discontentment

I feel for you and I far too much understand. I have only been a nurse for 3 years and am already so burntout that I dont know what to do with myself most days..... I love the patients, I love taking care of them, but.... policy and procedure get in the way... and on my floor, bathing is the MOST important item to do. It is nothing to have every person on the floor giving a bath to a patient and have the telemetry alarms blazing red with HR>140 in afib and O2 sats in the 60's because everyone is giving baths and noone is acting on these alarms. I want to do more with my degree, I want to love what I do.... I, like you, dont know what to do to change this either.

I don't ask my patients "do you want to take a bath?" I usually say something like, "are you ready to get cleaned up?" With the one patient (the trauma) I offered to just wash her front, her groin, her armpits..... some form of bathing, she still said no. I don't mind bathing patients, I helped bath 4 of the other patients on the unit. It is common practice on the floor to just walk in with everything and start bathing the patient, I have been asked by patients why this happens and why people commonly dont ask them if they are ready to take a bath. I can see doing this on patients that are confused, but only to some extent..... waking an alzheimers patient in the middle of the night and causing them anxiety to me is unacceptable...... but.... then again... where do you draw the line? To me, a patient should always have a choice if they are alert and oriented. Now mind you if they are willingly laying in poop,pee that sort of thing, it only takes some common sense to know that that needs remedied...............

I have seen a BNP of 12000 on a patient weighing 135 pounds..... BNP stands for brain natriuretic peptide. here is a link so simple explanation (you could use it for the patient education) http://www.webmd.com/heart-disease/brain-natriuretic-peptide-bnp-test

I appreciate all the replies! You guys are great! I work on a stepdown ICU unit, no vents, small unit, high acuity and high patient turnover. Night shift is responsible for over half the baths, this is a primary care unit in a hospital setting, we do not have CNA's and our LPN's are mostly our unit clerk/lab person. We must escort our patients to whatever test they have on day shift as they are often on cardiac drips that require constant monitoring. Generally speaking, bathing is hard to do on dayshift but we try to do our share, which reserves night shift to do the rest. Our manager is talking of writing people up for not bating the patients but you cant force them, some of the RN's dont give the patients a choice, they just walk in a say.... You are taking a bath and if the patient says they dont want to, the reply is, it will just take a minute and they start bathing them anyway..... I am not about to enter into the 'battery' zone, especially over a bath. I just feel frustrated over this whole topic and my manager says to document but then pulls stuff like.... do you really think that that lady would tell you she didnt want to bath right then...... who would at MN and 5am after xanax/sonata Basically, she says to do it anyways as it is in the best interest of the patient... which i agree that bathing is in the best interest of the patient, but everyones personal hygiene habits are not alike.

Could someone please help me with this delimna. First and foremost, I want to start this off by saying.... I dont mind to bathe a patient. I quit one job and took another with a lower patient ratio in order to be able to bathe patients and provide better care for my patients on a daily basis. Herein lies the problem. In working one night recently, i had three patients (work on a icu stepdown unit), one patient was on bedrest till the mornining and didnt want to bathe until he could get up a poop on the commode, he wanted to bathe himself. Another was an 80 yo with PNE, HCAPS she was asked at MN replied it was too late, then asked again at 5 am, replied it was too early. It was explained to her that days may be too busy and would she like to go ahead and bathe now..... still the answer was no (mind you she had had xanax and sonata at 10p before i assumed her care and was quite sleepy) and another patient was a trauma patient, she was tachy, hypertensive, humerus broken in 3 places (not fixed yet) scaplula broken and orbital fractures, and t11-t12 fracture. she was asked multiple times, she was extremetly anxious, she didnt want to be touched, she had a 100% non rebreather on and would desat quickly without it.... wouldnt allow it to be put around her head, she had a washcloth holding it in place. she refused the multiple times she was asked. all three of the patients were A/O X3, there were no overt signs of filth, infection or otherwise. the problem? my nurse manager was asking coworkers today if they felt that the patients really felt that way about getting a bath . I feel that it is unethical to force someone to bath when they do not want to...... AM I wrong??????? Please feel free to be honest..... I am really perplexed at why you wouldnt just ask the patient if they had been asked to bathe?????