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?

[ixchel]

Also, if CNA's are being told that the students coming in are going to do their work for them, I should find this out. That would cause a big stink with my instructor. I don't know who would do that, it certainly wouldn't be the nurses.

Being that techs typically get 10-20 patients to take care of head to toe, and a student isn't isn't necessarily going to get it right (meaning - they have to look after you anyway), you being there is only the smallest of favors. I assure you your instructor knows you are helping to lighten the load on ALL the staff. You are a GUEST on their unit, an inconvenient one at times. If you don't see this now, you certainly will when you get your first RN job. Students can be a complete pain in the butt and can quite rapidly put a patient in danger without trying.

If you think I'm looking down on students, love, I just stopped being one about 5 months ago. I LOVE students and am so eager to let them do small things to help when they volunteer. They usually recognize that we aren't under any obligation to do the job of their professors and they are appreciative of the time we give them. No, no one wants to clean a "code brown" or smell the bouquet that typically greets them off the elevator at the time clock. But this IS what you literally have signed up for, and you absolutely have to be on board with doing it if you want a job after graduation.

[psu_213, BSN, RN]

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.

I realize it wasn't yesterday, but I graduated from school approx. 6 years ago. In one of our very first nursing arts labs we went over making beds and given bed baths. While by the end of the program we were doing more that just basic care, from day one until the last day we, as students, were responsible for the bathing, pericare, bed making, feeding, etc. of our patient. I realize that my school is not every school, but your school and your professors are doing you a disservice if they are letting you believe that this basic care is not a responsibility of a nurse.

Further more, if I were in the position of hiring nurses and heard that School X does not teach how and/or expect their students to provide basic care to their patients, I would have a very hard time hiring anyone from School X to work on my staff.

[Red Kryptonite]

I get the feeling this student isn't anticipating 400 pound patients or their code browns. She probably thinks she'll just be passing meds and looking FABULOUS.

[psu_213, BSN, RN]

THESE THINGS ARE A NURSE'S JOB.

And when a patient's family member comes in and they find their loved one dirty, incontinent, etc., they are not going to demand to talk to the CNA. Even if was the CNA duty, it's the nurse's rear end on the line. Oh the CNA was supposed to do it? Well guess what, last night there was a call of and no CNA on the unit!

[BeenThereDoneThat74, MSN, RN]

Maybe this is a regional thing, I don't know

If your username indicates your region, I can attest that it is not a regional thing. It may be what your school, or your particular instructor deems as an appropriate assignment. But in said region, there are many nursing students who are performing AM care. Providing personal hygiene assistance is beneath no RN. I find it ironic how you feel it is so degrading to a human to leave them unclean, yet you are very proud to say that it is not your job. And in any region, there are units that are very short staffed with CNAs (when there are two 1:1s on nights, and 2 CNAs scheduled, guess whose doing the CNAs job: you are). Not to mention that in many ICUs, RNs are doing their own care. Those nurses can attest to the fact that 10 hours into the shift (or earlier), the patients will start to smell again, even though they may have already washed the patient on their time.

While I do agree that nurses do much more than AM care, the bottom line is (as evidenced by your post), if the skill is not reinforced in school, students will be less likely to want to do it.

[morte, LPN, LVN]

As a nurse with more than 18 years under my bt elt and a nursing instructor, if I ever found one of my student's patient assignments filthy and said student stated, "I'm a RN student- not a CNA student." Said student would be out of the nursing program lickety split. In my opinion, Veggie's post is symptomatic of the tremendous entitlement issue rearing it's ugly head in schools and facilities these days.

you are purposefully misconstruing her post. her assignment on that clinical day did not include hygiene, presumed to have been learned already and its repeat would be a waste of clinical time.

[morte, LPN, LVN]

If I could only hit the 'Like' button about a hundred times.....!

then, you also need to reread veggies post. clinical time has its assigned learning goals, this day hygiene wasn't one of them.

[amoLucia]

Sheesh I just can't step away from this thread

Ditto!!!!

This has been a double popcorn thread!

[morte, LPN, LVN]

If the expectation of your instructor was you would pass meds, you should have been given an incomplete for the day and have to make it up. you are not there to help, you are there to learn. That appears to be what a majority are missing here.

I guess I just don't understand your mentality, here.

I'm 11 weeks into my program, so far I've been checked off all basic CNA skills (though I am a certified CNA, we all had to get checked off in the beginning), physical assessment, injections, medications, urinary catheter, and NG tubes. I had clinical on Monday where I had the opportunity to give meds and injections to my nurse's entire hallway, it would have been awesome... However, my patients desperately needed baths. They hadn't had an aid on the floor for 2 days... I went in, spent nearly an hour with each patient, cleaning them up, getting them in fresh clothes, helping one female fix her hair. It's why I'm here - to help.

Just think to yourself why you wanted to become a nurse. It's not because you were dying to perform physical assessments, I'm sure, it's because we all want to help. And believe me, for a patient who can't get themselves cleaned up, they truly appreciate your help.

[morte, LPN, LVN]

I'm an RN student and in my clinicals we are expected to do morning care IN ADDITION to med passes, assessments, looking things up, etc. That means bed baths, linen changes, emptying foleys, washing hair, peri care, etc. as well as everything else.

and apparently not so in OPs clinical.

[Jenngirl34RN]

In my med-surg clinicals (last winter and spring) we had at most 3 patients, and it took a while to work up to that. When we had one or two patients, we were expected to take care of all of our patient's needs- we did assessments, meds, charting, any procedures we were allowed to do (supervised) AND we were expected to take care of our patient's ADLs. We were also expected to answer call lights if we were not busy doing something for our patient. If any of us had dared to tell our instructor that our patient was dirty because the CNAs weren't doing their jobs, we would have been reamed. If we got to the point where we were able to take on a 3rd patient we were allowed to ask the CNAs for assistance in ADLs, but we still took on as many of them as we could. It was made clear to us from day one that if we failed to take care of our patients' needs, whatever they were, we would fail.

I just finished my 4th clinical rotation. From my observations, the CNAs work their butts off, often caring for 10-12 patients. I have never seen an RN fail to step in and help bathe patients, or help a patient to the toilet, or empty foleys or anything that needed to be done when the CNA was busy with another patient. I have also often seen RNs step in hand give the CNAs a hand with their work when they have the time.

[KiggyPupPuff]

If we got to the point where we were able to take on a 3rd patient we were allowed to ask the CNAs for assistance in ADLs, but we still took on as many of them as we could. It was made clear to us from day one that if we failed to take care of our patients' needs, whatever they were, we would fail.

Yes! This is what I meant to convey in my post. Census dictates if we are allowed to delegate but full care is always our student RN responsibilities.