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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

smelly old ladies in hospital......

91 replies

psychomum5 · 03/02/2010 12:19

why can;t the nurses make them smell better??

is that not part of their job??

they help do bed baths on those stuck to bed, and change dressings, catheters, tubes going into/out of body parts, so why why why can they not help the little old lady opposite me who smells really bad.

she is mobile, but confused, and it isn;t fair, on her or anyone on the ward. it is such a shame.

I am sure if she had her younger self here, she would be horrified at the treatment.

I hope like hell that this never happens to me....it is hard enough losing dignity right now being stuck in here and having to go on commodes etc, without looking to the furture.

for her.

OP posts:

belgo · 04/02/2010 08:46

if you can place a catheter in the patient, then you can wash them as well.

agree with your comments ampere about families who should help but don't.

ToccataAndFudge · 04/02/2010 08:58

oh I see you're talking about this one particular case.

You see there's no way you'd have got a catheter (not without heavily sedating) into many of the residents that I had to help look after (and who we WERE expected to at least "top and tail" every day even if they didn't want us to )

belgo · 04/02/2010 09:03

toccata - I have some experience working with geriatric patients ( I don't want to be too specific about my own experience) and I know how hard the job can be but like you having to 'top and tail' un-co-operative patient, because you cannot just leave them in the state psychomum describes.

ToccataAndFudge · 04/02/2010 09:10

yea well if you think what I was "having" to do (if I didn't want to risk yet another warning for not doing things "their" way and potentially losing my job) was right you should have been there.

It was f*cking wrong

Original poster

psychomum5 · 04/02/2010 09:39

toccota, I am talking about this one in the main, but it seems to be endemic across the NHS if you go on what others also say.

poor lady is still insisting she is going home, doc says no, she asked why, he said because they need to arrange a package of care for her........has been like groundhog day for the last 15mins while same things were said by her and him........he has got to do rounds tho, so now the poor nurses have taken over, and still she smells

OP posts:

ToccataAndFudge · 04/02/2010 09:54

you know I was just thinkig about this again as I have to ring my mum (urghh haven't rung her for a LONG time). Anyhow, she washes everyday, and has carers come into the home to help her bath regularly as well, but she's quite incontinent now and wears pads - and she smells as well. It's horrible when they come to see us

Original poster

psychomum5 · 04/02/2010 10:10

oh toccota, thats sad. tis hard seeing parents get old like that. well, going on how I feel about the PILS.....not had to have that yet TBH, but seeing this, I am hoping not to go thru it

OP posts:

donkeyderby · 04/02/2010 10:30

It's such a shame they can't get this lady in the bath or to have a bed bath. This is one of the most important nursing jobs, not only to help keep the skin intact and prevent bedsores, but it is a wonderful opportunity for talking with the patient, listening, breaking down barriers, picking up on the nuances that can be easily missed on a busy ward and for offering the gentle touch of caring hands. In my nurse training, the holistic nature of bathing a patient was emphasized over and over again.

I would hope this woman is being discussed by the staff and creative ways of getting her to have a wash are being sought. It is not enough to ask 'would you like a bath?'. My son who is severely disabled and doubly incontinent would probably answer 'no' to that question but if he was left in his own shit, I would do the hospital for neglect. You have to find creative ways to persuade people to do what is obviously in their best interests. If there are not enough staff to provide adequate care, isn't that ones duty as a nurse to highlight this to the managers anymore, or has the Code of Conduct changed?

Original poster

psychomum5 · 04/02/2010 12:29

donkey, they moving her to the geriatric ward, where I am hoping they are set up for people like her to sort her out.

for my nose and her comfort.

OP posts:

Sassybeast · 04/02/2010 13:18

So you're 'not' a nurse or a carer Belgo ? Ward clerk or cleaner ? Have you EVER attempted to carry out personal hggiene on an agitated patient with dementia ?

NightShoe · 04/02/2010 13:53

I'm a staff nurse on a dementia ward. The pivotal point in this case is the patient's capacity to make a decision which would need to be formally assessed by skilled professionals under recent legislation. If the patient in question was deemed to have capacity to make a decision whether to wash or not, then this would need to be resepected.

If the patient was deemed to lack the capacity needed to make a decision about washing then a nursing care plan would need to be made on a individual basis. Where possible, this would be made in conjunction with family or other nominated persons in order to take into account what it is likely the patient would have chosen prior to illness, so for example if Fred only had a bath once a week for his whole life, it wouldn't be very respectful to try and force him to wash/bath everyday.

Capacity isn't black and white, and needs to be assessed for each intervention. So she may lack capacity to decide to wash or not, but may have the capacity to decide what to have for dinner from the menu.

Of course there are occasions where this means that people do need to be washed/have personal care when they really don't want to. There are definately ways and means of this and the nursing care provided is pivotal here. You don't just pile in with a flannel and a bar of soap, but you make great efforts to persuade, build up a rapport, think what is going to make this experience easier for the patient. Sometimes, the very last resort is a clean up despite protest, but this would be only done if the person was very dirty or was in danger of skin issues.

The main point is that there is no black and white answer here, as with much of nursing. It depends on so many carefully considered factors and also the patient themselves.

Donkey Derby, it is still part of the code of conduct that you need to highlight inadequate staffing to a manager, but sadly it is not often taken very seriously, even with repeatedly raised concerns. In fact I have even seen this reflected back at the nurses who are told that if they manage their patients effectively then it shouldn't be as much of a problem as they are making out.

Sassybeast · 04/02/2010 14:04

Sorry to be a pain but I've actually only just made the connection between this thread and the other one by the OP which clearly identifies the location of this elderly lady. I feel kind of uncomfortable knowing that a lot of information has been given about her circumstances and it's not beyond the realms of possibilty to think that a family member may read these threads and also make the connection. It just doesn't sit right with me sorry. (But am too incompetent to know how to flag it up as an issue other then tlike this )

No offence intended to the OP - hope you get your freedom soon!

Thelongroadhome · 04/02/2010 14:17

Agree completely with Nightshoe - it depends on whether she has the capacity to decide about her hygiene / bathing and if not then others can make this decision for her through legal means. It still doesnt make it easy for those carrying it out though.

donkeyderby · 04/02/2010 14:29

NightShoe, wonderfully put.

belgo · 04/02/2010 17:08

I am not saying if I am a ward clark/doctor/astronaut because I never use my profession to back up my comments.

Definitely not a ward clark though, I hate using the telephone.

ampere · 05/02/2010 10:57

Well done NightShoe for spelling it out in all it glory..Or is it gory??

I brings into focus the reality of treading that fine line between rights and responsibilities in health care, aspects that our red-top papers, for example are completely unable to grasp!

The only 'flaw' (and it's not your flaw, NightShoe!) is economics: I imagine often, despite the best intentions, nigh on impossible to build up that ideal rapport with an elderly patient who is in an understaffed ward for her needs.

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