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Slouched and Sweaty

June 14, 2013

One of my biggest pet peeves in nursing is when providers (nurses, doctors, students, interns) do not pay attention to the hygiene needs of their patients. Even though there is sufficient evidence stating the positive benefits (lowers blood pressure/heartrate, and relaxes patients) of bathing, and we are taught to do this for our patients in school, we appear to be lacking in this very important aspect of patient care. I notice that more seasoned nurses are really good at helping with bed baths. I’m not sure why it appears that newer nurses often forgo this important task. Now, I am a day-shift nurse, I get how busy it is. Most of the time I feel like a human medication dispenser and mediator between family members, doctors and patients. There are days I don’t know how I will be able to accomplish the day’s tasks and take care of my patients in the ways that they truly need me to, let alone assist with bathing and/or bathe them!

When I was on orientation a long time ago I remember that one of the of the nurses told me to “forget” helping bathe my patients as I had more important things to focus on. Now, in retrospect I know she didn’t really mean that. She was just trying to take something off my plate as I was probably seeming overwhelmed with all that had to be done. That said, for the first many months of working as a nurse, I didn’t help my patients bathe, I completely ignored it subconsciously.  It wasn’t until one of the nurses aides confronted me about this issue that I truly realized what I had been “forgetting” to do.

Patients after heart and vascular surgery are very sweaty. Their bodies have been to hell and back. They’re emotionally drained, in pain, exhausted and sometimes stubborn. When I walk into my patient’s room first thing in the morning, my eyes immediately are drawn to that patient slouched down in the bed, sweaty, on wrinkled sheets, despite how many times the night nurses and aides diligently boosted and repositioned/straightened them all night. Not only are the patients uncomfortable when this happens, there is this pressure of knowing that a patient’s family members will be arriving soon and you don’t want their loved one to be slouched down in bed, with their feet dangling off of the foot-board, sweaty and miserable.

Because of this, I’ve worked very hard on changing my routine. As often as I am able when I bring meds into my patient’s rooms, I start to get the patient set-up to bathe. On a given day, out of my 4-patient patient assignment, there can be 1-2 “heavy” patients, meaning they require full assistance with bathing, taking medications, etc. It is much appreciated by the aides if you can assist with or completely do at least 1 of your “bed baths.”

Recently I had a bedridden patient, severely depressed, who often withdrew from staff interaction. That morning, she was as I referred above, slouched and sweaty. As I washed her face, back, hair and legs/feet I noticed a smile form. The smell of the soap permeated the room, causing the room to smell like flowers. When the aide and I changed the sheets and bedding and repositioned her in the bed she thanked us. This patient doesn’t often thank us for our work. On that particular morning she took her pills without a fight. Not only did we notice a change in the well-being of this patient, I felt more relaxed from taking 20 minutes out of my morning routine to wash someone.

Moments like those remind me of why I became a nurse. In my eyes, it’s not about administering the difficult-to-pronounce medications, or starting IV drips that make you a nurse, it’s the private interactions you have with patients that make them feel better. Those moments are what most patients remember, not that time you started a Dilt gtt (gtt is abbreviation for drip).

To this day when I precept new graduate RNs, I teach them to do at least 1 of their bed baths. I tell them it makes the patient’s feel good, the aides will appreciate them more (being that they’re new) and it will give them a good opportunity to fully assess their patient.

Thanks for reading!

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