something, saw something, I was miserable" that can be explained pretty easily. Unless you WANT to call the staff at the time lazy. And I refuse to sit among my colleagues here and bad mouth them when I have no proof with which to bad mouth them.

I used to complain about this nurse that I had post-op one time, before I was in nursing. And obviously I had plenty of knowledge to judge her with, as I was working in a business that was similar to carpentry;) and was in management.;) And well, on top of that, I had a lot of fast food experience. Then a few years later, after I became a nurse, I realized that I was completely wrong in my post-anesthesia haze, as she was trying to make sure I didn't quit breathing.

So I take everyone's "patient experiences" and definitely take everyone's "student experiences" with a grain of salt.

Especially since after my surgery, the last thing I would do is go to a site full of nurses to bad mouth one of them. But we apparently WELCOME that here. It's uncaring to not listen to every woe is me story and agree, "THAT NURSE WAS HORRIBLE AND STUPID."

Bull.

THIS is why nursing won't get anywhere. It has nothing to do with being mostly women or level of education. It's because we're stupid enough to fall for every hard luck story in the name of compassion and throw our colleagues under the bus at the whim of a patient that says, "My hair wasn't brushed." And if we dare say, "I'm sorry, I didn't have time," our time management skills are called into question. And we get things like, "It only takes a few minutes." Yup, lots of things only take a few minutes. Those few minutes x number of patients x number of things that only take a few minutes + all the stupid stuff we have to do on top of patient care = around 15 hours for most of us. Yet we only work a 12 hour shift that's supposed to also give us time for a lunch and a couple breaks.

So you know what? YES. I'm proud to assume the best about my colleagues until I know better. And yes, I'm going to side with a PRACTICING NURSE over a student (I don't care how many years of management experience they have, because honestly, my fast food experience was better preparation for nursing than my management experience). And yes, I'm going to side with a nurse over a patient. Because I've been on both sides. I was a patient quite a few times. And I know the stupid assumptions that I made back then because as the nurse, I know what's going on across the floor. As a patient, I didn't know anything except what was happening to me. I didn't know the nurse that was "just sitting there" was waiting for a call back. I didn't know the nurse in front of a computer screen was charting, not playing Angry Birds, or if they're playing Angry Birds, it's during their break that they can't take off the floor because there's only two staff members on the floor at the time.

And even as a student, I had no idea. Until you have a full load, that you are 100% responsible for, no matter what happens. Yes, I'm going to make sure all of my patients are breathing before I spend any time doing oral care or brushing hair. If I get the chance, sure, I'm there. But if I don't, oh well. There's only so many minutes in a shift. And if there weren't enough to do everything that "takes just a few minutes" then I'm going home knowing I got the most important ones in. And I think there are a LOT more nurses like me than one would assume the way everyone is so quick to judge on the "That's just unacceptable!!!" bandwagon.

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What I'm seeing more and more of is the elderly coming into the hospital looking messy. Then the daughter (and it's always a daughter) telling us that Mum needs nall care, and a "proper" bath. It isn't going to happen.

I work a short stay unit, usually an overnight stay at max. Our patients 99/100 times walks in and lives independently. Don't expect the nursing staff to fix the problems that the family have allowed to exist at home. Yet the families suddenly decides that Mum/Dad need assistance with everything. Where are they in "real life" when it comes to nail care and bathing?

We encourage them to rub in lotion and help with the grooming but they usually give us a look of such disgust...

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i appreciate your perspective, wooh.

i've always respected you.

i'm sure i'll get flamed with the following, but hey, it's never stopped me before.

unlike you, i am not as confident about all my colleagues, as you are.

i won't automatically side with a nurse over a patient.

YES - most nurses take their profession seriously - i get that.

yet i've also had experience with those who just shouldn't be nurses...

the ones that make you scratch your head and mutter "wth?"

and it is this reason why i have advocated in raising the bar into nursing.

there are just (too) many that should not be.

they either do the very minimum, hang others out to dry, make frequent mistakes w/o realizing (or even caring) the extent of their errors...

it goes on.

why would i want to give them the benefit of the doubt?

and perhaps, i am too protective of our patients...

fully knowing how manipulative some of them can be.

what i'm saying, is i won't immediately side with the nurse or the pt...

but do recognize that as in any profession, there are duds.

i also disagree with you, about most of us taking pt's side.

if anything, i've guesstimated it to be split - with approx half protecting 'their own' and other half siding with pts.

fwiw, i would never, ever have any doubts about you.:redpinkhe

i'm hoping you know that.

leslie

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