Aside from Vital Signs taking, another major task by the student nurse during clinical duties is the ever famous and taken for granted tepid sponge bath (TSB) or sponge bath for fever. You have to note that originally, sponge bath was done for immobile clients. This includes clients who are bedridden, weak, or paralyzed. This could also be done to infants because this is easier to do than actually immersing them in water. We call it tepid sponge bath or sponge bath for fever to emphasize and to differentiate it from its alternative use. Usually, we use tap water to prevent chilling. You have to pat the towel mitt from the distal parts of the body towards the proximate parts and give more attention to the axilla, neck, groin, and the forehead. There are still many principles about the tepid sponge bath such as monitoring your patient’s temperature, etc. TSB is especially effective if you do it along with taking some antipyretic. Fever is no small matter. It could signify many things, like infection, for instance. I would also want to share with you some memorable experiences that I had as a student nurse involving the TSB.
We were assigned in the surgical ward one shift during our third year. My client was a post Appendectomy client. After the endorsement, I immediately assessed him and found out that he had fever of around 38°C. His operation was just done the day before and infection is common during the first few hours after surgery. But aside from this, he was having a really bad productive cough. I promised myself that by 10:00pm (our shift was from 3pm-11pm), his temperature will be normal. I performed the TSB, monitored his vital signs, and gave his medications. One special task that I did was to splint his incision site with pillows every time he coughed. Whenever I did this, I used my two hands and unfortunately, my mask was of no use at all. It’s always better if you’re busy because time can pass by so fast. By 9pm, his temperature normalized and the only problem was his cough. He was even ordered to have a sputum test the morning after. Anyway, I was scheduled to be on on-call duty during weekends. We were blessed to be the first group of students from our batch to be on top of the list for OR completion. Just two days after that night in the ward, I had my throat swab taken as laboratory requirement for OR completion and I had abnormal results. That was the reason that I became one of the last students in our batch to complete our scrubs. I was moved to the list of the “last priority”. Nevertheless, the client’s fever was gone and I know that I did what I had to do.
I was a folk that time when a student nurse from a different school came in to perform TSB to our patient. She got a basin and a towel. She squeezed the towel so tightly and wiped it vigorously on our patient’s arms. I told her that she wasn’t performing it correctly. I told her the mechanism used in TSB is evaporation. That means, the towel mitt should be damp and she should only pat it on the arms gently for the water to eventually evaporate and thus promote heat loss. Any student nurse would know that. Oh and yeah, I was the talk of the station after that incident.
Just this June, my younger sister and brother were confined in the hospital. My brother had a fever of 38.9ºC taken at the ER. The ER was peaceful and my brother was the only patient in but no one had the initiative of giving him a sponge bath but the nurse went to check his temperature from time to time. Finally after I settled his laboratories and all the other slips, I asked for a basin and did the TSB myself. My brother’s fever lowered down to 38ºC.
I know it must be hard for nurses to manage time. This is why they are so thankful for student nurses because they can do the minor procedures like this. But my brother was the only patient and they were just sitting there in the station doing some chitchat.
As nurses, even the tiniest detail about the patient’s condition should be regarded. A simple fever can lead to severe complications while a simple TSB cannot only prevent this from happening but it also brings so much comfort and security to the patient.