Nasty ....

[DiplomaNurseRN]

In my experience, the two most neglected areas of our practice are mouth and foot care. Our patients often come to us and present some nasty problems in these areas . Be it personal hygiene, a disease process, poor assisted care or disregard by the individual, family and / or primary caregiver it seems to me a continuing problem. Your thoughts?

[Esme12, ASN, BSN, RN]

Very recently I became a professional patient and spent 10 months hospitalized. Part of that time was on life support in critical condition from Sepsis. While I understand all about being busy as I have been a critical care and ER nurse for 38 years...mouth care AND feet care is important to the patient and to their recovery.

At my first hospital in ICU I received very little of the creature comforts. Yes...I was sick and been sick for an extended period of time at home (long story)....from high level O2 on a partial non-rebreather and being so ill, the roof of my mouth was crusted and painful. My nose also suffered and was crusted shut. My lips were cracked, dry, and bleeding. I would try to peel off this caked cement, AKA mucous, off the roof of my mouth in sheets. I was saved when my sister arrived from Chicago (also a nurse) and she took care of my mouth. My feet were weird. They were peeling as well in long sheets of dead skin. No one cared. It made me feel degraded and embarrassed.

At the other hospital I was transferred to...they cared. A warm wash cloth before meals, a back rub, a new pillow case at hs went a long way. I don't remember much from my ICU stay but after extubation (which I don't remember either) the first thing I remember was getting my hair washed by my nurse and 2 CNA's with real warm water and shampoo with a quick blow dry. I can't tel you how good that felt....I felt....human.

I was that nurse who would miss a regular length lunch for a shave, a hair wash, or a good back rub. I never realized how important it was for the little things.

While it might not save your patients life it will make them feel human.

[cyc0sys]

The mouth is the first front line barrier against disease without a doubt. The foot is what gets you from A to B. I learned this long before nursing. I'll sacrifice my time to provide this care in the fashion you described, but we're essentially falling on own swords to do so.

Often Pts are compromised on both ends of this spectrum waaay before they set foot in the facility. While it's never too late for education, self care should always be the first line of defense.

Total Pt care only exists in a world of rainbows, unicorns, and the kumbaya songs that administration sings. As longs as profits are valued more than nursing care, it's the nature of the beast and should be expected when care falls short.

Anything else is just romanticizing the self martyrdom of nursing, as others have described. It ultimately serves no one, especially the next Pt in line, when good nurses are burnt out and jaded, 'life boat politics' are disguised as 'time management'.