Question about assisting patients on the toliet

Nursing Students CNA/MA

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Hello!

I am taking my CNA certification test soon. I had a question.. after assisting a patient to the commode/toilet, how do I clean them? Do I use toilet paper or a wet cloth? How do I support the patients while cleaning the patient at the same time? Do I have the patient backside toward me?

Thanks for your help?

Wipe front to back, probably wet wipes, and I've always cleaned them while they lean forward on the toilet (usually holding a bar); if I have to clean someone who is standing (if they got bm on their legs or something), I get another aide to help me. Always keep their backside toward the toilet - if they are holding on to a grab bar in the bathroom, shifting the support is unsafe. You can clean them properly with them standing this way.

I assume you mean you're taking the state CNA exam. They didn't teach you toileting in classes and you didn't toilet anyone during clinical?

It all depends. Let's say you have a resident/patient who is an assist of one. I always use a gait belt no matter what, even if the resident is steady on their feet. I would much rather have a gait belt on just in case. In my facility, there is a large grab bar right next to the toilet. We use dry wipes that can be used with peri-spray or water. I get these wipes ready while the resident is on the toilet, then pull the curtain and stand back and let the resident have privacy. When they are ready, I instruct the resident to hold onto the grab bar and to stand on the count of three. I hold onto the gait belt and count to three and support the resident to a standing position. While the resident is standing and holding onto the grab bar, I keep one hand holding onto the gait belt while I wipe with the other (Obviously while gloved!). The resident is facing away from the toilet, I am standing right next to them, but facing a little more towards the toilet so it is easier for me to hold onto the gait belt and wipe. You will learn with practice what works best for you. ALWAYS wipe front to back and only use each part of the cloth once! I was taught a method in my CNA course of folding a washcloth (or dry wipe) so you have the four loose corners that can each be used for a new wipe. Then, I pull the residents' brief/underwear up and their pants, unglove, and assist them into their wheelchair. I usually have the resident's wheelchair positioned next to the resident for an easy transfer for them once I am finished assisting them. I hope this helped! Like I said, you will learn as you go and you will learn what works best for you. Best of luck to you! :up:

Specializes in Long term care.

I agree with the other people who posted a response. I'd add:

If you have to support the weight of the resident, then they will be a 2 person assist (or some sort of mechanical lift)and you will need another aide with you to help.

So find out first what type of assist they are!

Always use the gait belt.

One person assist can support their own weight, but you will need to have a hand on them at all times.

Use toilet paper or a wet wipe, doesn't really matter.

In addition to all the great replies, in the real world, you also want to let the patient do what he (or she) can do for himself. If the patient needed help standing and walking to the commode but otherwise has the strength and dexterity to clean himself, then by all means!

Specializes in hospice.

Yes yes yes to Cuddleswithpuddles' comment! Never make people more disabled than they are!

I'm also a little shocked that you're preparing to take the certification exam and have such basic questions....you should have learned this in your program and you should have practical experience from clinicals. In my state, pericare is guaranteed to be on the exam.

Yes, I also agree with Cuddleswithpuddles. I always let the residents/patients do as much care as they can for themselves. I let them brush their teeth, wash their face, put their clothes on, comb hair, etc. If they can do it, you should encourage them to do so. :-)

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