Baths on night shift?

[RNforLongTime]

I work night shift, M-F in a 6 bed ICU/CCU. Been straight nights since November. Worked at this place since last Feb. We have a new nurse who's been an RN for awhile and worked nights for 16 yrs. She's working days/eves for us. Since I started here, it hasn't ever been impressed on me that as a night nurse, I am EXPECTED to do baths on my shift. Usually, if my patient is intubated and sedated, I WILL bathe them on nights. When I worked days, I'd get irked to come in and find that NONE of my patients had been bathed on nocs. When I mentioned it to my manager, her response was well if they didn't do it, they didn't do it.

Now that this new nurse is here, and only works days/eves, she seems to think that us night shifters should bath at least 1/2 of the pts in the unit. Cause that's what she did when she worked nights at her last job. She SAYS she mentioned her concerns about baths to our nurse manager who told her

that she agreed with her. Now, this isn't how we've been doing things where I work. Nor has it ever been an issue with any other day shifter until this woman started working here. And frankly, where I worked before, at the only trauma hospital in the ICU, we didn't do many baths on nights there either.

Now, usually on nights, the nsg supervisor pulls our aide to the med-surg floor as their night shift aide quit, or she'll get pulled to the detox floor or the medical psyc unit. She's even been pulled to OB. Our aide works 4 nights a week--no weekends--and maybe gets to stay in ICU with us 2 of those shifts.

This new nurse said that she's been there for 6 weeks now and we on nights have not done ONE bath. Well, we haven't had any vented pts in awhile and most of our pts have been alert and oriented. I am not gonna wake an alert and oriented person in the middle of the night to give them a bath. If they are sedated on a vent, or confused with no concept of night or day, then I have no problem giving them a bath IF I HAVE TIME. New nurse says there's been plenty of confused pt's in her 6 wk tenure that we could've bathed on nights. Whatever lady. I think she's trying to cause trouble. She hasn't made any friends and believe me there's plenty of things that she doesn't do.

Now mind you, we run skeleton crew on nights and as a 6 bed unit, we never have more than 2 nurses on the unit...no matter what the acuity. Also there is no respiratory therapy at night either, so I have to do my own vent checks and respiratory treatments. Also have to restock the med area and do 24 hr chart checks on nights.

So, what is the policy where you work regarding bathing pt's at night?

[SactoRN]

One of the things I noticed NOBODY mentioned was the role of the family in all of this. I always try to involve family in the care of the patient, and one of the things they can do is bathe the patient in those areas that are easily accessed and not injured. I give family members small tasks all the time, and often I find that they become more comfortable with the situation and feel less powerless. The family must be part of the health care team, as well as the patient. Patients who are A/O and fairly mobile get small "tasks" as well. I'll tell them, wash everything that you can reach comfortably and avoid your dressings, I'll come back and help you with the more difficult parts.

I honestly believe this helps the patient in many ways. It gives them a sense of involvement in their care, it gives them a sense of control over their own body, it gives them motivation to help themselves (even if it's just this small way), it establishes a collaborative relationship between me and the patient, and it gives me teaching opportunities. Even the apathetic patients will do it because I tell them that if they can take care of washing the easily accessible bits, I may have time to give them a backrub (always appreciated). We aren't afraid to touch our patients and we should help the family to not be either, and I think we can give the rehabilitation stage of recovery a real boost by getting the family and patient directly involved in their own care ASAP :)

P.S. - This philosphy applies to either day shift OR night shift. I think that assigning a task to one shift only is a mistake. It creates a "task" oriented culture which is NOT what being an RN is all about.

[MellowYellow]

On my 8 bed SICU and the 8 bed MICU we do bathe the patients on the night shift. It's not a "rule" but it usually is in the best interests of the patient, and isn't that why we are there? For the most part the day shift really does not have the time between doctors, tests,families,3 meals etc.etc.

On the night shift we do chart reviews and check the MARs, for the most part we definitely are not as busy as the day shift (sometimes I think they should have our differential--but then I regain my senses.). Our staffing on nights is basically the same as days- we have no PCTs and we all help each other. Someone will start at 3 a.m and then we'll go down the line fluffing and buffing. We all take pride in leaving our patients looking and smelling good. The "walkie talkies" we usually leave alone.

Having said all that- it's a 24 hour, continuity of care situation- if I don't get to something (a bath, a tubing change--whatever) I pass it on. My co workers trust me enough to know I'm working hard and not shoving things off onto them if I truly cannot get to it.

[dorie43rn]

This has been a touchy subject in our unit also, especially with a new aide who thinks the patients should all be bathed on nightshift. On afternoon, or midnight shift, we go around together and bathe the vented or sedated patients. Alert and oriented patients get their "set up" in the morning. If its busy at night, and they don't get done, to bad. Bathing is not a first priority. Our aides get nasty on the daylight shift if you don't set your patient up. God forbid I have meds, assessments, new orders etc to do. Again, bathing is not my first priority. Pateints need their rest to heal properly, what the heck is the fuss about getting baths done? Lazy aides I say.

Dorie

[AliRae]

I just found this thread, and I have to admit, I'm shocked. The subject of baths has never once come up on our unit. We do them on days, and if we don't get to it, we pass it along in report. A couple of our babies who've been with us for months are night-time baths, just because they usually get paired with busier kids during the day.

I honestly did not know that this was an issue on other units. I should go count my lucky stars, I guess!