Depressed patient refuses positioning even though she is lying on her own bowel movement - page 3

Hi everybody, I am still a nursing student and have encountered a big ethical issue in placement. The ward got an elderly lady about 80 who just went for hip replacement, she was also depressed and... Read More

  1. by   RNrhythm
    I have been in this situation many times. First, make sure you are managing pain appropriately. Then, with assistance, gently turn and clean the patient. Don't get adversarial. I usually say things like: Please let me clean you. I respect that you don't want to be moved but I cannot leave you dirty. I know you'd rather be clean. You will be more comfortable afterwards. Thank you for being patient with us.
    I try to be verbally and emotionally gentle.
  2. by   caliotter3
    Quote from LovingLife123
    The ethical thing is to clean her up and not allow her to lay in feces and urine. She is obviously not in the right state of mind right now.

    Laying in feces and urine will cause skin breakdown and infection that could be deadly. It's a huge ethical issue to not clean her up.
    I agree with this. We had a younger lady, of sound mind, who had less 'reason' to be noncompliant, who was worse than this on an ongoing basis. This resulted in a pressure ulcer that went to the bone and had tunneling. She threw a fit over wound care, everything. People allowed her to have her way because everyone was tired of her and her behavior and no one wanted to deal with her. I don't know what ultimately happened to her, but it could not have been pleasant.