stinky patient pet peeve

[Fruit Sucker]

It really irritates me when we get to the floor, get patient assignments, and go in to see patients that have not been cleaned for at least a day. I'm not talking about diapers that need to be changed, I'm talking the entire patient is stinky and there are techs/cna's standing around. This really grinds my gears.

Do people working as nurses have this problem? If so, what do you do? Can you write up the techs for this?

I had a patient the other day who was stinky as all get out, Foley bag was full, and he was slumped down in his bed. The nurse is busting his butt trying to get all the medications out, and there are techs standing around talking. I say something to my clinical instructor and she says, "sometimes you'll have that, it's a game where they want to see if you'll do it for them." Can't people like this be punished?

[RainMom]

Interesting that no one has mentioned, unless I missed it, the possibility that the patient refused to be bathed. That happens, sometimes even when they super-crazy NEED a bath. I've seen varying levels of cajoling, convincing, and debating employed, and I've also unfortunately witnessed people being ordered to bathe or placed into shower chairs regardless of refusal. I also, once when very new, participated in a bed bath insisted upon by a nurse and completed while the patient screamed "no" the whole time. (I felt like a complete d'bag and swore never again.)

So I wonder what OP thinks should be done with a patient who refuses. Discussion, okay, but force?

I too wonder about this school.....

Yep, you missed it. The very first post mentioned the possibility of the pt refusing a bath or that baths might be given at different times of the day, not necessarily in the morning.

[dudette10, MSN, RN]

I spoke too soon. Getting to page 2 is where things really heat up.

To the OP, if you have never learned basic care in school, your school is doing you a HUGE disservice, not only to your skills but also to your attitude. A goodly number of your patients will be total cares, and if they are on tube feeds, that's when the fun begins! A big part of nursing often overlooked by the medical team is skin care. Skin condition and maintenance is nearly completely nursing's domain, including oral care.

We are also responsible for preventing deconditioning. Deconditioning can happen with only one day in a hospital bed, especially for those patients whose independent ambulation was compromised to begin with, such as those who use a walker. Basic care is getting them up to meals if their reason for admission does not contraindicate it. Often, this takes a lot of teaching, persuading, cajoling, and reassurance to the patient, not to mention pain management.

THESE THINGS ARE A NURSE'S JOB. Your current instructor is only half-preparing you for your future job.

You should demand more from yourself.

[Julie Reyes, DNP, RN]

...I am sorry, but I just had to copy/paste the OP comment to my class blackboard. This will definately be a discussion in my class.

[Red Kryptonite]

...I am sorry, but I just had to copy/paste the OP comment to my class blackboard. This will definately be a discussion in my class.

Would it be against the rules for you to post snippets of the best comments here?

[Nienna Celebrindal]

OP your attitude is ridiculous.

You seriously better check yourself because you already sound like a nightmare to worth with.

Not trying to be mean, just real.

[sandytoes]

Well, I can't speak to where you went to school 18 years ago, but today's instructors are not teaching students how to make beds and give sponge baths anymore. As I said, I follow the instructions I'm given BY MY PROFESSORS, not by some hospital staff members who think someone else should do their work for them. Nor do the nurses on the unit have time to do CNA work. Maybe this is a regional thing, I don't know. I've heard hospitals in more rural areas don't even have CNA's. But I do know that I go to school to learn, and missing out on inservices, missing meds, and missing actual student duties because I have to do someone else's work is not acceptable.

I have sooooo much to say to you but quickly I will say YES absolutely bed baths and making beds are being taught!! I'm so sorry to hear your school has not taught this and emphasized it's importance. But don't assume because you know what happens whe you do that....

I am in a BSN program in the south, if that matters to your research.

[Julie Reyes, DNP, RN]

Would it be against the rules for you to post snippets of the best comments here?

The comments from my students? no - I could certainly do that - I will just remove their names! Lets see what my guys say...they better not embarrass me!!!

[RNsRWe, ASN, RN]

You were much, much nicer than I would have been. Demolishing the pedestal that special snowflake put herself on would have been my priority task of the day.

Just reading your post burns me up.

I was much, much nicer than I have been since, LOL..... Also, after having been there for not 12, but closing on on 14 hours (because as charge I had the joy of coming in early to review/make assignments, handle my patient load, get report from every other nurse/aide on the floor, then report off to morning shift and administration) I had this VSSF whining she had a real "mess" on her then-clean hands.

That was then. Today I probably would have escorted her to the DON's office and asked her to bring it up right there

[RNsRWe, ASN, RN]

Interesting that no one has mentioned, unless I missed it, the possibility that the patient refused to be bathed. That happens, sometimes even when they super-crazy NEED a bath. I've seen varying levels of cajoling, convincing, and debating employed, and I've also unfortunately witnessed people being ordered to bathe or placed into shower chairs regardless of refusal. I also, once when very new, participated in a bed bath insisted upon by a nurse and completed while the patient screamed "no" the whole time. (I felt like a complete d'bag and swore never again.)

So I wonder what OP thinks should be done with a patient who refuses. Discussion, okay, but force?

I too wonder about this school.....

Yeah, it was mentioned a couple of times....there are always those who kinda LIKE to be stinky.

I remember one time when I was a student, I had the joy of being told my patient had been refusing baths (A&Ox3 AND able to ambulate to a shower in his room) and to see if maybe I could get him to bathe. ME? Well....sure, I have two clinicals under my belt, I'll give it a whirl

As it turns out, when I walked in and saw the MESS, I kinda switched into Mommy Mode, briskly picked up the wash basin, supplies, and asked him if he would be handling this himself or if he needed my assistance in the shower. BANG. Guess he didn't expect there to be no other option, LOL....and darned if he didn't walk himself into that bathroom and emerge clean! CNA swears I was a gift from G'd that day, LOL.....more like a freak benefit of chance :)

[RNsRWe, ASN, RN]

The comments from my students? no - I could certainly do that - I will just remove their names! Lets see what my guys say...they better not embarrass me!!!

I imagine they would be curious about a nursing program that didn't recognize the need for any RN student to learn the most basic of patient care techniques.

I'm also curious to see the OP's response to the pages of discussion that have continued, and whether her opinion of her program's preparation has changed?

[SionainnRN]

I'm seriously blown away by the OPs attitude. That won't last long in nursing school or on the floor if she manages to graduate. No nurse is above cleaning and bathing their patient. No one.

[ArrowRN, BSN, RN]

On one hand it could be lazy techs, on the other hand it could be the 1:15 tech ratio or worse at some of these places. All the techs I know are hard workers and yes sometimes pt care falls but only because they are overworked. Even if standing around it might be the only break they had, you never know. Sometimes I've gone 12 hours without eating. Then there are also some nurses who refuse to help the techs thinking RN means "no more butt wiping". I rather not make assumptions about people.