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- by onthejourney Jul 7, '12Hi all. I am a brand new RN on a slow stream rehab floor. I just thought of an interaction that I had with a patient and was wondering your opinions on it. I entered a patient's room to administer some afternoon meds. A family member was visiting and I asked the patient infront of the family member if they "felt wet". This pt is most often incontinent and sometimes confused and does not tell staff when they need a change.. Looking back it seems kind of insensitive on my part and could make the pt feel embarassed- but it is something that shouldn't be ignored. The pt said they didn't know and they family member stepped out so I could check. So do you ask in front of family members if a pt needs a change? What words do you use?
Thanks for your input,
- Jul 8, '12 by JAR0607This could go either way. It's based on your judgement, because would you rather your patient sit in it for a hour until you the family is gone, possibly making it look like, to the family, you ignore the patient. Or you could've done what you did and offered to change the patient asap and have the family step out for a moment.
- Jul 8, '12 by Bec7074I usually ask family if they could just step out for a moment if I think I'll have a "present" waiting for me. I usually tell family I'm just going to get the patient repositioned in bed. No one ever argues. I think family know if we ask them to step out, there's things we're going to be doing. You could use the words "change the sheets" too. I think they'd get it. I don't think you were insensitive though if you felt comfortable enough to say it.
- Jul 8, '12 by nursel56I'd probably go with Bec704 and Esme on this. Some people are extremely sensitive about their incontinence - and even if most of them don't seem to be - you never know for sure. The fact that you asked us about it demonstrates a sensitivity to your patient's unspoken state of mind that is more than many people ever get. That's such a great quality in a nurse. Best wishes to you.
- Jul 8, '12 by Daisy_08I depends on who the visitor is. If it is a spouse or parent, then there are not any issues.
If there are visitors in the room I say things like do you need to be freshened up or turned.
If I need to change or check the pt then I will ask them to excuse us for a moment so I can reposition them.
Just try and be as tactful as possible.
- Jul 8, '12 by MaremmaI always use the term "freshened up" whether there is another patient or family member in the room or not. To me it is still a dignity issue for the patient. I am in the room with them an therefore they are STILL not alone and deserve my respect of their dignity.I put myself in their shoes. How would I feel if another person, nurse or not just came in to me and asked me if I wet myself or if I am wet. I would feel embarrassed. Asking if I am ready to be freshened up would be far less embarrassing to me.
- Jul 8, '12 by Boog'sCRRN246If it's rehab, maybe the family member needs to be involved in the care. Of course, that all depends on the patient's discharge disposition. I'm not sure what you mean by "slow stream" rehab floor, but where I work, if the patient is expected to be going home with family, the family is brought in to learn what their needs will be after discharge and how to address those needs.