Oral care in patients

[boomshakelaka]

As a nursing student, i've observed that not every policy a hospital has is being upheld by nurses. one for example is oral care. Policy says every 12 hours, with 4 hour mouth assessments, but i sometimes only see one a day in other patients that are dependent. Does oral care often get missed because nurses and care aids are too busy?

[Gabby-RN]

As a nursing student i've observed that not every policy a hospital has is being upheld by nurses. one for example is oral care. Policy says every 12 hours, with 4 hour mouth assessments, but i sometimes only see one a day in other patients that are dependent. Does oral care often get missed because nurses and care aids are too busy?[/quote']

When I was a floor nurse, speech therapists, respiratory therapists, occupational therapists, nurses and techs could/would all do mouth care. Patients families would often do it too. There were shifts it would get missed, particularly on patients that are able to do it themselves. No excuse is a good excuse but sometimes there just is not enough time in the day to get to everything you are supposed to get to. I would say being busy is one reason it can be missed but another is that so many people are able to do it and sometimes do it that everyone thinks someone else did it. Say there is a vented patient, the nurse sees speech working on a food trial, usually the therapist does it but today she was behind and didn't do it. She assumes the tech will do it anyway. It isn't until the patients mouth is pasty and gross that someone realizes it was missed.

[MunoRN, RN]

This is the unfortunate, but predictable, result of when our plan of care/hospital policy meets the basic physical laws of time. Long ago, time studies were common; the amount of care that was expected was translated into an amount of time and that amount of time was then allocated to each patient, ensuring everything on the 'list' could get done. Those days are long gone, the challenge of Nursing has become squeezing 30+ hours of care into a 24 hour day. Even with our impressive short-cut skills we can't bend the laws of time, which means there will be things that don't get done, the only thing to do is pick which ones won't get done.

[RNperdiem, RN]

You know Maslow's Hierarchy of Needs? Nurses have their own hierarchy of "Things to get done".

The most important "Have to's" Start with assessments, meds and charting. Charting is on computer, no no quick dashing off a few bits of info on a clipboard-we will be audited on this stuff. Assessments come first. Without a proper assessment, you do not know your patients. After assessments and charting, we start our first round of meds. This also takes a bit of time, and has to be done right.

Between the rounds of assessments(which might be hourly in ICU), meds and charting, we move on to the next level of things to get done. Here we work on checking doctors' orders, labs, getting patients out of bed etc.

If there is time, then the next level of the pyramid can be done, oral care, more than the most basic of hygiene, time to talk with the patient and family and other things that make nursing rewarding. Usually there is not enough time, and the things from this level are the first things dropped.

[toomuchbaloney]

It is a shame, isn't it?

Good and timely mouth care can really contribute to the overall comfort level of a dependent patient.