A Simple Bath

While I’m a Jack of all trades type, I have significant experience providing patient care in various medical settings and I even completed several semesters of nursing school before I realized that it was not the right career path for me. Nevertheless, I was very fortunate to have had many amazing experiences in healthcare that left indelible impressions on me and have broadened my perspectives as both caregiver and patient.

Weekly, 12-hour hospital shifts on your feet, sometimes literally running, are a huge component of nursing school. In third semester, my clinical experience took place on a medical-surgical floor in a busy local hospital. One of the functions nursing students may perform is taking part in the normal duties of the patient care technicians on staff who take routine vital signs, blood glucose readings, and assist patients with mobility, dressing, toileting, etc.

It’s important to note that under normal circumstances both nurses and technicians are under extreme pressure to accomplish certain time-sensitive tasks while maintaining clean and sanitary conditions as well as a professional manner. This involves constant critical thinking, prioritization of duties, recall, and frequent changes of direction mid-stream based on sudden emergencies and the ever-unpredictable nature of the setting. Lives are literally at stake and the staffing ratio of caregivers to patients is often inadequate. This can be related to an insufficient number of qualified professionals being available for unfilled positions. Naturally, then, some items must be designated as lower priority and things being as chaotic as they are, these items may wind up never being done at all. And let’s be honest, some of these less urgent responsibilities (like emptying urine collection bags) aren’t exactly pleasant. Providing basic personal care, such as assisting patients with hygiene, is a big one that often falls into this category, which brings to mind a very impactful moment I had while performing typical morning care for my assigned patients.

The patient is a kind, 58-year old man from Africa, frail and too weak to get out of bed. His wife is sitting at the bedside on her phone, quietly updating relatives back home about his condition. It’s not looking good. The man is HIV-positive and is in isolation due to the present illness. His immune system is severely compromised so all who enter this room must first don protective gear – gloves, mask, gown, and wash hands immediately.

I walk in, all suited up in my blue disposable gown, verify the patient’s name and date of birth, and proceed to take his vital signs and perform a routine physical assessment. I ask some standard questions including: “How are you feeling? Do you have any pain? Would you like some water?” Then I inform him that I will be getting him washed up, helping him dress and brush his teeth, and changing his linens. I prepare the wash basins and other materials and casually ask, “When was the last time they bathed you here? He replies, “I’ve been here for seven days and have not had a bath at all.” I am briefly stunned but try to keep my horrified reaction to myself so as not to upset him further. I do, however, apologize for this shameful oversight by my predecessors and fumble to make some lame excuse for their behavior.

Hoping that my sincere empathy was received as such, I aimed to focus on comforting him in the present moment with the simple attentive care he needed, attempting to rectify this state of neglect to the best of my ability. As I gently and methodically cleansed his frail arms with the warm water, little clumps of his dry, dark skin were collecting on the bleached-white washcloth. I had to stop and rinse out the washcloth frequently as I worked. I tried to rise above my sadness about the situation and just keep going with this most basic of human care because who knew when, or if at all, he would receive it again.

I don’t remember exactly what he and his wife said as I stepped away to de-gown and return to the frantic activity that was waiting inches away, just on the other side of a door, but I do feel that my care was appreciated. Upon stepping back into the bright lights and sanitizing my hands, I was swiftly interrogated by my instructor about where I’d been and why I hadn’t yet completed several of my other assigned tasks. The clock was ticking.