Cant believe the nurse did..... - Page 3Register Today!
- Jan 1 by Glycerine82Quote from BrandonLPNOk didnt see the bed pan refusal statement but really? Why would someone choose to soil themselves over go in a bedpan. I have worked LTC and know how hard the nurses work. Not saying you don't do the best you can but MAN I can not imagine this.The residents in question refused a bed pan, it's always offered. I'm guessing you don't work in LTC. There's just no time for 2 staff to get a total care Hoyer lift up on the toilet every time. I have 49 residents with 3 CNAs. Should we neglect the rest of the floor to spend 20 minutes getting someone lifted onto the toilet? You do the best you can with what you have, that's a reality of long term care nursing.
"No day but today"
- Jan 1 by Nascar nurseQuote from BrandonLPNSorry Brandon - I've been in LTC since 1984 and have never one time told a resident to just go ahead and go in the bed. It is just unacceptable. Refuse the bedpan?....Guess, I'm not "offering" the bedpan but approach it more as "Sorry, the aide is held up helping someone else right now. Let me just put you on the bedpan so you don't have an accident in the bed". I'm not approaching this rudely or harshly but it does make it difficult to refuse the assist. Purposefully allowing someone to just go in the bed leads to skin problems, odor problems and a very basic lack of respect and dignity towards a resident.There just isn't time in LTC to get every hoyer lift resident up every time. If anyone has a suggestion, I'm all ears....
I'm renowned in my facility for being the nurse who helps out the most in hands on care. But, yes, medicating my 48 other residents sometimes has to take priority over toileting ONE resident. And my poor CNAs are sometimes simply unavailable. They're toileting half a dozen other residents. So if the resident can't wait for the CNA to get there..... I politely tell the resident "your aide will be with you as soon as possible. If you can't hold it, go ahead and go and she'll
clean you up" I don't think this makes me Hitler or anything.
- Jan 1 by BrandonLPNSo should I pull the aide out of another room and another resident to come help me with the hoyer?? I'm not operating a hoyer w/o another staff. I tell the resident we'll help them as soon as we can, but if they can't hold it we will clean him up afterwards. I have other responsibilities. Weighing responsibilities is part of being a nurse. I see a lot of people judging, but not one person has offered an alternative....
- Jan 1 by BrandonLPNI guess my residents are just different.... Some of them just flat out refuse a bedpan. Some of them have "no bedpan" right in their care plan.
I've never said "just go in the bed" in so many words. Thats gross and rude. I should have been more clear. I say if you can't hold it, we will clean you up ASAP. We all work as hard as anyone else, but sometimes I can't get people up when they ask. That's all I was saying.
- Jan 1 by SShannon81Quote from BrandonLPNI work in a hospital now but I have worked in a nursing home before and yes you cant be in 30 places at once if you have over . I do sometimes question why exactly at shift change all of the "Urgent " matters pop up.The residents in question refused a bed pan, it's always offered. I'm guessing you don't work in LTC. There's just no time for 2 staff to get a total care Hoyer lift up on the toilet every time. I have 49 residents with 3 CNAs. Should we neglect the rest of the floor to spend 20 minutes getting someone lifted onto the toilet? You do the best you can with what you have, that's a reality of long term care nursing.
- Jan 1 by BostonTerrierLoverRNGod I'm so sorry that LTC can be so understaffed for what you need. No, I would be the last one you'd want advice from, I haven't been in LTC since Nursing School. I have always been a fan of your other posts BrandonLPN, but this one is a dignity issue as I have said before my worst fear is laying in my own spent food with no one to help(not saying you don't CARE), but when something is out of my ability to change- I then advocate by reporting the resulting issue to my superiors.
I will be the first to admit I am not cut out for what you do, and I believe you when you say your doing everything YOU can do. I do humbly support the others sentiment that it must be addressed "somehow," as it is such a dignity issue.
I believe from your other posts you are a competent, caring, and exceedingly intelligent nurse
- Jan 1 by roser13[QUOTE=BrandonLPN; Sorry, when I'm busy with a med pass and my aide is busy with a shower, no one is going to get you up in the Hoyer and put you on the toilet. It's not that outrageous to tell a pt this[/QUOTE]
Umm, yes. Yes, it is.Last edit by roser13 on Jan 1
- Jan 1 by OnlybyHisgraceRNQuote from BrandonLPNI know I'm beating a dead horse, so I apologize in advance. I've done both LTC and hospital nursing. I don't agree with telling a resident to go in bed. However, if they were too unstable to get oob or complained of using the bedpan I would encourage them to go but I would clean them up immediately, as I wouldn't want a resident to sit in urine or BM.So should I pull the aide out of another room and another resident to come help me with the hoyer?? I'm not operating a hoyer w/o another staff. I tell the resident we'll help them as soon as we can, but if they can't hold it we will clean him up afterwards. I have other responsibilities. Weighing responsibilities is part of being a nurse. I see a lot of people judging, but not one person has offered an alternative....
Sometimes residents have urinary urgency and cannot make it in time for the commode or bedpan, that is another case where it is okay for them to "go" in bed as long as someone goes to clean them up right away.
Taking care of bathroom needs is a priority over passing routine medications , when working in LTC.
- Jan 1 by Glycerine82Brandon, can you say " I'm sorry but I'm not able to help you to he commode without help. Let me put you on the pan so you don't have an accident." I can see perfering a toilet over a bedpan.... but a bed pan beats going in the bed....Another thing I would suggest is a slide board for those who have sitting balance. It's much faster than a hoyer and takes little effort . If you put one of the sides down on the BSC and raise the bed just above it the pt will slide right on. A towel over the board will help bare bottoms slide. Is this an option? I've found it works wonders for some patients.
"No day but today"
- Jan 1 by 1pinknurseWhile I am not agreeing 100% with Brandon's post, I can empathize. I don't work in LTC (I work in Outpatient Surgery at a hospital) and I commend those who do. It takes a special someone to do it. Now I do agree 100% with not using a hoyer w/o another person. It is extremely risky using one by yourself & I would rather clean a code brown yet jeopardize skin integrity, then risk life. During my clinicals there were several accidents using the hoyer lift by the staff at a facility, when using it solo. We must remember his clientele is most likely older & fight to be independent so I see where the refusal of a bed pan comes in. I may not agree with the tatics but I empathize with the situation & I get it.