Nurses experience of oral care
A recent study used focus groups to explore the real-life experiences of nurses who undertake oral care. Here are some of the quotes from nurses who participated.
Nurse Experience
“So for my own experience of oral care, ah, primarily, ah, always — it’s always been part of my core nursing skills and practice, ah, basic care of — of a patient includes oral care and it’s included in hygiene in my practice… you also made sure their teeth that [sic] were clean and their mouth was clean and their dentures were fitted and those sorts of things“
Another nurse said:
“I think from my experience, um, within cancer care, it [oral care] was done very well. Um, not because of the relationship with pneumonia, but because of, you know, um, cytotoxic, ah, treatments, mouth ulcers, and so forth“
Nurse Attitude
However some nurses did not think that assisting with oral care was their priority. See this quotation:
“They’re in here for a sore hip, they’re not in here because we have to do their mouth care. We’re here to manage their – their sore hip or, um, you know, sometimes that, um, the patient engagement, we need to understand that just because they’re in hospital doesn’t mean the nurse has to, you know, do their mouth care, you know, twice a day. We are here to manage what their presenting problem is. Um, so that expectation around, is it the nurse’s role to actually do it when they have capacity and they’re here for a sore hip as an example, um, needs to be looked at. … it’s basic care and the nurses feel that the patient should just do it. They’re in here for a sore hip, they’re not in here because we have to do their mouth care”
What do you think?
Dealing with a reluctant patient
Some used creative approaches when patients were reluctant
“I guess if you look around dementia, it can be sort of like an issue that is hard to like navigate, but I think as nurses we can find a way, like, yes, it’s a thing that has to be done in the morning, but sometimes you can come back to it maybe after five, 10 minutes they’ve forgotten that they’ve refused“
Recognition of the risk of pneumonia
Additionally the link between oral hygiene for patients and pneumonia is not always recognised.
“And it’s only later that I started to realise that there was a link between oral hygiene and respiratory health, and it’s a fairly strong link. Um, and it — and it’s interesting that when I mention it to nurses who were quite experienced, they — they’re quite surprised by this“
Barriers to oral care
As ever, there can be barriers to performance of oral hygiene as these nurses explain.
“In terms of, ah, obstacles, ah, the technological advances in modern nursing have reduced the opportunity of time to carry out some of these more intimate and slower practices around hygiene”
“Time constraints as well. Staff don’t see it necessarily as important as other interventions with patients”
“So going back to, um, I think the perception of the importance and time, um, certainly a lot of the junior nurses, the new graduates, nurses who’ve only recently say, come into the respiratory space that they’re very consumed with other things that are going on. And sometimes that’s not at the top of their list of priorities“