Are patients not washed any more in hospital?

[Shortkiwi]

I am a nurse of over 40yrs plus. My 93 yr old father has been in hospital for a week. We have visited every day and had to wash and shave him in the afternoon or evening because it hasn’t been done. When I asked if he could be showered one evening, for the next day, I think they showered him but without using soap or shampoo, basically hosed him down from what he reported. His hair was definitely not washed. His teeth have not been cleaned without us doing them. Shaving is definitely not on the agenda. When I was a young nurse it was a given that patients were bathed each day, either in the bathroom or in bed. Teeth/dentures were cleaned and male patients shaved. We were admonished if these things weren’t done. Dad’s ward was very quiet today with several nurses chatting at the nurses station. They were very happy to get us any personal items we didn’t have. I just think if it wasn’t for us he wouldn’t be clean. He actually said, through his dementia, how much better he felt today after we showered him and washed his hair and said it would last him for a while! Which it won’t of course!
We had a list, in the old days, in terms of total patient care, in which we had to tick off items of personal hygiene for every patient in both our theory and practice. I’m sad for those that might not have relatives to attend to personal hygiene these days. It has never been discussed that we would do it, it’s just not been done. Basically, we have had to take the initiative. Years ago there were charts and care plans at the end of the bed, now it’s all computerised. I can excuse the 3 days of hell in A&E but not these last 4 days on the ward. My Dad is not mobile unless he has a lot of help and he is confused.

I was ill in hospital for 2 weeks and my family washed me daily. They were encouraged to, like it was expected!

I just asked my sister as she has been a nurse for nearly 10 years and she said that you are absolutely supposed to have full hygiene care and/or assistance (depending on mobility). She suggested reporting the lack of care as its unacceptable and would go against her hospital policies.

Oh I should add in the interests of fairness. ICU and then HDU staff in 2 different hospitals and 2 different stays. I can’t fault them. They were ace! All levels of staff and day or night they were friendly caring kind and genuinely seemed to care.

I was in hospital for three months 5 years ago. I managed to claim a shower 3 times. The rest of the time I was given a basin with 3 inches of water to wash in. It was horrible. Auxiliaries came round to make the beds in the morning and stood chatting during the process and never said a word to patients. They just ignored them.
One lunchtime, we all got the same thing for lunch no matter what we'd ordered. I overheard one nurse querying what was being served up. A couple burst out laughing saying the patients would never remember what they'd ordered so it didn't matter.
They had such contempt for all of us.

I have worked in most trusts in Scotland (admittedly not every ward) and every single ward I have been on every patient who needs assistance is washed every day and bed changed. If anything nursing staff tend to go a bit the other way and you end up with crazy practices like expectations of waking people at 4am 'to get all the washes done' a practice which i will not allow under my care. If the patient has capacity and refuses then that would be documented. Everyone I look after at risk of developing a pressure sore is checked and turned 2-4 hourly. I work nightshifts so only doing oral care at bedtime and it is of utmost priority, and soaking everyone's teeth at bedtime. I very rarely do days but I haven't shaved anyone since my student days. I also empty all my catheters and midnight and check what bags need changing.

I've said this 100 times but a vast amount of wards these days have 1 nurse to 17 patients. Some even higher (google stories of QEUH- 1 Nurse left alone over night with 30 patients). On that ratio I have 3.5 minutes an hour with each patient. People are increasily acutely unwell and increasingly medically complex due to an ageing population as im sure you have seen in the community. Last week I had 1 patient who needed 5 different IV antibiotics 3/4 times a day which took me 1.5 hours to get them all through a central line...back when I started nursing someone with that level of need would have been in HDU with much tighter ratios, same with chest drains or 40% o2 but the need is just so high now. That 1.5 hours thst I'm spending making up and hanging those abx has to come from someone else's allotted time and checking observations will always come before personal care especially if they are particularly unwell.

I'm not in any way denying that the care your father has experienced is substandard, there are some nurses I know if my granny was in I'd be staying overnight to keep an eye. But I just feel this is going to become a 'nurses are the worst people in the world and all lazy etc etc' thread. I hope he gets out soon and back to his normal routine.

I was a HCA before I did my training, one shift it was me and one other HCA for 30 patients ! Imagine needing to wash, turn , hoist , transfer and more than half needed to be hand fed. I imagine it's got a lot worse now. There's not enough time to give basic care it was just about keeping people alive , it's like a conveyor belt. I moved to psychiatric dementia and the ratios are a lot better.

Denti: There are half empty wards somewhere in the UK?

Yes, indeed, most of them. Has television told you otherwise?

I've been in hospital a lot.
At first things went downhill when I was asked to let a male care assistant wash me. I was in my early 20s but bedbound and it was suck it up and let him, or remain filthy for another week.

In my 30s I went for a shower and emerged to find I had swamped the whole ward with my water. Machinery was hurriedly being put on beds, slippers were floating down the ward. Tbf I'd had a very long shower as it had been a while. It turned out that as I was on a geriatric ward the shower cubicle had never been silicone in as they didn't expect anyone to use it.
Bed baths were not offered. 3 years later my nanny was on thay ward and a sign was on the shower room saying out of order, my mum asked why and it was due to a patient flooding the ward (me!!! And silicone is cheap)

A few months ago I was on a 38 bed ward with 2 out of use shower rooms and 1 disabled toilet that had a sink. I always washed in there. You could ask and maybe get a bowl of water on your bed but noone to help you wash, there were some very incapable people in my bay.
Covid then came to the ward and the disabled toilet was out of bounds so I had to do my best with the bowl but my curtains didn't fully close as the hand-wash sink was in my bedspace. Also in 10 days my sheets were never cleaned as there was a slight possibility I may have been moved to a different hospital site.

If i go back as far to being a lazy teen in and ouy of hospital it seems back then washing, changing sheets and cleaning the room was never ending each morning. When I as a grumpy teen (also ill but more Kevin the teenager) hated it, and the lukewarm water sloshing around everywhere.

But it needs to be done now, they are gross disgusting places. Again not nurse blaming but there did used to be more care assistants maybe if I remember correctly- but again crap wages for a very hard job.

Not my experience at all. About 3 years ago I spent 10 days in our local very large teaching hospital that is renowned for having ‘issues’. However personal hygiene care and nursing standards were excellent. I had sepsis as a result of gall bladder stones. Each day in the morning HCAs helped me wash myself providing water and clean towels or helped me walk to the shower, whilst my sheets were changed.
I also heard them trying to encourage other patients to wash or go with them to the showers. Some of these patients refused to be washed or helped. This must be a difficult issue with some patients who of course have the right to personal autonomy.

My relatively young relative was getting a knee replacement operation.
Everyone else on the ward were getting hip replacements and were quite elderly.
I was surprised to learn that washing of patients comprised of heated packs of wet wipes placed on the beds, with no assistance whatsover for the elderly patients to wash their backs, feet etc.

75 years of gratitude has caused this. We've all worshipped the NHS for far too long.

Did you not ask them to wash you and put clean underwear on you? Why not?

I don’t understand this, are you suggesting it is only patients who actively request basic care that receive it? Is being clean an extra perk?

I spent a week in during Covid, so no visitors allowed (not a covid ward but during restrictions). I had no help with washing or any personal care for almost 4 days. This only started happening when a nurse involved with my neurological condition visited my ward and highlighted that I was unable to carry out these tasks alone even before I was hospitalised. It had been assumed I was difficult/disinterested in personal hygiene and reluctant to eat, my “I can’t” was taken for won’t.
My long hair was brushed and plaited by a lovely nurse that night. I cried.

Also if people decline being washed , get aggressive , combative you have to do the relevant assessments under the mental capacity act, if they don't have capacity you can care plan. if they do you can't do anything. Then we have to care plan to restrain the person to give them a wash which won't be everyday for some people as it's bloody distressing. I've had to do holds in the bath while another staff member cleaned so the baths were once a week attempted strip wash the other days.

I’m finding this thread very upsetting. My beloved mum was in hospital two years ago and all visitors were totally forbidden during Covid (she didn’t have it). She just thought we’d abandoned her. It was like a living nightmare. By some miracle we managed to get her out, and I don’t know about showers or bed-baths but her hair definitely hadn’t been washed in the fortnight-plus she’d been in there. She was desperately upset about it as she was always meticulous about doing her hair.

She died a couple of days later and I’m still haunted by not knowing what happened to her in hospital without us being able to advocate properly for her.

I’m a HCA on a Healthcare for Older People Ward, so primary all geriatric patients. Providing they consent, every single patient will get a full strip wash by their bed / in the bathroom or a bed bath if they’re immobile - every day. I always shave the gents too. It might take until lunch time to get to everyone due to short staffing and a lot of doubles but no one is ever left.

I don’t understand why you haven’t questioned the nurse in charge about this instead of ranting on mumsnet? If that’s really the case then then Ward need to sort it out but bashing the hospital on the internet achieves absolutely nothing.

Just to add - I have close relatives who are nurses and I know how incredibly hard they work and how horrendous things are right now. But that was my personal experience. Had I been allowed to visit I would have gladly done all these things for my mum myself.

This is such an eye opening thread. Thanks for posting OP.

@CharlotteRose90
Shaving is a matter of dignity. Nobody should be left feeling scruffy or unkempt.

I had a 2 week stay in hospital in 2021 and even for my week on HDU I was helped to wash every day if I was well enough.

I annoyingly also had my period and the HCA’s helped me with everything. Due to ‘covid’ regs, nobody could easily bring me stuff in so I had no washing kit or san pro but they provided it all as soon as I asked. They gave me a fresh night gown everyday and changed my bed every day.

Part way through the 2 weeks, I asked for a toothbrush and they bought me toothpaste, comb and toothbrush. Once I was more mobile, I had a shower towards the end of the stay and HCAs made sure I could manage my O2 tank and were so caring. The day I removed my Cpap mask, a lovely HCA combed my manky unwashed hair without complaint and plaited it for me to make me feel fresher. The bowls of warm water with sachets of soap in and the soft gauze-like wash cloths made me feel so much more human and the care the staff gave was what kept me going. I never rang my patient bell unless it was absolutely necessary but when I did, they never made me feel rushed or that they were too busy.

I don’t doubt there are many uk hospitals not like this one but this was a major hospital with very good care, including amazing food!

The best part was the staff.

My son had a week on a childrens ward in traction. After several days I found he hadn’t brushed his teeth once.
No one had got toothpaste and toothbrush out of his locker for him or provided water or a bowl or anything.
Over thirty years ago now.

What an upsetting thread.
I have experience of both extremes of care in nhs hospitals - really wonderful caring staff and others who would hang out in the nurses’ station chatting and eating quality street , and ignore the patients

In my experience elderly or immobile patients need family members to help them otherwise they're left alone.

I was seriously ill right after having my second baby and was admitted for four days as an emergency - had only a couple extra pads and no underwear on me, and no one would help me wash/change/get extra supplies even when I asked. I still remember the smell, it was so awful and disgusting.

There is a current thread asking for the jobs that MNers would hate to do. Top of the list, Nurses and Carers. No one wants these jobs anymore. It is not about money ( although that is a factor) but about working conditions. No one wants to be a carer or nurse when they can do a nice, cosy wfh job so they are able to pick up their kids and walk the dog. Compare that to washing incontinent, elderly patients and you can see why the future of nursing, caring, teaching looks bleak.
I don't think most posters on here get it at all.
Having said that, my husband was in hospital recently and the nurses were wonderful. It was a major op and he was only in five days. We may have to get used to routine care being carried out at home or in a care home if a patient has no one to help care for them at home.
Of course it is not ideal but as so many posters make clear on the jobs thread, no one wants to be a nurse or carer anymore

Nurse (Sister) here. OP, I don’t understand why you’ve not brought this up with the Sister. I can’t speak for other places, but both in the Trust I work in, and also the Trust I trained in, washes (and assistance with washes) would be offered daily. Along with mouth care, changing bed linen and gowns/pyjamas. If a patient doesn’t have their own wash kits, we provide them. If a patient declines a wash (or refuses assistance), we have to respect that and we document it.

On my ward, all staff (trained and untrained) help with patient care. We don’t have time to shower and wash the hair of 30 patients (a lot of whom are Level 2/HDU patients), or shave them, as are staffing levels are shocking, but we do make damned sure that all are clean, with freshly made beds, brushed hair and cleaned teeth. Sitting them out and assisting with feeding/toiletting is also a given.

Please speak to the Sister/Charge Nurse about this - I would want to know if a patient hadn’t been washed for days on my ward.