After a number of tests she was diagnosed with a Colon carcinoma. This resulted in her having a colostomy which Is an opening In the large Intestine which Is brought onto the surface of the abdomen. This provides a new path for waste material and gas to leave the body.
This procedure can be either temporary or permanent. However in Mrs.. Murphy’s case it was permanent.
What? Mrs. Murphy was at falls risk, and was very weak after her surgery so my preceptor an I thought it would be appropriate to assist Mrs. Murphy with a bed bath.
However, I felt it was imperative that considered a number of factors before assisting this patient with her personal hygiene.
On entering the room, I Introduced myself to Mrs. Murphy and offered her my help assisting with a wash. I made sure to gain Mrs.. Murphy’s consent by asking her if she would be comfortable with this.
It happened to be my first time assisting a patient with a bed bath and I was unsure what response to expect. I was also informed by my preceptor that it was this patients first time receiving a bed bath. I was fully aware that she must have felt anxious and vulnerable at this time.
It was clear that she was tired and weak after the surgery and exhausted from not sleeping.
She then informed me that she was In main. So I Immediately Informed my preceptor of this. I did not feel It was appropriate to to help with a wash until the pain relief had taken effect. I could see that Mrs. Murphy was worried as she very apprehensive due to her colostomy, which understandably she was having difficulty coming to terms with. I subsequently spoke with my preceptor in relation to this and she explained to me that this reaction was normal.
I felt It was important to not only concentrate on the physical aspects of care, but to Instead care for her holistically. So I Informed Mrs. Murphy that I would come sack in an hour to see if she would be feeling up to having a wash then. She was very grateful, and thanked me for this. After an hour I found that the analgesics had significantly alleviated the pain. I could immediately see a difference in her and she responded positively to the suggestion of the bed bath.
First I made sure to draw the curtains to promote privacy, and ensured that the area was draught free.
I prepared the bedside with all the toiletries that were needed. My preceptor had Informed me of the Importance of using disposable flannels and wash cloths. These are used to educe the risk of infection.
However I did noticed myself having to go back and forth a number of times as I kept forgetting things. I made sure that the water was the correct temperature by checking it with the patient. Carefully helped her remove clothing but ensured that she was kept covered with a towel at all times to maintain her dignity.
I left the basin at the side of the bed and allowed Mrs.
Murphy to wash around the colostomy bag, however the bag did not need to be removed at this time. My preceptor had made me aware that a Waterloo score had been undertaken on Mrs. Murphy or Mary as she had now asked me to call her. Relevant interventions had been put into place to prevent any pressure sores from forming.
My preceptor and I had been made aware that Mary had been experiencing pain following her surgery. We therefore ensured that any unnecessary movement was minimizes.
However with the help of my preceptor, I gently helped the patient turn onto her side as it was important that I washed her back, legs and feet as she was unable to reach them herself. I assisted to dry her skin thoroughly. While Mary was on her side it gave me he perfect opportunity to observe the skin for any redness or potential pressure sores.
In particular to pressure areas such as the heels and sacrum area. Also while Mary was turned my preceptor and I replaced the bottom sheet in order to promote comfort. The top bed sheet was then remade.
I made sure to communicate with Mary at all times to make sure that she felt comfortable. I noticed that her skin was very dry, I felt it was necessary to apply some moisturizing cream into her skin in order to prevent any sores from forming.
Mary brushed her own teeth. I then helped her into lean cloths. I then disposed of any clinical waste. Throughout the procedure I felt that it was important that Marry bed bath was carried out with sensitivity and her individual preferences were taken into account.
I noticed how Mary became more comfortable with me throughout the time that I spent with her.
I felt a sense of achievement as I noticed how Mary had become more relaxed with me and I believe that I gained her trust. This activity also helped to build a therapeutic relationship between myself and the patient. I was glad that it was an enjoyable experience for he patient.
So what? Overall, I felt that the experience was a positive one , as it allowed both of us to become more familiar with each other. I can remember feeling nervous and apprehensive at my lack of experience. I was conscious of the fact that bed bathing is a personal and intrusive procedure.
I was worried that Mary may have felt embarrassed or even frustrated relying on someone else to meet her hygiene needs. However as time went on I became more confident and in control of the situation. I now understand the importance of communication, as it is central to the ruse patient relationship.
Communication is the medium through which interpersonal interaction takes place. One to one interaction with the patient during the process of bed bathing and promoting hygiene is an integral part of developing the nurse-patient relationship (Major 2005).
In my experience, I believe that I communicated effectively with Mary as she felt at ease and comfortable with me. During the bed bath I felt that I encouraged the patient to be as independent as possible. I felt by allowing her to wash her face and hands herself that she would feel art of the procedure, which I believed to be very important.
Having spent time with Mary it also gave me the perfect opportunity to assess her activities of daily living, such as mobility, hygiene, dressing and continence needs.
On reflection with my preceptor I do feel that I could have planned my time more effectively and I could have been more organized when gathering all of my equipment. I feel that the procedure may have taken longer due to my lack of preparation. However I now know the importance of planning care and gathering all equipment before starting any from the patient.
Also I realized later when discussing the procedure with my preceptor that for future reference, it would be more beneficial for me for raise the bed.
This would alleviate any back problems that I may incur due to over reaching and stretching. Now what? I have learned from my experience, how much a bed bath is appreciated by a patient. Whiting (1999) suggests that the maintenance of personal cleanliness is fundamental to nursing.
I also realism how it can help to contribute to a patients well-being and comfort. It also occurred to me from my experience that it is essential to maintain self aspect, confidence and dignity in the patient which subsequently will help develop nurse patient relationship.
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