I have skilled nursing experience since 1988, working with patients needing total care.  I want to comment on Nurses Bath sheet placement as related to bed sheet changing to help the new user.

In my work, many times the patient is in their bed while I change the regular bed sheet, and so when using the “Nurses Bath” sheet there is basically no difference, because it is designed that way to facilitate the normal daily routine.

First, when greeting the patient, explain what you the nurse/caregiver are going to do.  Remember to always consider the need for providing privacy.   To begin the bed preparation discuss with the patient,  choices of which side is their most comfortable to turn to, or follow the instructions, if there is a restriction regarding the patient’s position, from the doctor.   If there is no restriction regarding lying on her/his back, the best way is to begin with the patient in the middle of the bed, in supine position – (lying on her/his backcenter of bed).

Second, turn the patient towards the chosen side of the bed by gently, using “log rolling” technique, hold the shoulder and hip,  turning both areas of the body at once.  If patient is lying on a draw sheet or chuck, use the sheet or chuck for the  turning process which is easier and safer.  Use One hand to grab the top side of the “draw sheet”, the other hand to grab the bottom side of the “draw sheet”, roll the draw sheet close to the body, positioning one hand close to the shoulder area, the other hand close to the buttock area, then turn with momentum, not too slow or not too fast, opposite from you/the caregiver/nurse to the chosen side of the bed.

Third,  using the Nurses Bath bathing sheet, remove sheet from the bag, partly unfold and take mental note where the designed mark, that shows the location for the head and feet are located.  The “Nurses Bath” sheet comes pre folded addressing both directions,   from the right to left and from top and bottom area, marked with head and feet symbols face side down away from patient, so the nurse or care giver can easily find the place that is folded to then position “Nurses Bath” sheet in the center of the bed, establishing the proper position of the patient.  Now place the “Nurses Bath” sheet in the center of the bed, align the center point of the “Nurses Bath” sheet behind the patient near the center of their back.   Open the sheet length wise, with the white paper designed marker symbol face down, touching the mattress.  Position the head designed marker symbol near the patient’s head. Roll up half of the sheet lengthwise, creating a full length of the body  bump of cloth and tug in under the patient like you normally do when changing the bed sheet while patient is in bed.  Then, turn the patient facing towards you, and pull exposed sheet  spreading open the “Nurses Bath” sheet away from the center, (as far as your arm and hand can reach while stabilizing the patient) spreading the sheet towards the  edges of bed.  Then return the patient back into the “lying on back “position.   Complete  Spreading the sheet in all directions making sure to smooth out sheet without major creases.  The bed should be positioned, to accommodate patient and facilitate the drainage of the bath water (regarding the water drainage a very little lower angle is needed towards foot of the bed and the cart)  Remember during this procedure to monitor patient, and keep covered with blanket (before bath begins) when bath begins use a towel to cover  the areas to be or have been bathed providing a higher level of privacy and comfort.

Forth, to finalize the “Arranging of the Nurses Bath” sheet for the bath, spread the sheet to make sure to cover the head board, foot board, and bed rails.   Then gather the ends of the sheet at each corner to fold them to create a box shape, use the same folding way on each corner, creating a fold crease that does not allow leaks, clamp if necessary and then chose one area of the bed to drain the water off.  In so doing after you pick which quarter side of bed you will use, place the bathing cart in that area to receive the run off water, making sure to position the cart close to the bed, lock the wheels and open the sheet in that area drawing the sheet to a spout point like shape and then tuck it into the recovery container bag tub located at the bottom of the cart.   Most bed mattresses surfaces are higher than the carts lower tub, top rim, utilizing the natural flow of the water it will drain easily into the carts lower tub, capturing the used bath water. (Note: Utilizing a big garbage type bag liner in this lower tub will make it easy to move this water after bath without splashing by closing the bag with a tie or string, avoiding splashes when taking the cart to the drain area. Also making clean up as easy as replacing the bag with a new one and throwing the other bag out. Note: using bags as liners in all the tub containers including the soapy water solution, clean rinse and conditioner rinse area makes it simple to clean and maintain.

I hope this helps the future and new user to use this wonderful bath.  Grace M.

Above is a You tube video that explains it or read below.

There are many reasons people find themselves bedridden, here might be one you have not heard about.  Please if you know of a bedridden person,  contact me,  giving me their contact info, so I can arrange to send them a Nurses Bath and give them a better bathing experience.

What Is Ehlers-Danlos Syndrome? :

Ehlers-Danlos Syndrome is a group of inherited connective tissue disorders, caused by faulty collagen (a protein in connective tissue).

Connective tissue helps support the skin, muscles, ligaments and organs of the body. People who have the defect in their connective tissue associated with Ehlers-Danlos Syndrome may have symptoms which include joint hypermobility, skin which is easily stretched and bruised, and fragile tissues. There are six major classifications of Ehlers Danlos Syndrome.

What Are The Six Types of Ehlers- Danlos Syndrome?:

Ehlers-Danlos Syndrome has been classified into six types:

Hypermobility Type of Ehlers-Danlos:

The primary symptom associated with the Hypermobility Type of Ehlers-Danlos Syndrome is generalized joint hypermobility which affects large and small joints. Joint subluxations and dislocations are a commonly recurring problem. Skin involvement (stretchiness, fragility, and bruising) is present but to varying degrees of severity, according to the Ehlers-Danlos Foundation. Musculoskeletal pain is present and can be debilitating.

Classical Type of Ehlers-Danlos :

The primary symptom associated with the Classical Type of Ehlers-Danlos Syndrome is distinctive hyperextensibility (stretchiness) of the skin along with scars, calcified hematomas, and fat-containing cysts commonly found over pressure points. Joint hypermobility is also a clinical manifestation of the Classical Type.

Vascular Type of Ehlers-Danlos:

The Vascular Type of Ehlers-Danlos Syndrome is considered the most serious or severe form of Ehlers-Danlos Syndrome. Arterial or organ rupture can occur which can lead to sudden death. Skin is extremely thin (veins can be seen easily through the skin) and there are distinctive facial characteristics (large eyes, thin nose, lobeless ears, short stature and thin scalp hair). Clubfoot may be present at birth. Joint hypermobility usually only involves the digits.

Kyphoscoliosis Type of Ehlers-Danlos:

Generalized joint laxity (looseness) and severe muscle weakness are seen at birth with the Kyphoscoliosis Type Of Ehlers-Danlos. Scoliosis is observed at birth. Tissue fragility, atrophic scarring (causing a depression or hole in the skin), easy bruising, scleral (eye) fragility and ocular rupture are possible clinical manifestations as well as spontaneous arterial rupture.

Arthrochalasia Type of Ehlers-Danlos:

The distinguishing feature of the Arthrochalasia Type of Ehlers-Danlos is congenital hip dislocation. Severe joint hypermobility with recurrent subluxations are common. Skin hyperextensibility, easy bruising, tissue fragility, atrophic scars, loss of muscle tone, Kyphoscoliosis, and osteopenia (bones which are less dense than normal) are also possible clinical manifestations.

Dermatosparaxis Type of Ehlers-Danlos:

Severe skin fragility and bruising are characteristics of the Dermatosparaxis Type Of Ehlers-Danlos. Skin texture is soft and sagging. Hernias are not uncommon.

Increasing Awareness of Ehlers-Danlos Syndrome :

The types of Ehlers-Danlos Syndromes (EDS) are treated based on the clinical manifestation which is problematic. Skin protection, wound care, joint protection, and strengthening exercises are important to the treatment plan. The debilitating and sometimes fatal condition affects about 1 in 5,000 people. At least 50,000 Americans have EDS. It is estimated that 90% of people who have Ehlers-Danlos syndrome go undiagnosed until an emergency occurs which requires immediate medical attention.

The Nurses Bath changed that, You see before the Nurses Bath, all baths were furnished with water from the tap, with the Nurses Bath, I can customize to my patient,  even the bath water, as a matter of fact, especially , the water, making it clean better

I recommend using Pool Chlorine (another name for common laundry Bleach) test strips; I found mine in Wal-Mart, to test the level of bleach in your liquids you make to bath and deodorize your patient.  You see, the recommended mixture of bleach in a swimming pool to kill all the stuff  the swimmers bring to the pool from their bodies, is 4 parts per million and the test strip will tell you when you have that mixture.  No special pool chlorine necessary, the regular laundry bleach will do fine.  If you start with that level (4 parts per million) you can safely, wash (in my opinion, you know in this day and age I have to say that or be vulnerable to a law suit) your self or your patient. Of course keeping clear of the eyes, but remember you or your kids open their eyes when swimming, anyway this will cut odors and if you experiment with just increasing it a tiny bit it can easily become your first defense in the hygiene war.

So, getting back to the Nurses Bath, use it ( the bath water) or even when using a sponge bath in a bowl, add a tiny touch of bleach, I recommend a teaspoon to a gallon, to get much better results when cleaning up after BM or just a general body rinse.

Now remember this is a Blog so I invite you too comment and give me your experience.  Richard

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Neglect can be difficult to detect, and with a smiling and friendly staff there to answer all of your questions and put on a happy face during your visit, neglect can seem like an impossibility in some situations. However, nursing home neglect is often much more prevalent than most of us are willing to believe.

At the first sign of bedsores, the situation should be handled immediately. The area should be treated and the patient should be elevated to a rotation schedule that is much more frequent, nor more than two hours between rotations. It is possible that bed sores may initially begin to develop if the patient is newly bedridden, has recently lost quite a bit of weight, or has had a recent procedure done such as surgery.
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