showers on nightshift and time for residents to get up in the morning?

Specialties Geriatric

Published

Recently I have been instructed to have my CNAs to get up certain residents for a shower on 3rd shift because of the residents refusal to shower on 2nd shift. I have two excellent CNAs working with me on this dementia unit. We have 30+ residents who are ALL expected to be up and dressed before the morning crew arrives. We try to wait as long as possible before waking the residents up but the CNAs start dressing people by 5am at the latest. I am unable to offer them much assistance with their tasks as I have morning meds to pass on this hall plus one additional unit that I also have to begin giving very early.

In order to give any showers the residents will have to get up even earlier and many already don't seem thrilled to be gotten up at 5am. Of course the notion of showers did not go over very well when it brought up to the res that early. 11-7 showering was declined and never requested by resident.

I have heard more than once that you can't give showers at night. I have it set in my mind that I've been advised at least once that having residents get up that early to shower was against regulations or against their rights. In the years I've worked nightshift I can't think of a single time that a shower was given to a resident on 11-7 unless the resident had gotten something all over themselves that a shower was necessary to remove it or unless they simply wanted to take the shower at that time. Some coworkers on nights agreed that they were also under this impression while coworkers from other shifts disagree. Perhaps I am mistaken but I'm quit sure that I didn't just conjure this up in my mind.

I've tried to search out information on this from the internet without any success. I'm hoping someone can set me straight on what the guidelines are for showers or for what time in general is acceptable for residents to be awakened and dressed for the day. I want to say the time to wake up is supposed to be no earlier than 5am or 530am but I'm not sure. If I've got things completely wrong, I don't mind being corrected :wink2:

I'm primarily concerned with this because it seems like they introduce things slowly to start and then leave you with a whole list of new tasks. I'm hoping this isn't going to turn into regular shower days being set for 11-7 on multiple residents but I wouldn't be surprised if thats what happens.

Thanks for any information or thought you may have about this

At my facility my night shift girls have certain people that like to be up early and certain people that like to go to bed at 6 or 7 at night so they get ready first in the morning. Only 3 people recieve showers on our shift and it's the same people who like to get up at that early time. Many times 1st shifters like to try to sneak an extra person on us or state, well they have alot of time so they can help us out more, but it doesn't get very far because i set them in their place. Even when doing my own skilled assessments, I don't bother them between the hours of midnight and 5am unless medication is prescribed. It is their right and their home.:nurse:

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Specializes in Psych, Med/Surg, LTC.

I feel for the elderly in places where they have to get there shower in the middle of the night. Its one thing if there is a code brown or the res. requests it. But not routine baths/showers. Thats just mean. Night time should be for sleeping, at least resting. There is so much less staff on nights anyway. Its not fair to res. or staff.

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I feel for the elderly in places where they have to get there shower in the middle of the night. Its one thing if there is a code brown or the res. requests it. But not routine baths/showers. Thats just mean. Night time should be for sleeping, at least resting. There is so much less staff on nights anyway. Its not fair to res. or staff.

So true.

I also heartily agree with the previous poster who asked, WHY are things arranged for the convenience of the staff?

The residents are the ones who matter! Plan care according to their needs, their best interests.

:nurse:

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I remember years ago when I worked as a cna, the only baths that we gave on a night shift were to bed bound patients. No showers were given unless we had a code brown or some one enjoyed getting up extra early and wanted a shower. Other wise we were all pretty busy getting people up and toileted and ready for the day. Our staffing did not allow for anything beyond that. The only regular showers we gave were to wheel chairs.

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Specializes in Long term care, pediatrics, orthopedics,.
They tried this on the Memory Care unit I work as well. Management seemed to think that nights just didn't have enough to do. I just wrote up several forms about how certain residents kept refusing and became agitated during showers, or approach. Things got changed rather quickly.

If dementia resident is refusing a shower in the evenings, what are the chances it has something to do with sundownning? Have day shift try to approach these residents for showers.

State Surveyors will tag you if you are getting residents up before 6 am unless they are early risers, etc. If they are being gotten up before 6 am, there better be good reasons and care planned.

Ask your self this " Would a reasonable person want to be woke up at 5 am to shower or getting ready for the day" This is a question the surveyors ask themselves.

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Specializes in Gerontology, Med surg, Home Health.

My facility got cited last year because the lab techs were coming in before 5 am to do draws. So, if you can't get your blood drawn before the crack of dawn, you shouldn't have to take a shower then either.

I think we over do the bathing thing anyway. These elders are not used to bathing as often as we do. I had a 94 year old patient ask me one day, "Dear, do you take 2 baths a day?" No I told her, I take one shower a day. She didn't like bathing at all and her answer to me was, "Well, dear, you're young so I'm sure you get MUCH DIRTIER than I do." She was continent and didn't smell so she politely declined an am and pm bath. She was allowed to bathe on her own schedule and she was much more content.

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That's a great point.

Most of the elderly took a weekly bath (on Saturday night;))

Why would they want to be washed up and down 2 txs a day! Half the time the water is barely warm, and there's not enough blankets either. Brrr!

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Specializes in LTC.

I work the 11-7:30 shift as a CNA in a LTC facility. Night shift does do one shower a day, but not until after 6am, which is when day shift comes in and starts getting residents up and giving showers as well. I never get anyone up before 6 unless they request it or are restless and trying to crawl out of bed. I sure wouldn't want to be dragged out of bed at 5 am, especially after being woken up q 2 hrs all noc to be changed and repositioned! The only time I've given a shower in the middle of the night was one time when a resident vomited in bed and it ran down the side of her neck and into her hair.

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With all my years working in "aged-care" (having nursed since the late sixties), the business of showering on night duty has always caused some challenges (trying to be polite) with staff, not to mention the refusals and upsets from the clients. I will not allow my night staff when I am on duty to shower anyone on night shift unless the client in question is extremely dirty (Incontinent etc.) or specifically requests to get up early.

Get the clients to agree to being showered early or get your senior nurse to talk to them and the day staff, and have the day and senior staff make the decision for them. There has always been some pressure from the day staff to "do something" on nights to lighten their load. It took many years to get the night showers reduced and finally stopped unless unavoidable because of incontinence etc. or special request. Don't go back to those bad old days, please.

Good Luck, Mister Chris. (Not quite over the hill!)

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Specializes in nursing home care.

We do not get residents up until at least 7am and even then they usually want to get u then. The majority of residents don't get up until 8am onwards, some stay in bed until 11am. Our night shift can do showers before people go to bed but would not wake someone up to give them one.

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Specializes in Med/surg,Tele,PACU,ER,ICU,LTAC,HH,Neuro.

We had a whirlpool team who came in at 5 AM everyday. They were wonderful. Female residents would get up even earlier to be first in line, esp on Holidays.

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Specializes in LTC, FP office, Med/Surg, ICU, Dialysis.
What about a bath team during the day? When I worked as a CNA, the bath team was the best thing ever invented. They came in around 0530-0600 and started getting patients up for baths/showers. Some patients would already be up in time for breakfast, but not all would. Folks didn't mind signing up to work bath team either- once you were done, you went home (meaning a much shorter shift). -Andrea

I've never heard of that (bath team) and I think that's a great idea!

In my experience in LTC (as a pract. nurse), I think there were only two residents who are getting their baths in 11-7 shift. But I'm not sure if they're minimal help and not complete care residents.

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