No time to bathe pt's, feel bad, help

BGgirl · Jun 21, 2006

Even on my unit with a 4:1 ratio on nights and a 3:1 ratio on days baths don't always get done. Can some of your patients clean themselves up? I work nights and I understand when some baths don't get done and I'll try to get them done on my shift. We can be just as busy on nights and when we do have time to do baths it's usually very early in the morning and people who are alert and oriented don't want to get washed up then. We typically only bath confused patients or people going for tests the next day on nights.

I'm not sure how you can fit baths in but you shouldn't be responsible for getting all your patients bathed. It tends to be a problem on my shift where day nurses assign us baths in their shift to shift report. If you just tell the next nurse that you didn't have time to bathe someone and if they had time could they please make sure they're bathed during the night it is typically not a huge issue then.

General E. Speaking, RN, RN · Jun 21, 2006

Reminds me of this past weekend. Two of the three days, we worked short. I could barely keep up with passing meds, fingersticks, IV starts, confused and incontinent patients PLUS all the docs and numerous consults coming in and writing orders for meds, dsg changes, etc... I barely sat down during my 3 twelve hr shifts. I had a talk with our NM about the bath situation. Almost all of the baths are being done by the day shift. There is no reason why some of these can't be split up among the other shifts. We are about to lose a few good nurses/techs on the day shift who are simply exhausted. I left feeling like I didn't take the best care possible of my patients.

Please don't misunderstand my comments, I don't want this to be a day shift vs. night shift issue. It is simply something that is occuring at present at our facility. It wasn't always so.

Furoffire · Jun 22, 2006

I know the feeling. My first job long ago was in a DOU and I worked 3 12's at night. The unit ran like a well oiled machine. The CN would assign the confused etc. to be bathe, we would team up and whip right through them, tidying up the room etc. The rationale was that days were busy and we needed to free them up. The post hearts were allowed to sleep, others took a shower in the evening. But now at this hospital baths at night are unheard of, its like the unspoken and one does not want to tip the scale.

I like the attitude of not making it a big deal and just doing it, we should work as a team. I know that nights are busy too but if I could sleep during the day I think I would switch to nights in a heartbeat. Must go, my head is pounding.

bethin · Jun 29, 2006

I may only be an aide, but I feel guilty when not all of my patients get bathed. Last week I worked days, and I had 14 pts to bathe. I was still doing baths at 3 when I was supposed to leave. I felt so guilty, like a failure. I wanted to cry because I was so busy that there was one patient that I never saw. I don't want to be a nurse and not see my patients because I'm so busy.

On days like that I tell myself this: I am doing the best I can, the fastest I can. I'm giving all I can give.

Have you asked about hiring aides? I cannot imagine the stress level of a nurse to get meds passed, new orders read, patients assessments, etc. It sounds like your dept needs some help.

prmenrs, RN · Jun 29, 2006

Seems like the NM needs to re-assess the staffing needs. There are plenty of staffing tools out there that quantitate hours per pt day needed by these pts. If she can show (by the numbers) what the needs really are, she ought to be able to justify increasing the RN staff, or augmenting w/CNAs.

Meanwhile, bring up these issues w/her. Are other nurses able to accomplish baths, etc? If you have staff meetings, maybe staff can brainstorm and see if the divide and conquer approach could help.

Can you @ least get their mouths, pits, hands and butts taken care of? You'll feel better and so will they!

I wish you luck!

General E. Speaking, RN, RN · Jun 29, 2006

I may only be an aide, but I feel guilty when not all of my patients get bathed. Last week I worked days, and I had 14 pts to bathe. I was still doing baths at 3 when I was supposed to leave. I felt so guilty, like a failure. I wanted to cry because I was so busy that there was one patient that I never saw. I don't want to be a nurse and not see my patients because I'm so busy.
On days like that I tell myself this: I am doing the best I can, the fastest I can. I'm giving all I can give.
Have you asked about hiring aides? I cannot imagine the stress level of a nurse to get meds passed, new orders read, patients assessments, etc. It sounds like your dept needs some help.

bless you for caring so much about your patients!

LoriAlabamaRN · Jun 30, 2006

Wow, you really need some aides!

Can you speak to your supply clerk about ordering bedbath wipes? They are wonderful timesavers, premoistened cleaning cloths that you warm up in the microwave. No rinsing required, sorta like huge wetwipes. They really work, leave the patient clean and have a fresh scent. I must admit, I have swiped one when running around all night had left me sweaty and they work surprisingly well! You can give a thorough cleaning in a couple of minutes. I know it's not as good as a "real" bath, but it's certainly better than nothing.