Cant believe the nurse did.....

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VinoLover2030

428 Posts

Specializes in lots of specialties.
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.

I 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.

BostonTerrierLover, BSN, RN

1 Article; 909 Posts

Specializes in Adult/Ped Emergency and Trauma.

God 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:)

roser13, ASN, RN

6,504 Posts

Specializes in Med/Surg, Ortho, ASC.

Umm, yes. Yes, it is.

Specializes in LTC and School Health.
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....

I 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.

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.

ComeTogether, LPN

1 Article; 2,178 Posts

Specializes in Transitional Nursing.

Brandon, 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"

Specializes in 4.

While 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.

momo72

13 Posts

I have worked LTC before, I understand how crazy medpass's can get and how far behind one can get. But I'm sorry Brandonlpn, your reasoning for having a resident soil them self, I don't understand. If your in the room already and your behind already, taking 10-30 minutes to help a resident toilet is NOT going to hurt anyone! I'm sure the CNA's you work with, will also appreciate NOT having to clean the resident after they have soiled themselves and the bed.

This is just my thinking.....

One of the "oh no the nurse, did not do that" moments, was seeing documented by a new lpn "full does of Lantus 150 units not given, due too PT fs of 110 @ 2100. Lantus 75 units given instead, for PT safety." Yes that is exactly what the nurse had documented! Yes I felt bad showing the DON, as this was not the first time this new nurse changed orders on her own. But we both had a SMH moment when we saw the MAR!

Michele RN

uRNmyway, ASN, RN

1,080 Posts

Specializes in Med-Surg.
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.

And THAT my friends is why I will do everything in my power before I let my parents or loved ones in a LTC center, if at all.

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.

I absolutely understand what Brandon is saying -- I too encounter patients who refuse to use a bedpan. While my ED setting is perhaps the polar opposite of BrandonLPN's LTC environment, I too tussle almost daily with patients who are alert but have some issue (new lower extremity fx, new onset symptomatic a-fib, worrisome heart rate or BP) who cannot seem to understand my patiently explained reasons why it's not safe for them to get up to the bathroom right now. Interestingly, the more recalcitrant (or belligerent, if you prefer that term) patients in this predicament usually say to me at some point in the conversation, "if you won't get me up to the bathroom I'm going to (insert colloquial vulgar term for urination and or defecation) in this bed and you'll have to clean it!" Now whose dignity is being insulted, hmm??

And NO patient/resident should EVER be moved in a Hoyer by a single staff person.

Back to the regularly scheduled thread ... :smokin:

Covettt

3 Posts

We had a code one night i locked my med cart . This RN told me, sorry i have to pass my meds:artist:. I was speechless..

ohmeowzer RN, RN

2,306 Posts

Specializes in ob/gyn med /surg.

here is a gross one , hehee i worked with a nurse and when ever he had anxiety he picked his nose. i mean wham right out in front of everyone at the nurses station and go wash his hands in the bathroom ( i suspect he ate his boogers in the bathroom) . he did it alot and i was sooo grossed out .. ewww well someone spoke to him and he cut back, but after a code or a real stressful sitiuation he would pick like crazy . he was digging for gold..

ComeTogether, LPN

1 Article; 2,178 Posts

Specializes in Transitional Nursing.

Just to be clear, I never suggested anyone should use a hoyer alone. It's a 2 person machine.

"No day but today"

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