Patient rights v. Clinical instructor?

Nurses General Nursing

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Last week, my clinical instructor and a fellow student got into, well, let's call it a discussion, regarding bathing our assigned patients. In this case, this student's patients was A&0x3 and completely independent. He refused, even after encouragement and rationale for hygiene was given, to bathe or have his linens changed. When the clinical instructor heard this from the student, she said she didn't care and it was a requirement of each day that we bathe our patients and change their linens. She stated that we should not ask, we should demand and state that we WILL be assisting/giving our pt their bath and changing their linens. IF the patient refuses, tell them it is our job and we have to do it and that it WILL be done. I understand the importance of hygiene and comfort and what a lack of can do to a patient's immune system and overall well being, as do my fellow students and we are NOT above assisting our pts. If the patient asks for a bath or says yes to one, we will give it in a heart beat. My question is: Is it a violation of their rights if we "force" them to bathe? Can we be found guilty of any sort of abuse as students if we are following the instruction of our clinical instructor? We are second semester (out of 5) RN students if this makes a difference and we are currently doing our clinicals on an Oncology ward in a hospital. Thanks for your opinions. :-)

I had a somewhat similar situation when I was in nursing school. I was taking care of an A&Ox3 older gentleman. While I was doing vital signs, I told/explained to the gentleman that the physical therapist would be in shortly (he had was on an ortho floor) and if he wanted to clean up before they got there, I would be more than happy to help him. His wife was at the bedside and he said he would be more comfortable with her helping him instead of me. I then asked her if she had helped him with AM care and she stated she had and only needed the supplies (ie towels, washcloths, etc). I set everything up for them and told them I'd be back to check on them in a certain period of time, something like 30 minutes and if they needed anything before I got back to call the nurses station.

I then proceeded to help a fellow student with AM care on her patient. After helping her, I went back to my patient and took out all the dirty linen and cleaned up the room. While the patient was working with PT, I changed the bed myself.

During the med pass, my instructor asked me if I had done my AM care yet and I explained the situation to her. She proceeded to tell me that I was responsible for AM care myself and I shouldn't have "put off" the care on the significant other. I tried to explain to her what had happened but she didn't want to hear it, so I just brushed it off and went about my business. I knew I didn't do anything wrong, I respected my A&O patients wishes.

Actually you did do the AM care....you offered, arranged and gathered the supplies. You also respected your patient and his wishes. I've had several patients in clinicals who have prefered a family member help them and several cases where I've assisted the wife give her husband a bath and still others where I did it all. Any of those are fine with me as long as it gets done and everyone is happy and comfortable.

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