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Discussion

time to bathe patients--whose responsibility and is it every day/when?

I know this sounds really dumb, but I'm a new nurse and this is something I have come into conflict with. I want to be able to give all my patient's baths, but unfortunately, giving meds or doing other nursing things takes priority. I had an instance of when I didn't have a CNA until 3 pm, and right when she came she did a bath. I feel bad I hadn't done one but I simply don't have time. Is it normal to not do them if you don't have a CNA? I have no issues giving baths (I actually enjoy it), but I feel like I am usually focused on other things and then don't have time to sit in one room for 30 minutes. What is the right answer here? Am I expected to give each patient a bath??

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    When I was working LTC, whirlpool bath/shower days were usually care planned on a schedule. Quick bed baths were given at the end of NOC shifts (around 6 am) if the care team (usually 1 RN and 1-2 CNAs) had to get people up before 7-3 (depended on staffing and resident census) or on 7-3 when the 7-3 aides were getting people dressed and up.

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    • Experts

    When I worked as a CNA in many-beds LTC facilities, if no other CNA's showed up for work or some other catastrophe, the Charge Nurse would just dispense with the baths altogether. The CNA can take a basin of hot water and give each patient a hot wet washcloth to wipe their face and hands. Better than nothing. Nurses never had time to do the CNA's jobs. Help them, perhaps, but take over the whole bed bath, no. What are you going to do if right in the middle of doing the bottom, another patient has a crisis? Just pull a sheet over the bath patient and leave them there while you spend the rest of the shift calling doctors, starting IV's, doing other things that a CNA can't do for you? That is why the nurse sticks to nurse duties.

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    It varies day to day and gets prioritized the same way everything else does.

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    • Experts

    Personally I've never had a nursing position where I was responsible for doing baths (although I was responsible that they got done.) I've helped CNAs with tons of baths and have teamed up with them to also do a good skin assessment at the same time, but I never had to do them completely alone except maybe in nursing school. I've also never worked in a position where patients required bathing without CNAs, maybe I'm just lucky? If I did have a position without CNAs for help, I would've expected a much lower patient assignment.

    I think it also depends on your unit. Some ICU nurses do total patient care.

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    On 6/3/2020 at 12:03 AM, dream'n said:

    I think it also depends on your unit. Some ICU nurses do total patient care.

    I actually thought all of them did! Me and my pod partners would basically go down our row of pts and bath all of them together. The techs helped when available but regardless there was always at least one nurse bathing the pt.

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    In the ICU, they get done every day. Vents get done on night shift and the others on day shift. And the nurses do them.

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    Recent hospitalization early May. I don't remember any full type kind of bath being done - just freq peri-care/incont care when I was being assisted into positioning for tests or transfers or for peri-checks (post-op gyn surgery and urinary leaking despite that Pure-Wik).

    And the 2nd hosp did personal care activities usually on the 7p shift. Day shift was just tooo busy for testing & consults & tx. So the 2nd shift did them.

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    My floor was converted to the covid floor for my hospital and for a while we were a dumping ground for nursing homes so there were a lot of totals. We did our best to split them up between night shift and day shift but most were done on nightshift.

    Right now if they can get done on dayshift they will get done, either by the RN/aides or the pt (if they are able to).

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    23 hours ago, OUxPhys said:

    My floor was converted to the covid floor for my hospital and for a while we were a dumping ground for nursing homes so there were a lot of totals. We did our best to split them up between night shift and day shift but most were done on nightshift.

    Right now if they can get done on dayshift they will get done, either by the RN/aides or the pt (if they are able to).

    OUxPhys - this is very demeaning to all the LTC/NH HC providers who struggle to deliver good care to such a vulnerable population under conditions that I'd bet you can't even guess.. I'm sure if one of your loved ones were a NH resident, your sentiment would be different.

    So sad that such denigration within our own ranks still persists.

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    37 minutes ago, amoLucia said:

    OUxPhys - this is very demeaning to all the LTC/NH HC providers who struggle to deliver good care to such a vulnerable population under conditions that I'd bet you can't even guess.. I'm sure if one of your loved ones were a NH resident, your sentiment would be different.

    So sad that such denigration within our own ranks still persists.

    Sooo Im not demeaning the nurses but let's be honest: nursing homes pass the buck to hospitals sometimes. The patients we did get were medically stable and were basically just being quarantined on the floor....which is not what the floor was designed for.

    You're right. I don't know what it's like to work in a NH but I do know it's not the nurse's fault for the conditions. I also know the nurse's do the best they can with what they have.

    As for my loved ones I wouldn't even consider putting them in a nursing home.

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    I think it all depends on the type of setting that you work in. When I worked on a Geriatric unit a lot of the patients required assistance bathing or were too much of a risk to be left alone in the bathroom. I always asked each patient if they would like a bath/shower and I would try really hard between me and the CNA as well as other staff to ensure everyone got a bath. I would schedule the bathing in between other nursing tasks when I was caught up, but obviously if you have a lot of nursing only tasks that need to be done it should be delegated to the support staff. See if your unit has some kind of protocol regarding this issue. I personally made sure my patients were clean (if they wanted to be) and had clean sheets every shift I've worked. I do realize that it may not be feasible in every setting unfortunately.

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