"We don't clean patients we are a procedural area"

5 I was thinking about an issue that has recently come to my attention as I have been working day shift for the past few months. In addition to noticing that my IV poles and pumps never seem to come back from CT/Xray/what have you, there seems to be a rash of nurses who believe that if a patient is in dialysis and has an accident it isn't their responsibility to clean them up. I was really surprised to come across this so frequently when I started days. After talking to a few of my techs I realized it was happening even more than I was even aware.

It is hard for me to decide if this is a case where we should start UO'ing (unusual occurrence reporting) this to get a paper-trail on the incidences, or if there is too much "he said she said" involved. The times we have confronted other departments we have gotten the "We don't do patient care, we are a procedural area" speech. Give me a break, we all do patient care, it isn't limited to the patient's room and home floor!

Thanks for listening, bored overdue momma here just thinking on work stuff.

Tait
I'd talk to there manager. I'm in procedural area. Can't imagine letting a patient leave my area soiled. We are a team. that is basic care.

I noticed that during Clinicals...oh and the NP who will go trolling down the hallways looking for you to give the PT a bedpan, when Its.right.there.... it takes 2 seconds! end result? newly dyed sheets (super unrelated...sorry!!!)

I was quite astounded the first time I had a pt getting dialysis in their own room, and the nurse hunted me down to tell me that the pt had a BM, so I could I please get her cleaned up. It was a 2 person job, and when I started, the nurse pushed herself into a corner, so I had to stop and go get the tech, as I was obviously getting no help there. I was much happier two days later when the RN found me to ask me to get the linens together so that WE could clean up the pt.

Actually as a Dialysis Nurse I can tell you in our facility we do not have the staff nor supplies to clean a patient. We have no wipes, no gowns, no briefs, no shower, nothing! We our told by our medical director to send the patients back, they are not willing to staff for that. Just a bathroom and TP. Our facility staff is skeleton crew always (cost thing) and I am the only RN for 12 patients. We have 2 dialysis techs there with me. So 3 of us on the treatment floor, and we are doing the cannulating & vital monitoring, and I am doing all the assements, meds, interventions myself. Patients on dialysis can code at any moment, we need to monitor them constantly. If a needle slips they can bleed to death in under a few minutes. You can not take your eyes off of them. We really can not spare a single staff member. Rarely do we get an uninterrupted break even. And many of our patients would need 2 staff members to roll, lift, or move. And if we could spare them for a few minutes (which we can't) we have nothing to clean them with and nothing to dress them in after. And during shift change when patients are coming off and on we are all running. For the most part our patients are well cared for but we have one facility in particular in which the residents are often sent to us sitting in soiled clothes, covered in vomit, or not clean. It is obvious that this didn't happen on the ride over (which they always try to claim when we call them on it). I would never make a patient sit like that for their 4 hour treatment. If they are not in clean dry clothes, I am sending them back to be cared for so they can be treated while clean and comfortable. I worked in a hospital I know how busy you are, but please treat the patients as you would want to be treated.I feel I should mention this is a chronic facility. Most of our patients come from SNFS and ALFs.

Quote from MJB2010Actually as a Dialysis Nurse I can tell you in our facility we do not have the staff nor supplies to clean a patient. We have no wipes, no gowns, no briefs, no shower, nothing! We our told by our medical director to send the patients back, they are not willing to staff for that. Just a bathroom and TP. Our facility staff is skeleton crew always (cost thing) and I am the only RN for 12 patients. We have 2 dialysis techs there with me. So 3 of us on the treatment floor, and we are doing the cannulating & vital monitoring, and I am doing all the assements, meds, interventions myself. Patients on dialysis can code at any moment, we need to monitor them constantly. If a needle slips they can bleed to death in under a few minutes. You can not take your eyes off of them. We really can not spare a single staff member. Rarely do we get an uninterrupted break even. And many of our patients would need 2 staff members to roll, lift, or move. And if we could spare them for a few minutes (which we can't) we have nothing to clean them with and nothing to dress them in after. And during shift change when patients are coming off and on we are all running. For the most part our patients are well cared for but we have one facility in particular in which the residents are often sent to us sitting in soiled clothes, covered in vomit, or not clean. It is obvious that this didn't happen on the ride over (which they always try to claim when we call them on it). I would never make a patient sit like that for their 4 hour treatment. If they are not in clean dry clothes, I am sending them back to be cared for so they can be treated while clean and comfortable. I worked in a hospital I know how busy you are, but please treat the patients as you would want to be treated.I feel I should mention this is a chronic facility. Most of our patients come from SNFS and ALFs.

I must mention when I started working in dialysis, having come from a hosptial, I was horrified by the fact that we send them back. You should try to shadow a day there is a lot more too it than you probably think. It is really interesting, but takes a lot of constant monitoring.

I've actually had the dialysis nurse (small community hospital - dialysis done at bedside) tell me after dialysis was completed that the patient had thrown up during dialysis. I found the patient soaked in her own vomit - and the clean linen cart was LITERALLY right outside the patient room. I understand that the dialysis nurse may not be able to leave the patient during the procedure, but to simply leave them 'dirty' seems so wrong...

Thanks for the insight MJB2010. I always wondered why people got sent back poopy.

This is upsetting. People sometimes forget (or dont care) that the whole reason that healthcare jobs exists are to take care of others. When you focus more on completing the task instead of the person thats sitting in urine or feces or vomit for hours...well, its time to reevaluate why you come to work in the morning/evening/night in the first place.

Quote from Crux1024This is upsetting. People sometimes forget (or dont care) that the whole reason that healthcare jobs exists are to take care of others. When you focus more on completing the task instead of the person thats sitting in urine or feces or vomit for hours...well, its time to reevaluate why you come to work in the morning/evening/night in the first place.

Quote from 0402I was quite astounded the first time I had a pt getting dialysis in their own room, and the nurse hunted me down to tell me that the pt had a BM, so I could I please get her cleaned up. It was a 2 person job, and when I started, the nurse pushed herself into a corner, so I had to stop and go get the tech, as I was obviously getting no help there. I was much happier two days later when the RN found me to ask me to get the linens together so that WE could clean up the pt.

Coming from the LTC standpoint, we always sent a CNA with the pt. to dialysis for ADLs. That way someone is there to clean them up, help with blankets, repositioning, etc. I thought that was common practice.