Double diapering alert patients who ask? I think it's neglectful. However...

  1. The manager (who is apparently also not a nurse, but a CNA like myself, even though she measures insulin and passes meds!! Wtf kind of place is this!!) says it's okay if they're alert and oriented, and request it. She said as long as the wings are removed from a diaper u can use it as a diaper liner for "heavy wetters."
    The way I see it, these people who are alert and choose to not go to the bathroom when prompted, are bound to get soaked either way, and the only thing a double liner really does is protect their clothes and furniture. I think it keeps them in a wet brief longer and does nothing for their well being. I have seen this person wearing DOUBLE FULL PULL UPS not one and a liner, but just one over the other. Today, it was a diaper liner. She does fine if she's toileted every hour and a half or so. Totally dry.
    There are actually two patients that the staff are doing this to, and both are alert, but their (the patients') only reasoning for a diaper over or an insert, is one wants it at night and says she will be soaked if it's not done (which seems like she's not getting changed enough)
    and the other one told me once (I'm new here, actually I think I'm fired for explaining resident rights to these same people, wowwww) that she has agreed TO it but she also said she feels more comfortable in a single pull up and that she feels like she's got a big load in her pants wearing the diaper insert as well. Thats the one I saw double diapered!! The other lady said that the CNA that passes meds also, and is a manager, was putting "the blue thing" on her which she said she "can't tape up" so I really think maybe I need to call an ombudsman. Oh and the CNAs here all call this woman a liar. She hasn't lied yet. Maybe her perception sucks and she's a bit abrasive, but she's no liar. She does tell the truth.
    I have an application in for a home health care agency and have an interview already scheduled since this morning, so I'm fine with not working there. It's just those patients have rights and I really hate how poorly these old people are treated!!!
    If this was your facility, would you report it?? What would you do??
    Last edit by Gillyboo on Dec 12, '17 : Reason: Missed something
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  2. 27 Comments

  3. by   cleback
    If I'm alert and competent and request a double liner (maybe I just go a lot at one time?), please honor my request.
  4. by   Ambersmom
    not really enough info here and its a bit confusing but...
    If a competent person requests double briefing that is their perogative.
    If patients are being double briefed so staff does not have to toilet them or change their briefs in a timely fashion. That is neglect.
  5. by   vanilla bean
    As an aside, it may not be the best course of action to come on a public internet forum and bash your current manager when using a selfie as your avatar.
  6. by   soutthpaw
    there is a tremendous variation in quality and capacity of diapers. most facilities by the cheapest they can get. which hold less, leak more and fit poorly. There are several brands/versions I can think of off the top of my head where one good quality diaper is equal to 2 or 3 cheap ones. but they cost 2 to 3 times as much. $1-$2 per diaper. So I see nothing wrong with a patient requesting a booster pad or adding a second one with the backing removed. As for staying wet. Quality diapers wick the moisture away very well and will basically be dry to the touch even when saturated.
  7. by   Tenebrae
    If the patient is alert and orientated and has requested it, what is the problem.

    If they were enforcing it on an alert and orientated patient against the patient issues, then that would be a whole different story
  8. by   Tenebrae
    There are many reasons why a patient may not take themselves to the toilet to avoid being wet, including simply loosing the ability to sense when they need to take a pee or pass a bowel motion.
  9. by   Gillyboo
    There's two patients.

    OK let's get a few things clear, here.

    1: I just got let go on the basis that I said inappropriate things to residents. Not something the admin substantiated or could give an example of. I informed one of these residents of their rights as a resident, after she said she prefers ONE pull up. Apparently this facility does not like residents knowing their rights. I haven't been there long, and am extremely sweet to the patients, and everyone was shocked that they let me go.

    2: Again, there are two patients. The first patient is very alert and oriented and simply occasionally refuses to be toileted. She said she prefers a single pull up. This was passed on at report, yet she was still put in an added diaper liner anyways. She had on a double pull up the other day, despite this. We do the patients laundry ourselves, so there is no worry about someone running out of clean clothes, due to having a linen service wait time. We do the laundry ourselves on site. She needs to be toileted every hour and a half, and she will stay dry. I have witnessed this myself. If she refuses, and goes more than three hours, she will almost definitely have incontinence. Having to change her pull up and clothes due to her refusal to toilet, is not the issue. The issue is she is not being toileted often enough and instead is getting double diapered, for the staff to not have to toilet or change her as often. I see this as neglect. She also doesn't like wearing the pull up and inner brief liner and says it's uncomfortable.

    The other patient has some brain damage and was telling me what she needed to not be soaked in her bed. I've never worked at a facility that used two diapers as a means of caring for incontinent patients.
    We change their clothes, use a chuck, change their chuck, and entire bed, PRN. And their ONE brief/pull up. So this particular patient also doesn't wet heavy, and is just asking for what is usually done, because it sounds like she and her bed are not going to get changed if she wets overnight. She also specifically asked for the same manager to do "the blue thing" that she can't tape herself, the same manager that said they don't do a full double diaper. That's a lie.

    Im not interested in comments from people who double diaper as a way to lighten their workload.
    I could care less if my former employer sees my face on here. I seriously doubt any of them are on here anyways, since they use CNAs to pass meds, and it's not done with any sense of privacy or even within the scope of assisting in self administration of medication. There's a memory unit and CNAs are feeding meds to patients. Its like wow.

    This place is a joke. And now I'm seeing that neglect is a standard of care that many people think is perfectly acceptable. I do not.
  10. by   heron
    It's tough being perfect, isn't it?
  11. by   NutmeggeRN
    Quote from Gillyboo
    This place is a joke. And now I'm seeing that neglect is a standard of care that many people think is perfectly acceptable. I do not.
    It is on you to call the state ombudsmens office to report neglect. Will you?
  12. by   TruvyNurse
    In my LTC facility if a patient or their POA request a double pull up or pad then we do it. If there was no request that is a huge no no
  13. by   Orion81RN
    Quote from Gillyboo
    There's two patients.

    OK let's get a few things clear, here.

    1: I just got let go on the basis that I said inappropriate things to residents. Not something the admin substantiated or could give an example of. I informed one of these residents of their rights as a resident, after she said she prefers ONE pull up. Apparently this facility does not like residents knowing their rights. I haven't been there long, and am extremely sweet to the patients, and everyone was shocked that they let me go.

    2: Again, there are two patients. The first patient is very alert and oriented and simply occasionally refuses to be toileted. She said she prefers a single pull up. This was passed on at report, yet she was still put in an added diaper liner anyways. She had on a double pull up the other day, despite this. We do the patients laundry ourselves, so there is no worry about someone running out of clean clothes, due to having a linen service wait time. We do the laundry ourselves on site. She needs to be toileted every hour and a half, and she will stay dry. I have witnessed this myself. If she refuses, and goes more than three hours, she will almost definitely have incontinence. Having to change her pull up and clothes due to her refusal to toilet, is not the issue. The issue is she is not being toileted often enough and instead is getting double diapered, for the staff to not have to toilet or change her as often. I see this as neglect. She also doesn't like wearing the pull up and inner brief liner and says it's uncomfortable.

    The other patient has some brain damage and was telling me what she needed to not be soaked in her bed. I've never worked at a facility that used two diapers as a means of caring for incontinent patients.
    We change their clothes, use a chuck, change their chuck, and entire bed, PRN. And their ONE brief/pull up. So this particular patient also doesn't wet heavy, and is just asking for what is usually done, because it sounds like she and her bed are not going to get changed if she wets overnight. She also specifically asked for the same manager to do "the blue thing" that she can't tape herself, the same manager that said they don't do a full double diaper. That's a lie.

    Im not interested in comments from people who double diaper as a way to lighten their workload.
    I could care less if my former employer sees my face on here. I seriously doubt any of them are on here anyways, since they use CNAs to pass meds, and it's not done with any sense of privacy or even within the scope of assisting in self administration of medication. There's a memory unit and CNAs are feeding meds to patients. Its like wow.

    This place is a joke. And now I'm seeing that neglect is a standard of care that many people think is perfectly acceptable. I do not.
    Wow, how ridiculous. I'm not seeing one single comment in favor of neglect.
    As an aside, if you do not wish to take the advice of not using your picture, you do you. You'll see on your own how far your attitude gets you in your career. I'm not surprised they fired you. This was not the comment I intended to post until I saw how quickly you could turn snotty.
    Have a wonderful career, and congrats on being perfect. You really taught us a lesson in how to provide wonderful healthcare.
  14. by   TruvyNurse
    Quote from vanilla bean
    As an aside, it may not be the best course of action to come on a public internet forum and bash your current manager when using a selfie as your avatar.
    Vanilla bean I could not have said it better!

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