What I have learned during bedbaths

[mamamerlee, LPN]

This is a follow-up to another thread about practicing bedbaths. It's about what is NOT taught in school, whether or not you use dummies or each other....

I have done lots of informal teaching during baths. Sometimes patients are more receptive at these times.

How do you get all that dried stool out from under those unkempt fingernails? Why aren't we taught this sometime?!! Try to get that dementia patient to hold his hand in a bowl of warm, soapy water!! Put a chux (or whatever they call the disposable bed protectors these days) under the pt's arm, slather on a large amount of hand/body lotion on the offending hand, wrap in a warm wet washcloth, then wrap in the chux. Do that hand LAST if possible. You will need an old-fashioned orange stick to get it all out.

Assess ROM and skin - get the patient to reach whatever is possible. They may seem helpless until they wash between their toes. Look for bruises, rashes, skin tears. The bruises on Mrs A's back? What bruises? Oh, she says, my stepson 'accidently' hit me a week ago. Some very quiet conversation revealed continual abuse from the 6 foot 15 year old that the woman was afraid to tell her husband. Convinced her to let me call social work.

Don't know the outcome, don't ask me.

Interesting tattoos may reveal information about the patient past or present. "Oh yeah, I got that one about 10 years ago. That reminds me, I forgot to tell the doc about the hepatitis I had then".

So the technique of the bedbath is only a small amount of what is done during the bedbath. Practice therapeutic conversation, interviewing and assessment, and all manner of information exchange that can be done during this time.

And that really annoying patient who is always on her bell? She may rest comfortably for a while, just because you took the time to care.

[llg, PhD, RN]

When my mom was dying and went into the hospital for the last time, I keenly remember her saying how good it felt to have her nurse give her a good bath. She hadn't been able to do a great job on her own at home.

Some nurse did a really good thing for her that day.

[General E. Speaking, RN, RN]

I have been known to grab an extra toothbrush to scrub those yucky fingernails! Yes, you can really learn a lot from/about your patient during a uninterrupted thorough bedbath. Too bad many times it has to be a quicky because of time issues or concerns about another unstable patient.

[canoehead, BSN, RN]

Big thumbs up to this thread. I love fixing the hard of hearing once I discover the big wad of wax in their ears.

[brownbook]

I love the simple basics of nursing care. I'd put giving a good bed bath near the top of a list of important things for a nurse to know. Way above interpreting Swan Ganz numbers or EKG's etc.

PS What works really well for matted hair is rubbing alcohol.

[maiday]

Thank you for this post. I am a nursing student (graduate May 2011) and I'm about to start my first job as a PCA-Student Nurse (basically CNA). I want to do everything I can to learn while I'm in this position and I'm sure I'll be doing plenty of bed baths. Sometimes it's easy to forget that these things are as important sometimes more than the "tasks".

[tri-rn]

TOOTHBRUSH!!!! Why on earth didn't I think of that??? I may not need it at work right away, but I WILL be using it on my demented 83 yr old MIL ... she is a "digger"...ugh.

[llg, PhD, RN]

Another great (and often lost) skill is that of a good back rub at the hour of sleep. Do you remember when that was standard practice?

[happy2learn]

Another great (and often lost) skill is that of a good back rub at the hour of sleep. Do you remember when that was standard practice?

They still teach that in CNA school, but they never do it. I thought it was a great idea, but it seems that no one really does that! What a great and easy way to help someone relax.

[leslie :-D]

Another great (and often lost) skill is that of a good back rub at the hour of sleep. Do you remember when that was standard practice?

i never gave a pt a back rub.

i'm sure it's my hangup, but it feels too personal to me.

but i do give a mean, lotioned footrub.

they seem to really like those.

leslie

[anonymurse]

To get the yellowish stain out when scrubbing the undersides of fingernails with a toothbrush, use toothpaste. It took me 3 years to figure this out.

The most return for the least time invested in a backrub is to lotion up the hands and wipe them back and forth across the small of the back at the same time with the hands moving in opposite directions.

Even if you don't have time to bathe your pt yourself, make sure your aides call at bath time you so you can do your skin assessment.

[GinaCat]

shaving is so important. it's not a priority as an aide, so it often goes undone, but a man who shaves every morning probably doesn't feel like himself, he may feel sloppy and not right. I get that impression from the mid-70s men that ask to have their face shaved or for a razor, or bring their own razor. it's always important to look and feel your best, so i try to make time if i see that an older man needs his face shaved and is too weak to do it himself, i put it on my to do list for the afternoon.