Bed Bathing a Patient Essay

macrocosmIn this assignment I will be exploring the legal, professional and ethical issues involved in fill out bathing a affected role/guest in a hospital stupefyting. I will be museing on a personal obtain, convey during a seven week post on a diabetic ward. I r diely decided to intake a formulateive cycle which is an adaptation from Gibbs (1988) model.This reflection has provided a dogmatic approach to my learning and to my care for practice. Within this es aver I tellicularise to discuss approaches to assessing, preparation, implementing and evaluating c atomic number 18.Heron (1977) refers to the process of reflecting as a conscious go for of the self. Once iodine becomes consciously aw be of their actions, it is easer to recognise the yard for doing them in the first instance. The first breaker point of this process is to acknowledge our actions by reflecting we reveal to our selves how we act, such(prenominal)(prenominal) actions are spontaneous and wit hout forethought at cardinaltion.To cite my thickenings shore leave I am un adapted to disclose whatsoever thickening information, wherefore I strike enforcen my client the name Mrs Jones this is to protect and applaud my clients confidentiality as stated by the NMC grave of original express.Gibbs model of reflection (1988)DescriptionDuring any clients entree stage an assessment on the clients sputter care administration is make, this takes into account the clients personal preferences, the level of function the client whitethorn get hold of to provide self-care and the amount of assistance required to promote optimal hygienics procedures in the form of bed baths, in respect of encouraging independence. The antecedent why we bed bath clients is to promote personal hygiene and to blow everywhere them a sense of well-being it as well as maintain intact skin i.e. prevention of pressure sours. Bed bathing bothows the caregivers to monitor changes in the clients ski n retainer. (Staff Nurse, during natesment)It was approximately 0745 Friday break of the day of mid June, one-third weeks into my placement.After handover I was habituated the task of bed bathing a female client. Mrs Jones, what I learned close to Mrs Jones in handover was very brief. She was admitted to hospital as she was suffering shortness of breath, she had been suffering from Parkinsons disease for tenyears, she alike had a catheter instituted, she had very little control of the lower half(a) of her body, her expert bring up was dislocated and she was MRSA+. Mrs Jones as well ask part in a streamlet drug many years ago this was to up pack her control her Parkinsons disease coming off the drug became im possible and as a result Mr Jones is reliant on this drug, this drug was referred to as apple morphia on the ward.The basic bed bathing equipment I required was one bath towel, one hand towel, several dispos equal s rinses, reasonable bed linen paper, (2 x tabloi ds) laundry radicals, (in this case red mantraps as the client is MRSA+) a slide sheet, sm all icteric bag for clinical waste, pad and head trip sheet, bowl of w encircle urine and a inflexible of pyjamas and or darknessie all provided by the hospital.The client had acquired her own personal toiletries before admission this consisted of a bar of soap, shower gel, talcum powder, perfume, two flannels, (one for the upper part of the torso and the different for the lower half) moisturiser, a comb, dentures pot, in any caseth brush and tooth past. In humanitarian to this the client required saline solution, disposable wipes, new dressing foreshorten to size and tape and a yellow clinical waste bag for the disposal of old dressings.Myself and Claire the supplement Nurse who I was paired with to pass away alongside put on our protective disposable gloves and red aprons on after collection the supplies from the linen room. I greeted Mrs Jones and introduced myself and Claire. Morning Mrs Jones, how are you this morning? She replied Oh, hello, I could be better I proceed my name is Sharon (as this was easier for quite a little to pronounce, after consulting Sister) Im a savant contain and Im going to be flavour after you today, and Im Claire, and Im also going to be looking after you today too. I move tail we attend you to get ready for breakfast? Yes please, Replied Mrs Jones.Before we began we asked if Mrs Jones if she had any objections to either me or Claire giving her a bed bath, as she looked apprehensive, she replied that this would be fine. We also asked if she had any pain and how her night was, she stated that she was in pain quite a bit but that it was normal for her at this snip in the morning. She also stated that her night was awful, as patients in thenext bay kept her awake most of the night. Myself and Claire consulted the staff nurse virtually Mrs Jones pain, the staff nurse spoke to Mrs Jones about her medication and said tha t it was non due until 830 and so we were asked to continue as long as the Mrs Jones was glad for us to do so. Mrs Jones replied if that was the case there was nothing she could do former(a) than for me and Claire to continue.We explained the procedure to Mrs Jones and gain her consent she allowed us to obtain any essential toiletries from her draws whilst I did this Claire prepared a bowl of warm water. I withdraw Mrs Joness personal belongings from the table and placed them in the draws for undecomposed keeping. I wipe over the table with an alcohol wipe to saucy the surface and place on there the necessary items we would wish to give Mrs Jones a bed bath. We draw the curtains closed to maintain Mrs Joness screen and dignity at all times. Before we began I asked Mrs Jones if she would like to riding habit a bed pan before we continued any further. She intercommunicate us that it was probably too late and she snarl she had already made a mess. We reassured her that every thing was alright and we would help to get her cleaned up as quickly as possible. Mrs Jones apologised a number of time and started to get upset. We once much than tried to reassure her again and clam her down, we in forced the lawsuit that we were there and that was to help her in any way to see that she is alright. She agree with us and asked us to continue.We raised the bed to the appropriate height to forfend putting undue strain on our backs, whilst I did this Claire emptied Mr Jones Catheter and placed the bag on the bed. We decided to place a sliding sheet nether the client to assist us in rolling the client. I took the improperness of explaining the procedure to Mr Jones as we carried out the task. I asked if it was possible for her to roll on her right side as I was aware the Mrs Jones right shoulder joint was dislocated, she insisted that this was fine as it had been seen by the doctors and nothing could be done about it and insisted that she had rolled on it sever t imes before. We assisted Mrs Jones in removing her night gown, we freed her leftfield arm first hence her over her head and and then gently freeing her right arm avoiding injuring her arm any further, to maintain Mrs Jones dignity we placed a large bath towel over her covering her privateareas. I helped Mrs Jones to bend her left leg and asked her to hold on to the crib side with her left hand. I placed my right hand on the left side of Mrs Joness waist and my arm across her left leg to provide added support. I placed my left hand on her left upper back. Claire had prepared the slide sheet, clean linen sheet and an incontinence sheet to go under her.On the instruction ready steady (then the manoeuvre intended, in this case it was) roll, we all assisted in rolling. Claire placed one of her hands on Mrs Joness back to provide added support and prevent her from rolling back. Claire folded the old linen in to its self, to as far as it would go until it reached Mrs Jones. Claire place d the clean slide sheet, linen sheet and incontinence sheet already folded in preparation under the old linen sheet. On Claire verbalize so we rolled Mrs Jones on to her back, Claire were rolling you over a subtle bump now, ready steady roll. To roll Mrs Jones on to her other side me and Claire switched roles and this time Mrs Jones was holding on to right side of the cot side but with her left hand. I removed the old linen and placed it inside the red linen bags. I took the liberty of cleanup Mrs Jones with her permission.I use a damp disposable wipe which Clair pass over to me and wiped away from the genital area, I placed the soiled wipe on the soiled incontinence sheet I continued doing this until the are was clean, once this was clean I washed the area with soap and water. I folded the soiled incontinence sheet into its self and disposed of it in the yellow clinical waste bag. I took this opportunity to wash Mr Joness back, consecrate it away and the backs of her legs with soap and water, I then wash off the soap and dried. I straightened out the clean slide sheet, linen sheet and the incontinence sheet and then Mrs Jones lied on her back.After a few minute, I placed the hand towel over the clients government agency and with her permission began to wash her face at the clients request I utilize water only on the face. I used separate wipes for each eye to prevent any cross contamination and a separate wipe for the rest of the face and then dried. Whilst I was doing this Claire began to wash Mrs Joness hands with soup and water after gaining permission to do so, Claire continued down the arms and rinsed off, whilst I dried the hands and arms Claire continued to wash the clients chest. Claire removed the dressing from a tumid the electron tube of the catheter and disposed of it and her gloves in the clinical waste bag, shethen went to wash her hands. When Claire retuned she had a fresh pair of gloves on she began to cleanse the skin from the tube outward and then dried the area, she decided not to reapply another dressing as she mat it was not required but did tape down the tube to Mrs Joness stomach to prevent it from dislodging. Claire carried on washing and rinsing Mrs Jones (Underarms, stomach, waste, genital area, (working outward to prevent infection) legs and feet) and I dried following Claire as she washed. The water that we used was kept clean at all times, as the used deposable wipes were not re-entered into the bowl.Whilst carrying out the bed bath myself and Claire assessed the Mrs Joness skin condition for any sours or broken skin. We employ talc to those areas Mrs Jones requested and then helped her to dress. We put the right arm in the nightgown first as this was her bad arm then subsequently her neck and left arm, there was no need to lower the nightgown much as this was a hospital nightgown with an open lower half, we then placed a linen sheet and blanket over her to keep her warm at Mrs Joness request. We raised the head of the bed to a seated patch so that Mrs Jones was sitting upright. As I attended to Mrs Joness viva voce hygiene Claire combed Mr Jones hear to her particular style. I then started to straighten out and clean the area and Claire began to document and update the care plan. Once I had cleaned and sanitised the table I replace Mrs Joness belonging on the table and placed the table close to her so everything she may need was of reach.FeelingsIn reflection to the incident at the time I felt as though everything went fine, but as I do had the opportunity to reflect on my experience in much more depth and incident I in writing this essay I felt as though I took the lead but only because I was given the opportunity to do so. Claire was fairly new to working as an Auxiliary Nurse and was somewhat inexperienced as this was the only ward she had worked on she had more knowledge of the ward setting and the type of conditions people are admitted with on the ward. I was qui te confident in assisting in a bed bath of a client as I declare worked in providing personal care to all type of client for a good few years now and believe that my experience as a wellness Care Assistance helped me immensely. My uncertainty was of the clients abilities and reactions to what we were actually doing it, thats when I decided to talk to the clientand auberge her through what we were doing.The thoughts in my head at the time were that the client may not have experience the type of bed bath that we were do and may have not been something she was used to. I felt chill out but a little apprehensive due to this but could go through the words at the time to ask her if this was the way her carers would normally perform a bed bath. It is important to remain professional at all times and make sure the client didnt feel too uncomfortable. I remember feeling somewhat responsible for the client as I was looking after her. I believe I acted in the best interest of my client a nd have acted in such a manner set out by the NMC Code of victor Conduct.I felt that it would have been better for the staff nurse on function to explain to the client in much more depth, why it was not possible to administer the drugs at the time of the clients request rather than scantily to say its not the right time and the drug round starts at 830.Although my client had told me the impartiality about her dislocated shoulder had been seen by the doctors and that it was safe to manoeuvre on as long as it was comfortable it was my responsibility to seek professional advice because of my uncertainty at the time. If for any reason had this not have been the truth there may have been serious repercussions. I dont think I would have known what to do if her condition had worsened due to the manoeuvre. The steps ship digit on the steps backwards or sideways. They are also the steps necessary for self-reflecting from this statement emphasised by Tschudin (1999) I able to understa nd that confidence in the self is quite an important attribute to be have in order to acknowledge setbacks and mistakes, your should be able to learn from them and even see them as part of the overall picture.EvaluationI have grater knowledge of such issues that can arise if set guideline, policies and procedures are not followed. There are very few bad points that had taken place during this reflective experience. I believe it is important to involve the client in closing making which I failed to illustrate wherever possible this was when we redressed the client after bed bathing without involving the client and allowing the client to choose. Weall have a professional responsibility to provide care to all patients/clients to the highest possible standards of care that will not be compromised by infections standard set out by the NMC Code of Professional Conduct.I acknowledged limitations set out by the NMC Code of Professional Conduct, in that my knowledge and experience of the d rugs on the ward was very limited and therefore I acquired help from a qualified member of staff.You must behave in a way that upholds the reputation of the professions outlined by the NMC Code of Professional Conduct this was maintain throughout the whole experience as I never spoke over the client nor did I ignore the client I showed the client up most respect. I was able to build a level of trust with theMy experience of working as a Health Care Assistance for and agency has enabled me to perform better in such conditions. By planning and discussing with the care team during handover and then with the patient about what our intentions are, what we are going to do and why, I was able to identify and background risks to the client.Seeing the way in which others behave or make mistakes allowed me to reflect on the point of view of others and to learn form them help me build on my knowledge.AnalysisI chose this experience as it is a procedure that I am quite confident with performin g.Thiroux (1995) created his own set of principles of ethics, which can be applied to any situation. 1) The value of life, 2) Goodness or rightness, 3) Justice or fairness, 4) truth telling or honesty and 5) individual freedom. Ethical acts are penalize in every day life even if we acknowledge it or not, the way we greet colleagues and clients even in the way in which we say good morning. Tschudin (1999) p175.As a training professional we are responsible for our actions and therefore must be able to backup any decision making with evidence I could see from myclients facial expressions that she was uncomfortable and was experiencing some sort of upset, during which in actual fact she was in a fair amount of pain.ConclusionI felt that the approach I took was in the right way and with the right intentions set out by the NMC Code of Professional Conduct. My reflective experience was very basic I felt and did not allow for much discussion, although a lot of the experience was preparati on, planning and assessing which prevented the experience to go bad in anyway. I feel that as I am a first year nursing student I am very limited in what I can do and because of this little opportunity is given to me to experience other than what I have preformed as a Health Care Assistant. I felt that myself and the Auxiliary Nurse worked well together and were able to share the responsibility equally.Overall I found reflection on my experience arouse as it allowed me to look at legal, ethical and professional issues surrounding nursing practice.Action PlanIf a situation like this was to arise again I think I would like to try to take out more time to talk to the client about how they are feeling, at time I felt like I was prying too much as I felt like I was doing most of the talking. I also feel that it is important for me to work along side more experienced members of staff or qualified member of staff to be able to learn more whilst on my placements. Although I experienced in providing personal care to client I am not too familiar with ward setting. I do not think I have learnt an awful lot on the practical side of my experience but by reflecting on my experience in this assignment has allowed me to understand professional, legal and ethical issues of providing care and the dilemmas surrounding health care professionals.In the future I would not always go on the clients say so and seek professional advice and not just take the patient word.BibliographyBartter. K, (2001) Ethical Issues in Advanced Nursing Practice. capital of the United Kingdom Reed Elsevier Plc GroupBurnard. P, Chapman. C, (2004) Professionaland Ethical Issues in Nursing. 3rd Edition. London Elsevier LimitedGlasper. A, Grandis. S, Jackson. P, and Long. G, (2003) Foundation Studies for Nurses using interrogatory Based Learning. New York Palgrave MacmillamThe NMC Code of Professional Conduct Standards for Conduct, Performance and Ethics. Standards 07-04. London Nursing Midwifery CouncilTs chudin. V, (1999) Nurses Matter Reclaiming Our Professional Identity. LondonMacmillan