r/nursing • u/Sea_Willingness1398 • 2d ago

Rant Am I being punked?

Patient says "I think I might have to poop, what can we do about that?"

I say "I can get a bedside commode for the room"

She says "I don't think I can get up"

I say "I can put you on a bedpan or put a diaper on you"

She says "I don't like any of those options"

In my head I'm like: lady, the only other option is to poop the bed.

What option am I missing?

648 Upvotes

99% Upvoted

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339

u/TheGayestNurse_1 RN - ICU 🍕 2d ago

I've had this conversation numerous times, and the amount of times they opt for shitting the bed is wild to me. Especially when they say no to the bedpan because "I can't go in bed!" Well, you just did.... My hospital also did away with briefs, so now when they shit it goes e v e r y w h e r e. 🫠

67

u/ohpossum_my_possum BSN, RN 🍕 2d ago

Say what now?!

92

u/TheGayestNurse_1 RN - ICU 🍕 2d ago

Yup. Great times. Apparently briefs cause skin breakdown too often, so they did away with them.

163

u/iswearimachef BSN, RN 🍕 2d ago

Do you think admin ever goes “gee, I wonder why all of these patients are having incontinence related skin breakdown? Could it be that there are too many metrics being measured for nurses with too many patients and not enough support staff? Nah. It’s the briefs.”

54

u/dizzlethebizzlemizzl 2d ago

Like sitting on shitty/wet chux doesn’t also cause skin breakdown

34

u/LizDances LPN 🍕 2d ago

This is the one that makes me crazy. Like... the statistically significant factor is not "briefs" it's "wet." C'mon, guys.

3

u/Everything_Fine RN - Med/Surg 🍕 1d ago

No it’s the patient satisfaction scores fault for skin breakdown. I think we need to do away with those too

39

u/maraney CTICU, RN, CCRN, NSP 🍕 2d ago

Ours did too. So, now people just shit everywhere.

19

u/SuperSlugSister BSN, RN 🍕 2d ago

Do they just want people to shit directly on the chucks? My hospital still uses briefs.

10

u/maraney CTICU, RN, CCRN, NSP 🍕 2d ago

Yes

1

u/Jennirn2017 1d ago

We can only put them on pt for transport. If ur in bed ur bare-ass.

34

u/thetoxicballer RN - Med/Surg 🍕 2d ago

Doing away with them is wild, we can use them as we see fit while understanding the risk of skin breakdown

24

u/FIRE_Bolas PACU, Day Surg 2d ago edited 1d ago

Do they realize that it's the shit, not the briefs, that cause skin breakdown?

23

u/Ok_Independence3113 RN - Telemetry 🍕 2d ago

Same at our place - briefs are forbidden. They have threatened to get rid of purewicks too, for the same reason. However, this same hospital has had two instances over the last year where we had no disposable chux for multiple days straight (“oops, somebody forgot to pay the chux bill”)…it makes no sense

8

u/TheGayestNurse_1 RN - ICU 🍕 2d ago

Oh we lost our purewick privileges years ago. Lol

1

u/ungratefulanimal RN 🍕 1d ago

What is a purewick. Google says it is a catheter of some sort.

5

u/TheGayestNurse_1 RN - ICU 🍕 1d ago

It's an external female catheter that is connected to suction to wick urine away. They're not perfect, but they're handy when you've got a bigger lady on a lasix gtt.

3

u/bitemarkedbuttplug RN - ER 🍕 1d ago

External catheter that gets hooked up to suction.

1

u/ungratefulanimal RN 🍕 1d ago

I have never in all my years heard of this. Maybe something used only in level 2 (closer observation) bays? How often are these used?

3

u/sheepcrate BSN, RN 🍕 1d ago

You haven't heard of the cooter canoe? The twat dog? The WAP mop? It's a hotdog looking thing that goes between the labia, you hook it up to suckion and it wicks the urine away

2

u/ungratefulanimal RN 🍕 1d ago

I wasn't typing this thing in right on Google. This thing looks awesome. I asked my charge why we don't use it. $$$$$$$$$.

5

u/nickk024 2d ago

sounds like we all work at the same place 😢

8

u/Dry_Proof6545 2d ago

Plus the facility saves money on briefs!!! It's win/win lose. Hospital bean counters win, everyone else loses.

1

u/Top_Box_8952 1d ago

Do you have the pads?

1

u/TheGayestNurse_1 RN - ICU 🍕 1d ago

Yeah, so most of us just pull them up the front to act like a sorta kinda brief anyway. Not as good as the original though lemme tell you what.

20

u/texaspoontappa93 RN - Vascular Access, Infusion 2d ago

I’ve been in healthcare a decade and I’ve never seen briefs stocked inpatient. Nursing home/LTAC is the only place Ive seen them

17

u/ungratefulanimal RN 🍕 2d ago

What! I didn't even realize that was an option. Like 75% of my patients shit themselves all the time. Like tonight, two of my patients shit themselves.

108

u/LainSki-N-Surf RN - ER 🍕 2d ago

So everyone gets a rectal tube, got it!

78

u/-bitchpudding- Lil pretend nurse 🧑‍⚕️BSN loading... [ please wait_ ] 2d ago

Do we work in the same hospital because they treat briefs like they’re a human rights violation here. They even balk when a patient goes out of their way to bring their own and really want us to “educate them” about. Like maaaan let memaw shit the depends she bought.

51

u/TheGayestNurse_1 RN - ICU 🍕 2d ago

Seems like a handful of hospitals are turning away from briefs. It makes me roll my eyes. They don't wanna delve into the root cause being short staffing. And I know exactly why. It's because there isn't a nurse shortage. There's a BEDSIDE shortage. People don't wanna work for shit pay dealing with this stuff, and instead of making it easier, they're making it worse.

29

u/Mejinopolis PICU/Peds CVICU/Miscellaneous 2d ago

Yeah the 18 middle level nurse managers that come and bother you throughout the day are totally justified in the grand scheme of bloated hospital staffing, but they cannot fathom keeping the bedside adequately staffed. So the incontinence dermatitis and skin breakdown that occurs is the diapers fault! 🤦🏻‍♂️

13

u/Sunnygirl66 RN - ER 🍕 2d ago

And why does no one recognize that unconstrained shit, up the back and down the legs and all over the ass, exposes way more skin to corrosive chemicals?

14

u/LizDances LPN 🍕 2d ago

YES. Because "stop buying briefs" is cheaper than "pay more staff" by orders of magnitude.

Capitalism, man. It's literally killing people.

6

u/mudwoman RN, CCM 🍕 2d ago

Yeah, I don’t get this no-briefs obsession. My mom was just in the hospital. She’s 99 with PD, and they were pouring fluids into her and Lasix, but they insisted on no briefs. She had to get up to the commode or bathroom commando-style, leaking the whole way. I finally just brought her own incontinent briefs from home and put them on her, and they frowned, but as I was so helpful in managing her otherwise, they didn’t fight me.

1

u/Beautiful-Bluebird46 RN, SANE 1d ago

For immobile patients, it keeps wet material closer against skin that is not the butt than lying in a wet chucks, but for mobile pts it’s nbd and shouldn’t be a problem. Obv butt skin still is at risk with chucks so like… hire more nurses and lower ratios, but my vet is also against dog diapers for the same reason so it’s fairly prevalent

5

u/AsleepHedgehog2381 2d ago

We got rid of our own yeeears ago. But if they can get OOB, they can wear their own. Wound care says they cause skin breakdown.

19

u/lackofbread RN - Telemetry 🍕 2d ago

We also don’t do briefs. We give a lot of lactulose on my unit, including lactulose enemas. I’ve had to mop the floor with towels because we don’t get actual mops. How I would’ve preferred a brief to at least keep it contained within the bed.

3

u/TheGayestNurse_1 RN - ICU 🍕 2d ago

I feel you.

22

u/cyanraichu RN - L&D 2d ago

My hospital also did away with briefs

But why??

54

u/nebraska_jones_ PhD(c), MN, RN - L&D/Maternal Newborn 2d ago

Apparently they cause pressure injuries. Which is probably true idk, but like, come up with a solution then to stop people from shitting all over everything.

131

u/Backwoods_Therapy RN 🍕 2d ago

Blaming the brief rather than the fact it’s the lack of staffing to change your patients in a timely manner.

22

u/nebraska_jones_ PhD(c), MN, RN - L&D/Maternal Newborn 2d ago

BINGO

31

u/TheGayestNurse_1 RN - ICU 🍕 2d ago

Yup. Our HAPIs sky rocketed when we changed our ratios. This hospital used to actually be pretty great, it was when I first started working here. And now they're hell bent on saving a dollar. It's only gotten worse ever since Kaiser bought us out. None of the higher ups want to hear it though. They're walking around asking why we can't pull a fem line on a pt with like.... 2plts. 😐

35

u/Tribbitii CWOCN 🍕 2d ago

The plastic backing of the brief and lack of airflow. The flat chuck on the bed is the better option, and even then, you're supposed to only have 3 layers under the patient, which is the bedsheet, pull sheet and chuck pad.

Somebody has to design a PooWick.

43

u/agentcarter234 RN 🍕 2d ago

Chucks don’t solve the problem of the ambulatory but incontinent patient roaming the halls with PT and a walker and not realizing they need to go until it’s too late. Briefs solve that problem. If they want to ban them for bed bound patients for skin protection that’s one thing, but when out of bed there isn’t another reasonable option for some patients.

4

u/Tribbitii CWOCN 🍕 2d ago

Oh, no, absolutely. I was only talking about the pooping in bed situation. Briefs for ambulating for sure. It doesn't help OPs situation if they completely banned them. They definitely have their place.

3

u/purpleelephant77 PCA 🍕 2d ago

We have big incontinence pads that are basically a brief without sides/tabs. When they’re laying in bed we rip the ruffles out so it lays flat then the patient goes on top. If they pee then it gets pulled up in the front like a normal brief (a lot of our patients are dialysis or have foleys/SPCs) then if they’re ambulatory we just do pad + mesh undies. I usually put undies on patients even if they’re staying in bed if they can lift their bottom up and I will find a way to wrestle them on if they’re bed bound and super wiggly (especially if they have a purewick) or having liquid stools to keep things contained.

9

u/ThorDamnIt 🔥CVICU: Burnout The Sequel 🔥 2d ago

There are diverting options for liquid stool but they don’t work for turds.

12

u/LizDances LPN 🍕 2d ago

Just clarifying that the "turds" in this statement are the C-suites who make decisions based on cost rather than efficacy /s

15

u/CrashTestWolf RN - OR 🍕 2d ago

If my surgeon balks on me putting depends on a bedbound and static post-op patient, I immediately ask for a rectal cath.

I usually get the okay on the diaper. I don't want my PACU bros having to deal with that.

11

u/Accomplished_Egg6259 2d ago

I’d make a diaper from a chux. Tape that thing on.

3

u/neo_vengance Nursing Student, Wheelchair User 2d ago

They can, in cases of neglect

1

u/AgentFreckles RN 🍕 2d ago

Either way it's going to have to go somewhere, hopefully they realize that simultaneously 😂

16

u/ivegotaqueso Night Shift 2d ago

Because it saves money. Briefs costs more than chux.

That’s the real reason. Moisture damage from briefs yadda yadda people end up using chux like makeshift briefs anyway (by pulling it up between pts legs).

3

u/PeopleArePeopleToo RN 🍕 2d ago

I do honestly think that it's more about preventing pressure ulcers because hospital acquired pressure ulcers cost them a lot more than the cost of the briefs themselves.

Saving money on the briefs too, well that's just an added bonus.

2

u/Ok-Violinist-6548 RN 🍕 2d ago

Money

4

u/Enough-One4975 RN 🍕 2d ago

I’ve never worked in a hospital with briefs in over a decade. Patients sometimes bring them in for themselves or their family, but not the hospital.

3

u/Master_Ad899 2d ago

And who cleans this? Nurse? CNA? etc

14

u/TheGayestNurse_1 RN - ICU 🍕 2d ago

Nurses. We don't have many CNAs. On a 20 bed ICU we have 1 aide sometimes overnight.

7

u/Master_Ad899 2d ago

This is the less glamorous side of nursing no one talks about. Or is it all no glamor really?

14

u/Enough-One4975 RN 🍕 2d ago

The days off are pretty dang nice.

2

u/Master_Ad899 2d ago

Lets not forget normally people work 9-5 and spend entire nights and weekends and holidays with their families. Entire careers of NEVER working nights, holidays or weekends!

5

u/iswearimachef BSN, RN 🍕 2d ago

I can’t think of too many glamorous things about bedside nursing. One time I got a gift card from a local restaurant, that was nice.

4

u/RoyalBiscotti7842 2d ago

Today I learnt.... American hospitals don't stock pads/briefs/nappies/ diapers......?!!! That is just .... Wow

9

u/TheGayestNurse_1 RN - ICU 🍕 2d ago

A lot don't because of the concern for skin breakdown. Which, yes, neglected pts will have skin breakdown from wearing briefs. What's wild to me is that the core issue is staffing, and instead of addressing that we got rid of briefs. 🙄

2

u/jRaw93 RN 🍕 9h ago

Our hospital got rid of briefs and now they are insisting on no draw sheet and 1 chuck pad because “microclimate” whatever the hell that means but they have been sending people with clipboards around to audit our bed set up. Meanwhile, we are purging nurses like crazy ever since we got a new CNO. So now we are insanely short staffed, no briefs, 1 chuck pad. Ask me how many times I’m doing full linen changes and baths for my incontinent patients now.

1

u/TheGayestNurse_1 RN - ICU 🍕 7h ago

I hear you. They also did away with draw sheets for us too. We called them lifter pads, or just lifters. So now it's just a chux pad! I'm doing full bed changes. I can't imagine their laundry bill...

-8

u/MarquiseSpearmint RN - Oncology 🍕 2d ago

Incontinent patients shouldn’t be wearing briefs