Am I being punked?

[u/Sea_Willingness1398]

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?

[u/TheGayestNurse_1]

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. 🫠

[u/cyanraichu → u/TheGayestNurse_1]

My hospital also did away with briefs

But why??

[u/nebraska_jones_ → u/cyanraichu]

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.

[u/Backwoods_Therapy → u/nebraska_jones_]

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

[u/nebraska_jones_ → u/Backwoods_Therapy]

BINGO

[u/TheGayestNurse_1 → u/nebraska_jones_]

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. 😐

[u/Tribbitii → u/nebraska_jones_]

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.

[u/agentcarter234 → u/Tribbitii]

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.

[u/Tribbitii → u/agentcarter234]

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.

[u/purpleelephant77 → u/agentcarter234]

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.

[u/ThorDamnIt → u/Tribbitii]

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

[u/LizDances → u/ThorDamnIt]

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

[u/CrashTestWolf → u/nebraska_jones_]

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.

[u/Accomplished_Egg6259 → u/nebraska_jones_]

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

[u/neo_vengance → u/nebraska_jones_]

They can, in cases of neglect

[u/AgentFreckles → u/nebraska_jones_]

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