Ok, so there's this obese patient...

LindaMarie76 · Jan 29, 2005

I am going to jump right on in here. Our hospital performs many of the bariatric surguries, thus we often have totaly very ill bariatric patients in the unit. The average weight is 400-700 pounds. Anything under 300 pounds is considered lightweight.

Anyways...one of the things that many nurses on my unit (including myself) find extremely annoying is when nurses jump right in and perform bed baths on the patients at the beginnning of shift. It's one thing if the patient is lying in their own excrement, but otherwise, it is just not necessary in the first four hours of shift. When we care for a bariatric patient, we know that we will need assistance turning. Everyone knows that. Therefore, BEFORE we start bathing the patient, we go nurse to nurse and say, "I'm going to bathe Mary. I'll need you in about 1/2 hour." You need to line your ducks up in a row when you know that you are going to need mass assistance. There may be a problem with another patient or patients. We often set a specific time to bathe an extremely obese person, usually when we know the unit is expected to be slow, around 2-3 AM. And as for the nurse who took care of Mary four days last week, she may very well have an injured back and can not or will not help turn. If you can't get help when you ask others before you starts to bathe, then just do the parts that are accessable. When you report off in the morning, say, "I washed these bits and pieces, but was unable to get assistance in turning so I couldn't get her back or change her linens." Then mention it to your immediate supervisor. Remember - no one ever died from lack of a bath.

When we had an 800 pound patient who came in with resp distress, became intubated, and eventually received a Bivona Trach, it took 6 people to turn him. Hell - it took three people to hold up his belly so we could clean his pelvis area. It took 5 people to hold his legs apart and do peri-care. Turning him meant enlisting the help of people from other department. One night in the middle of his turn, the trach fell out.

Lesson learned, "It's not necessarily night shift's job to bathe the patients. Sometimes extenuating circumstances require day shift to do this. Second - no one ever died from not receiving a bath".

It seems to me that there is more to the situation than meets the eye at first glance.

Linda

....I'm caring for. She's approx 400lbs, and since I'm in the prn pool, naturally I am assigned to her for the night. So as usual, I dive right in and bathing her, cleaning her room. I normally don't mind as long as there's some help to turn her. Well, I'm finished with her front, and I come out to request help in turning. We need about 4 people to turn this woman as she is too weak to help.
Well, one nurse says, "I've taken care of her 4 days last week and my back hurts" She turns her back to me and I just stood there with my mouth open. Luckily a few of the staff took pity on me and came to my rescue.
I have said nothing to her, and I've only worked with her here once before and got the same attitude.
I'm definately considering a full time position in this hospital as the prn work isn't really my thing. I thought I would be able to deal with the attitudes, but it's become too much, and I really think the patient suffers.
Anyhow, just wanted to vent. I'm not going to say anything as I thought for sure my mouth would get me in trouble.
Thanks for letting me bend your ears, or eyes in this case.

gwlillith · Jan 29, 2005

Ok...first of all: For lack of time and space I just gave the highlights of the story. I could've gone on and on...So yes, there sure is more to the story.

Second: I'm certainly NOT on a bariatric unit, I'm in a trauma ICU. As a 10 year veteran Neuro/Medsurg Trauma ICU I'm used to the team work and comaraderie of my colleagues. This experience has been quite a change for me.

Third: I certainly did, indeed, notify the charge nurse (who by the way has no (zero) patients) of my intention to bathe this patient at this time.

Fourth: I spent 8 weeks out of work last year for an L4-5 herniated disc myself, due to assisting in turning a 500 lb comatose trauma patient.

My point and question was, Whatever happened to good old fashioned professional courtesy? When the days I simply couldnt' help out because of my back, I would be in the room with my colleagues picking up the trash, maybe giving meds to the other patient, or simply just moral support.

I appreciate your input and comments, but sometimes if there is even the suspicion of more than "meets the eye" perhaps a clarifying question or two is more appropriate than lambasting someone who just wants to vent about what a rotten night she's having....

Have a heart Huh?

lindymarie · Jan 29, 2005

Ok...first of all: For lack of time and space I just gave the highlights of the story. I could've gone on and on...So yes, there sure is more to the story.
Second: I'm certainly NOT on a bariatric unit, I'm in a trauma ICU. As a 10 year veteran Neuro/Medsurg Trauma ICU I'm used to the team work and comaraderie of my colleagues. This experience has been quite a change for me.
Third: I certainly did, indeed, notify the charge nurse (who by the way has no (zero) patients) of my intention to bathe this patient at this time.
Fourth: I spent 8 weeks out of work last year for an L4-5 herniated disc myself, due to assisting in turning a 500 lb comatose trauma patient.
My point and question was, Whatever happened to good old fashioned professional courtesy? When the days I simply couldnt' help out because of my back, I would be in the room with my colleagues picking up the trash, maybe giving meds to the other patient, or simply just moral support.
I appreciate your input and comments, but sometimes if there is even the suspicion of more than "meets the eye" perhaps a clarifying question or two is more appropriate than lambasting someone who just wants to vent about what a rotten night she's having....
Have a heart Huh?

Sorry you're having a bad night. I hope and pray you didn't reinjure your back while you were trying to make one of your pt. comfortable . You sound as though you are very dedicated. If I'm ever in the hospital I certainly hope it you I run into, you do have a heart.

cannoli · Jan 29, 2005

I have to agree, there are a lot with bad attitudes out there.

gwlillith · Jan 29, 2005

Sorry you're having a bad night. I hope and pray you didn't reinjure your back while you were trying to make one of your pt. comfortable . You sound as though you are very dedicated. If I'm ever in the hospital I certainly hope it you I run into, you do have a heart.

Meeeee toooo!

Thanks for the kind words

gwlillith · Jan 29, 2005

I have to agree, there are a lot with bad attitudes out there.

It's really been an eye opener, and quite shocking!

BeenThereDoneThat74, MSN, RN · Jan 29, 2005

she's approx 400lbs, and since i'm in the prn pool, naturally i am assigned to her for the night.

what's up with that??? :angryfire i'm a per-diem, and feel like lately i've been dumped on. but the prn pool (we call them the gwyn- 'go where you're needed' team) has been getting the better treatment lately, so as not to 'scare' them, i guess. i guess they are more valuable than me. maybe i'll join the gwyn team (wanna come work with me? i assure you you'd never get a pt. like that!!!)

gwlillith · Jan 29, 2005

That's a really good question, bonemarrowrn. It seems that since I started this gig, I've been getting the "shi***y end of the stick. (literally!) I used to be staff nurse in a Level I ICU, and we never did that to our prn pool. When I moved here a few months ago, I did prn to see which place would be the best to make a "home" with, so to speak. Little do they all know, that they are definately not in the running. They're about to lose a very "seasoned" nurse.

fergus51 · Jan 29, 2005

I don't really understand. Were you upset that she didn't help you or that she wasn't polite about it? If she really couldn't help because her back hurts, I'd let that go. I'm sure you don't want her to be injured like you were and after 4 days of looking after that patient she may be very sore. If you're upset that she didn't offer other help like you did when your back was injured... well, maybe that simply didn't occur to her and you can cut her some slack. I've been offended at times when nurses didn't just jump in and help me when I was swamped, but I've found most of them will if I ask directly so that's what I do now and it works for me.

If she was rude, I would be mad too and maybe just mention it to her. It sounds like the real beef you have is you feel you're being dumped on. If that's the case I don't know what you could do other than speak to the charge nurse or unit manager. No one, whether they be prn or full time should get dumped on. That isn't fair.

SHAMROCKY · Jan 29, 2005

I truly feel for you! I have worked in my level 1 ICU for 12 years and the great teamwork is a big part of what has kept me there. I am moving this summer and I'm so scared to work anyplace else for fear people will act exactly like that! Good luck and remember that you will be an asset wherever you work!

Marie_LPN, RN, LPN, RN · Jan 29, 2005

I could see why she's upset. The other nurses' back hurt, probably because she was doing more physical lifting than she should, and it seems like the oncoming nurse is expected to do the same.

It never fails that when we have 500-700 pound pts. that we are literally short-staffed of orderlies, or even better, their hours are cut "to save cost". Last i heard, worker's comp wasn't cheap.