Residents not being showered, am I being dramatic?

[brendacg]

Hi all,

I've posted in this forum before about random things and I've always gotten some good advice. Just for some background info, I'm a new nurse and have been working on a skilled floor since August. I am finally settling into a routine and getting a little more comfortable with my role on the floor. So with that being said, there was an incident on the floor yesterday which really bothered me and continues to do so...

One of my LTC residents on the floor had been asking for a shower, so I asked her aid if she could give her one when she got a chance. When I asked her, the aid told me about how the "B" beds were supposed to get their showers on the 3-11 shift (I work days), but that they never give their showers. This story all goes along the lines of one of my skilled patients who said he hadn't received a shower in 2 weeks, and once again I had to ask my aid to give him a shower... simply because otherwise, I'd consider that neglect. Well anyways, I looked through the aid books and found that none of the residents in the B beds were getting their showers...

I brought this to the attention of my unit manager, who then said that it was the responsibility of the 3-11 supervisor. I felt like this was not a good enough answer, so I asked the ADON what to do about this - and she kind of brushed me off as well.

Am I being dramatic about this? Does anyone consider this to be wrong? I was disturbed by the fact that one of the residents had not gotten a shower for the whole month of October!!! No documentations of refusals or anything!

[FLArn]

I would make 1 last attempt to bring it to the attention of the 3-11 staff and the DON. After that, if there are no changes I guess your only in house option is to give the B bed patients bed baths or showers on your time. If you feel strongly about it I guess you could call the state anonymously (or not) and report it. Yes, it is neglect and it is disgraceful but there is a limit to what you can do about this yourself. I would be making sure that B bed patients got "extra" thorough hs care. But I'm not sure what you personally could do beyond that. Thank you for caring but pick your battles carefully, you have a long career ahead and need to conserve your energy for the "life and death" battles.

[artsmom, BSN, LPN]

Sorry, but I disagree with the above poster's advice about doing them yourself. These people need showers, and the 3-11 staff needs to do their jobs! My place assigns each aid one shower per day. There is no excuse. Follow the chain of command up. if everyone, including your DON, blows you off, bring it to state. That is repulsive and unfair! I agree with picking your battles, and I would pick this one. Be an advocate.

[Tankweti]

There is also the issue of skin breakdown from lying in your own sweat for weeks on end, not to mention other body excretions. I would personally do body audits to be sure no resident has suffered any adverse effects.

[FLArn]

The point I was trying to make was that there is a limit to what you can "make" other people do. I DID suggest going up the ladder to the DON and the State. I also suggested dumping it back in the laps of the 3 to 11 staff. If you have no support from the administration all you really accomplish is painting a target on your own back. The only control you have is over your OWN actions. You can write up the responsible staff for their omissions, you can hope the administration will discipline those who are not pulling their weight, you can hope being cited by the state will force the administration's hand to make the offenders tow the line. It has been my experience that any cite from the state brings an "action plan" from the admin which is enforced long enough for them to get the state off their backs then it's business as usual. Do you really think that the entire 3 to 11 staff is going to be disciplined or fired? More than likely the work will be reapportioned to those who "have time enough to check and see what everyone else does" or to the 11 to 7 staff because everyone "knows" they aren't that busy because everyone sleeps all night. In every facility I have ever been the bulk of admissions come on the 3 to 11 shift. That is the main task expected of them, that is not likely to change any time soon. Saying that the OP should have her team do all the showers was largely sarcasm but I do feel that extra attention should be given to the morning care rounds and maybe an extra shower now and again for someone who is in danger of breakdown because if the OP notes the problem and does nothing to help the patient she will find her self in the same hot water as the ones who were responsible in the first place. Just sign me "Been there, done that":blackeye:

[lovingtheunloved, ASN, RN]

Welcome to LTC.

[NamasteNurse, BSN, RN]

In my facility this type of behavior recently resulted in a unit manager, charge nurse and two CNA's being fired. What happened was, a new to the floor CNA reported that there was no documentation and it was followed up on immediately. I say, if you have gone 'up the line' as required and now the charge nurse, nurse mgr AND the DON have really done NOTHING? It's time to call either the state or the ombudsman. This is neglect plain and simple and the higher ups have a legal, moral and ethical obligation to make sure the residents receive care. Make them do thier jobs. Period.

[CapeCodMermaid, RN]

You should be sure you've spoken to the DON before calling the state. Let her/him at least have the chance to rectify the situation.

[CoffeeRTC, BSN, RN]

It is a chain of command issue. Mention it to the shift supervisor, if nothing done..go upwards.