Back to Basics

I've been waiting for months for something to inspire me to write, which admittedly is a bad strategy because if you're waiting for inspiration, chances are it will never come. Thankfully I was rewarded this week in hospital when someone said something that set my mind on fire. I was talking to one of the nurses on the ward about how my school organizes the progression of our skill development. The semester I'm currently in is traditionally described as being extremely skill-heavy. We learn a large number of technical nursing skills such as injections, sterile wound dressings, managing IV medications, removing sutures and staples, and removing all kinds of exciting tubes and drains from various body parts. The nurse I was talking to gave me a knowing look and leaned in close. 
 
"Must be nice to get away from those bed baths."
 

Oh, the dreaded bed bath. They were one of the first things we learned upon starting nursing school, and as our first clinical placement was on an acute medical ward for geriatric patients, we got more than enough practice giving them. Now, being on a surgical ward, our patients are typically younger and much more independent with their basic needs. Assisting with hygiene is still required of us, but full bed baths are a less common occurrence. I've written about bed baths before and I'm starting to realize that they have a special place in my heart. When I hear someone talking about them disparagingly, I have an overwhelming urge to rush to their defense. They are the underdog, an often-looked-down-upon skill that has been mocked and sexualized by popular culture. But as defensive as I get about it, I understand why they have developed a bad reputation in the hospital: they take time, they can be quite physically challenging if you have a patient with limited mobility, and, of course, they often involve getting up-close and personal with unpleasant sights, smells, and sounds. As technical nursing skills go, they are the bottom of the barrel. How much training do you need to fill a basin with soap and water and wash a body? Anyone can do it.

Giving bed baths and attending to other hygienic needs are the most basic of nursing skills. As student nurses, we are impatient to learn more advanced skills that will bring us closer to the image we have of ourselves doing important things like saving lives. But we quickly learn that most of the time, being a nurse (and especially a student nurse) isn't as glamorous and exciting as TV would have us believe - it's being sprayed with bodily fluids, it's figuring out the best way to roll an obese bedridden patient, it's wiping bums, it's measuring what goes into and comes out of your patients, it's celebrating the first bowel movement after surgery. It's messy, stressful, and downright disgusting at times. 

But along with the mess comes the best part: caring for another human being in their most vulnerable hours and providing the most basic needs for those who can't provide for themselves. What a privilege. 

Ask any nurse or nursing student why he or she pursued nursing and the answer will almost always be, "because I want to help people." As students, I think we fall into the trap of believing that the more skills we have, and the more advanced they are, the more we are helping others. And let's be honest - we want to do the cool stuff. We want to feel like the highly educated, highly trained nurses we are being groomed to become, and the advanced technical skills get us closer to that identity than do some of the basics. But the more we lose sight of the basics, the bare bones of nursing, the more we move away from the ultimate goal of helping others. I've seen nurses talk over patients about their weekend plans while they give bed baths or make gagging faces at each other as they clean up a particularly gruesome mess, and I've seen patients who are overcome with gratitude when someone offers them a toothbrush because nobody thought to do so for three days.

As I progress further into my nursing training, more and more skills are added to my arsenal. I'm grateful to have the opportunity to practice the ones that are more advanced and more interesting, but I never want to lose sight of the basics. Washing a body isn't difficult, neither is wiping a bottom or changing a diaper. The skill of it comes by figuring out a way to do so that preserves the dignity of the human being in the bed, and I would argue that that is a skill worth mastering.