2 Nurse Skin ✔ q Shift ❓

Updated:   Published

I was talking to a gal who told me that the latest and greatest at her hospital is that 2 nurses have to document a head to toe skin check on every single patient,  every shift, no matter what their risk factors. Real awkward on a 14 year old, ambulatory pediatric patient. Every crack and crevice, she said.

Sounds like more regulatory and desk jockey overkill to me. What happened to nursing judgment and preserving patient dignity? I would flatly refuse if they tried that on me.

Specializes in Hospice.
Emergent said:

Interesting. There are plenty of unbalanced and/or litigious patients in acute care. Maybe the second nurse is more of an escort, in case of false accusations. 

Eventually they're probably going to go to bodycam. It's been a life saver for law enforcement. 

Interesting - how would they handle HIPPA  issues?

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Specializes in ER.
heron said:

Interesting - how would they handle HIPPA  issues?

On my last job I had a lot of time on my hands. I watched a lot of body cam video to fill the time. Then I talked to a police officer I knew. These websites on YouTube are able to obtain body cam video through the Freedom of Information Act. He says it's a real burden on their records division, because they have to go through it all and redact private information, blur out faces of people who aren't suspects Etc. Probably the laws vary from state to state.

So, regarding healthcare, perhaps it would all be confidential unless there was an accusation or a lawsuit. It's just the way the world is going. Add the unknown future that includes artificial intelligence, and the skies the limit on being constantly monitored and videoed. It's A Brave New World.

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Specializes in ER.
heron said:

Interesting - how would they handle HIPPA  issues?

Interesting article

Should Healthcare Employees Wear Bodycams?

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Specializes in Psych, Addictions, SOL (Student of Life).
Emergent said:

Interesting article

Should Healthcare Employees Wear Bodycams?

If the body cam is only worn by the nurse on shift there is no HIPAA issue. Just as a brain sheet does not have HIPAA concerns if shredded before nurse goes home. The nurse is not wearing it home.

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Specializes in ER.
hppygr8ful said:

If the body cam is only worn by the nurse on shift there is no HIPAA issue. Just as a brain sheet does not have HIPAA concerns if shredded before nurse goes home. The nurse is not wearing it home.

I think the idea is, a) to protect healthcare workers from false accusations, and b) as evidence in a possible malpractice lawsuits. 

My law enforcement friend says, only he or his supervisor are supposed to review the footage,  although they do share highly amusing ones with their colleagues sometimes. Otherwise, it has to be requested officially under the freedom of information act, as I've described. 

I suppose it could be reviewed by the nurse at the end of the shift to make sure he or she charts properly. I would hope that, just like police officers can turn it on and off before and after a traffic stop, or some other police activity, that the nurse would also be able to turn it off when she leaves the patient's room. Nurses need to have some off the record conversations with each other, just like police officers do.

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Specializes in Psych, Addictions, SOL (Student of Life).

In the 20 years I have been a nurse in hughly litigous (sic) specialties I have only been named in a lawsuit once and only as a witness I kept real time notes o fetal monitoring slip which saved me from being named in that suit.

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Specializes in ER.
hppygr8ful said:

In the 20 years I have been a nurse in hughly litigous (sic) specialties I have only been named in a lawsuit once and only as a witness I kept real time notes o fetal monitoring slip which saved me from being named in that suit.

Yes, me too. I think my name was on the chart. I think it was a criminal case against a patient who'd been brought to the ER, that was settled before any deposition from me was needed. As I recall, I'd  looked up the chart when I got the letter, and had zero recollection and hadn't been the primary nurse. 

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Specializes in Psych (25 years), Medical (15 years).

Interesting idea, the body cam, Emergent.

As I was briefing through the article, a memory from the 1990's came back to me of a visit I made to the local Children's Home School Department: As I was visiting with the principal, an old co-worker/friend, one of the boys began acting out. The principal gabbed a camcorder and began filming the acting out behavior, which immediately ceased.

The principal said something along the lines of, "They don't like having to watch their behavior on the video when we show it to them during therapy meeting afterwards, so when they see the camera, their behavior ceases".

Most want to show their good side when being monitored by audio/video.

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JBMmom said:

That's crazy. We have a two RN skin check on admission and let's face it, on busy days/nights we all have our go-to friend that we say "hey I'm charting you as the 2 person check on my admission, okay?"

And nursing should never be that way. That's why nurses are quitting left and right, for the ridiculous administration that doesn't put a stop to things that make nurses have to do like this. Facility penalties are their own and try to pin it on nursing.

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Specializes in Patient Safety Advocate; HAI Prevention.

Skin check was part of routine hygiene in both my training and my practice when I became a nurse.  Bathing and other patient hygiene was integral in all of the care we gave, and during AM bathing and PM wash up and back rubs, we did skin checks.  My husband was hospitalized and mostly bed bound for a month this Summer before he died.  The only time he was bathed (unless I did it)  was if he soiled himself.  The only time they took positioning and cushioning seriously was AFTER he got a bedsore on his coccyx.  If a nurse is going to take the time for so called "skin checks", maybe bring along some bathing wipes or a good old fashioned washcloth and towel and help the  patient to bathe, and help them to change positions from side to back to side too.  I was horrified at the lack of assistance for just routine hygiene for my husband.   He shaved ONCE in a month, and I helped him to brush his teeth...nobody else did.  What happened to good old fashioned patient hygiene?  

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Specializes in ER.
KathyDay said:

Skin check was part of routine hygiene in both my training and my practice when I became a nurse.  Bathing and other patient hygiene was integral in all of the care we gave, and during AM bathing and PM wash up and back rubs, we did skin checks.  My husband was hospitalized and mostly bed bound for a month this Summer before he died.  The only time he was bathed (unless I did it)  was if he soiled himself.  The only time they took positioning and cushioning seriously was AFTER he got a bedsore on his coccyx.  If a nurse is going to take the time for so called "skin checks", maybe bring along some bathing wipes or a good old fashioned washcloth and towel and help the  patient to bathe, and help them to change positions from side to back to side too.  I was horrified at the lack of assistance for just routine hygiene for my husband.   He shaved ONCE in a month, and I helped him to brush his teeth...nobody else did.  What happened to good old fashioned patient hygiene?  

I'm sorry for your loss. 

I think all these computer charting mandates have eaten away at any time for that. The nurses are too busy clicking drop-down boxes so the chart reviewers won't have a fit.

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Specializes in Psych, Addictions, SOL (Student of Life).
KathyDay said:

Skin check was part of routine hygiene in both my training and my practice when I became a nurse.  Bathing and other patient hygiene was integral in all of the care we gave, and during AM bathing and PM wash up and back rubs, we did skin checks.  My husband was hospitalized and mostly bed bound for a month this Summer before he died.  The only time he was bathed (unless I did it)  was if he soiled himself.  The only time they took positioning and cushioning seriously was AFTER he got a bedsore on his coccyx.  If a nurse is going to take the time for so called "skin checks", maybe bring along some bathing wipes or a good old fashioned washcloth and towel and help the  patient to bathe, and help them to change positions from side to back to side too.  I was horrified at the lack of assistance for just routine hygiene for my husband.   He shaved ONCE in a month, and I helped him to brush his teeth...nobody else did.  What happened to good old fashioned patient hygiene?  

I have seen this with both my parents and often had to perform routine hygiene for thme. I also taught my siblings to do this. As a family we were all estranged from my mother but we still showed up on a schedule to be sure she was taken care of. I can't fault the nurses because they did the best they could. When I spent a year working LTC I always started my shift by checking in on each patient and offered warm wash cloths. If they needed assistence I provided for it. I charted in real time as I moved from room to room. If there was a wound or skin issue I would coordinate with unlicensed staff to get these cares done efficiently. 

Hppy

 

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