permitting a patient to urinate in bed versus holding it in

Altra, BSN, RN · Jul 1, 2011

Sorry -- your learning will be greatly enhanced by researching the components of this scenario yourself ... and asking the question on a message board does not constitute "research".

Good luck with your studies.

canesdukegirl, BSN, RN · Jul 1, 2011

Here is my insight, for what it's worth:

A bedridden pt should always have a bedpan within reach. Why was a bedpan not in the room to begin with?

It is unnatural to urinate in the bed. We were trained early in our lives NOT to do this. There is a stigma of shame and embarrassment associated with bedwetting, no matter the circumstance. The lab tech was only trying to comfort the pt by telling her that she should pee in the bed if she couldn't wait. However, the pt is no doubt completely humiliated at the thought of having to pee in the bed. The pt is already feeling helpless simply from being bed bound. Can you imagine how completely defeating it must have been for her to pee in the bed? She LIVES in that bed.

I doubt there are any nursing articles or references that you can look up regarding this situation. It is simply common sense to have a bedpan in the room for a bedridden pt.

nep1980 · Jul 1, 2011

Possibly the reason there would not have been a bed ban is if the patient was transported down to the radiology department for a test. I know that when I was with a patient I was assigned to as a student nurse a few clinical rotations ago, I went down for an X-ray with him. While he was down for the x-ray he told the x-ray tech that he had to go to the bathroom, she told him that she was "unable" to get him out of bed for him to use the bathroom. He insisted that since his "nurse" was with him he could go. I remember looking around the room, wondering who he was talking about.....Yup it was me, his STUDENT, nurse....I don't think that I was really supposed to be getting him out of bed so he could go to the bathroom; however the x-ray tech was giving him no choice. Oh I forgot to mention, I asked her for a urinal for him 1st as I was supposed to be keeping I&O on him and they did not have a urinal down there, I went over to the ER as it was down the hall, and guess what I was told there.....No urinals???

Jenni811, RN · Jul 1, 2011

bedridden patient should always have a bedpan within reach. a lot will also have foley catheters. but i'm going to take the situation for what it is...

i'll admit, i HAVE permitted a patient to urinate the bed. She had a draw sheet and it was this little old lady who needed to go and could not be left alone (a 1:1 observation). I cannot turn my back on her for 1 second, she is QUICK and terribly unstable. So when she tells me, i put on the call light and im waiting and waitng and waiting for someone to come help me move her to the commode. She is up with 2 and pivot, sometimes a ceiling lift so i CANNOT move her myself!! Nobody is coming, i can't leave her since she is 1:1. I briefly poked my head out the door- nobody.

She is yelling "I CAN'T HOLD IT I CAN'T HOLD IT"

....gave her permission to go and we would clean it up. One of the CNA's finally showed up. My remark "well since nobody came i just let her go on the bed. Going to help me clean it up now?"

Luckily it wasn't alot. Buuut you do what you gotta do in certain situations. I wouldn't urge all patients to urinate the bed everytime they have to go. but i definitely don't wan't this lady to be uncomfortable and mad at me for "not taking her to the bathroom" i cleaned her up good and still set her on the commode while i cleaned the bed. Apologized for the situation and told her what iwas going to do to correct it. Since we hadn't been using a bedpan with her, we didn't have one in the room but i kept it in there for "emergencies like this"

Maybe another nurse would have handled it differently but i felt i was acting in the best interest of the patient. Who cares about the bed and the linens?

Double-Helix, BSN, RN · Jul 1, 2011

A patient should always be encouraged to urinate in a way that feels natural and comfortable for them. If that means a toilet, a urinal, or a bed pan, that's what should be encouraged.

However, if the patient does have to urinate in the bed (some people really can't hold it) the patient should be reassured that it is okay, not a big deal, etc. It makes the patient feel a little better in a very uncomfortable and embarrasing situation.

This reminds me of a labor and delivery situation. Many women in labor feel that the urge to push in very similar to the urge to have a bowel movement. When pushing, the same muscles that are used to defecate are also employed. It's not uncommon for laboring women to have a bowel movement during labor. Sometimes the woman knows this is going to happen, but getting her up to the bathroom isn't a realistic option. The labor nurses, when I have heard about these situations have always told the patient that this was fine, acceptable, happens a lot, they were used to it, etc...

cherrybreeze, ADN, RN · Jul 1, 2011

A patient should always be encouraged to urinate in a way that feels natural and comfortable for them. If that means a toilet, a urinal, or a bed pan, that's what should be encouraged.
However, if the patient does have to urinate in the bed (some people really can't hold it) the patient should be reassured that it is okay, not a big deal, etc. It makes the patient feel a little better in a very uncomfortable and embarrasing situation.
This reminds me of a labor and delivery situation. Many women in labor feel that the urge to push in very similar to the urge to have a bowel movement. When pushing, the same muscles that are used to defecate are also employed. It's not uncommon for laboring women to have a bowel movement during labor. Sometimes the woman knows this is going to happen, but getting her up to the bathroom isn't a realistic option. The labor nurses, when I have heard about these situations have always told the patient that this was fine, acceptable, happens a lot, they were used to it, etc...

I think you've got the best grasp of the situation. It's not a matter of having them urinate in the bed because it's "easier" or they can't be bothered to help them find another means (I've read plenty of THOSE scenarios questioned on this forum). In the OP, they were trying to find a bedpan, but she was having trouble being able to wait....so I think the tech was basically telling her that if she COULDN'T hold it and wait any longer, that it was ok, and not to be embarrassed by it. Their efforts to rectify the situation unfortunately weren't quick enough (not saying that's they're fault, either; she just had to go THAT BAD, RIGHT NOW).

I don't have any "articles" to back this up, however; to me it's common sense. If you need articles and references, that tells me that it's not curiosity, it's an assignment of some kind...meaning I went against my normal personal code by answering it at all (I don't believe in answering homework questions on a forum, it's not good for the student in the long run not to do their own work).

whichone'spink, BSN, RN · Jul 2, 2011

Eek! I can't imagine telling a patient to wet him or herself.

txredheadnurse, BSN, RN · Jul 2, 2011

My thinking is why didn't someone toilet the patient before transporting them? Prevention is preferable.

chicookie, BSN, RN · Jul 2, 2011

.......... O_o

This sounds like a homework assignment to me......

sharpeimom · Jul 2, 2011

eek! i can't imagine telling a patient to wet him or herself.

that isn't a realistic approach to the problem; nor does it make the patient feel any better about what is about to happen or has happened. unbelievable as it might seem to you, very very few people will deliberately urinate in bed or or an exam table when they could have used a bedpan, commode chair,

or the john.

my thinking is why didn't someone toilet the patient before transporting them? prevention is preferable.

i had a stroke caused by an earlier three congenital aneurysms the day after my 54th birthday. there were no warning symptoms whatsoever. i worked on my birthday. i had lunch the next day with my husband. i went home to let our five month old puppy out, came back in, and it hit. bang!

among many other things, it affected my bladder. no, i haven't had any accidents, but i do have to wear a pad in my underwear. it finally doesn't bother me to buy those %^&$ pads anymore. i absolutely cannot imagine how i'd feel if a nurse or other medical professional were to tell me to

"just hold it in because you cannot go right now." i'd simply shrivel (sp.?) up and die. right then and right there.

going beforehand doesn't always make any difference. please give your patients the benefit of any

doubt when they tell you they have to go right now. most of us with bladder issues aren't being

difficult.

rn/writer, RN · Jul 2, 2011

Back when I was an EMT it would sometimes take a long time for us to extricate a patient and transport them to the hospital. If the patient was immobilized (C-collar, KED and longboard), we would let them pee into a large trauma dressing that would absorb quite a bit while covering them with a blanket. This gave them much-needed relief with minimal embarrassment. You do what you have to do in an emergency. Still, it's not a good thing to do as a habit.