Attending the Las Vegas conference in June was a great experience for an old old-timer. I want to share with readers of our national journal that the plethora of ideas and comments during those days appeared in stark contrast to the absence of letters-to-the-editor in this publication.
Whatever the reason, it would be refreshing to read regularly what our members think, experience, and observe.
Sincerely,
Edith S. Lenneberg, ET Ret.
The Bed Bath
As a nursing instructor in a traditional diploma school of nursing, I can assure you the "bed bath" is alive and well, at least in my facility. Our students perform bed baths throughout the three years they are students. How can nurses effectively delegate or supervise care given by ancillary personnel if the nurse has no idea how to perform the task? I tell my students repeatedly that the best way to assess their patients is during the bed bath or morning care. In your editorial, you mentioned that today's clients are discharged earlier and encouraged to perform their own care-this is true and is the case for elective surgical clients but what about our medical and geriatric patients. We have a large population of patients who require daily bed baths or at the very least cleansing after incontinence episodes. Starting next week we will be having our traditional hygiene skills lab (lovingly called "Bed Bath and Beyond" by our students). We not only stress the importance of the bed bath but positioning, oral care, and skin assessments, but also stress the Braden scale, off loading of heels, and other pressure ulcer prevention strategies.
I left my acute care CWOCN position four years ago because I always considered myself a nurse first and CWOCN second. I didn't like the direction nursing was taking in some respects, and I wanted to make an impact on the next generation of registered nurses. Even in my CWOCN role I assisted patients with hygiene and on and off bedpans, how could I not? I remember one elderly diabetic gentleman wearing AE hose who needed ostomy teaching. As I looked down at his legs, something just made me ask "Has anyone washed your feet or taken off the stockings?" His reply: "I was told these stockings cannot come off." A diabetic patient wearing AE hose and no one has assessed his feet for days!! I immediately washed and lubricated his feet. That is just basic nursing care.
As wound care experts, we encourage the staff to perform daily skin assessments. I am not saying that the only person who can give a bath is a registered nurse, that would be ridiculous. But, what is wrong with the registered nurse giving a bath to the most acutely ill patient assigned to his or her care? Physical assessment, patient education, and emotional support could be given during the 10 to 15 minutes required to wash this patient. I always loved that aspect of nursing; it was the few minutes of uninterrupted time I could spend with my patients.
Tracey Siegel, MSN, RN, CWOCN
Charles E. Gregory School of Nursing, Raritan Bay Medical Center, Perth Amboy, NJ