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Any tips for placing a bedpan?

Posted

I'm a CNA in a nursing home and I have one patient that always requests to use a bed pan but every time I give her one, she pees all over the sheets and I have to change the whole bed. She is a larger patient and not very mobile so I have a hard time with her, especially since she has to pee quite frequently (every hour or two). Lately I've just been having her get up to use the commode and she's been fine with that but that still takes a decent amount of time which you may know is in very short supply for CNAs!

Anyway, I wish I could know what I'm doing wrong! I know that I'm placing it the correct way because I do have another patient that also likes to use bed pans and she never wets the bed with them. But she is thinner and more mobile so maybe it's because I can place it better with her?

Are there just some patients that it doesn't work well on because of positioning issues? Or is it something that I'm just doing wrong? Any advice is appreciated. This is my first CNA job and I've only been there for 6 weeks so I know I still have a lot of learning to do.

CVICU-Nurse1.5

Has <1 years experience.

Sometimes it still gets the sheets wet no matter how you do it.

RainMom

Specializes in PACU, pre/postoperative, ortho. Has 10 years experience.

I usually try to have them flare their thighs out a bit. Otherwise, the urine will pool & hit everything but the pain. Sometimes it doesn't matter what you try; there's still a mess. If the pt is able to get up, I'd try to do that as much as possible.

If she can get up to the commode, she needs to do that. Using the bedpan all the time will only encourage her to not get up and she will lose what motility she has. There are, of course, times that she will need the bedpan, but one of the best things we can do for patients is to encourage them to get out of bed to void.

Try placing a chuck ( bed pad) under the bedpan. That should keep the sheets dry.

nursephillyphil, BSN, RN

Specializes in Medical Oncology, ER. Has 5 years experience.

i line the bedpan with chux or absorbent pads , and usually with a chuck sheet under that as well. no mess :)

Try placing a chuck ( bed pad) under the bedpan. That should keep the sheets dry.

My facility does not have those :( The beds just have 1 fitted sheet and 1 or 2 draw sheets (which are those thick sheets for pulling a patient up in bed). She soaks through the draw sheet(s) and fitted sheet.

i line the bedpan with chux or absorbent pads , and usually with a chuck sheet under that as well. no mess :)

I do line it with paper towels and that works perfectly for my other patient but not this one. I told another poster that we don't have chucks. But now I'm wondering if maybe I could put a brief around it to try to absorb it? Seems logistically complicated though. I tried putting a towel around it last time but that didn't work. hmmmm

marienm, RN, CCRN

Specializes in Burn, ICU. Has 8 years experience.

I agree that getting her up to the commode is probably better for her overall mobility. That said, sometimes I've had luck tucking a chux pad into the folds of the thighs and then draping it down into the pan. With some ladies the urine seems to go straight out & overshoots the pan! The chux "apron" redirects it (hopefully). Also, sit her as upright as she can tolerate so that gravity is working for you!

My facility does not have those :( The beds just have 1 fitted sheet and 1 or 2 draw sheets (which are those thick sheets for pulling a patient up in bed). She soaks through the draw sheet(s) and fitted sheet.

Sometimes with larger patients it can be difficult to get the bedpan under them correctly and you end up with a mess. Try using a blanket instead of the draw sheet as it is thicker and will absorb more preventing it from going straight through to your fitted sheet.

I understand it can be difficult to find the time (or staff) to help a patient to the commode (trust me, I know!) but, as PPs have stated it IS important to get the patient up to the commode if they are able to and would likely be the best option as you are adding on time to this task by having to change the sheets every time, anyway.

Sometimes with larger patients it can be difficult to get the bedpan under them correctly and you end up with a mess. Try using a blanket instead of the draw sheet as it is thicker and will absorb more preventing it from going straight through to your fitted sheet.

I understand it can be difficult to find the time (or staff) to help a patient to the commode (trust me, I know!) but, as PPs have stated it IS important to get the patient up to the commode if they are able to and would likely be the best option as you are adding on time to this task by having to change the sheets every time, anyway.

It must just be positioning issues due to her size and limited mobility. If I can't get the bedpan under her right, I don't think it'd be able to get a big blanket!

I think you all are right. I'll continue to just get her up to use the commode and it does work pretty well and she hasn't wet herself in that case yet!

Thanks!

(Also I hope it doesn't come off as condescending when I say anything about her size! I've got some weight to lose myself and seeing my larger patients struggle with things like this really motivates me to want to lose the weight!)

anewsns

Specializes in Neurosciences, stepdown, acute rehab, LTC. Has 8 years experience.

Can you raise the head of the bed a tad ? I've had some people tolerate that, and it angles everything down towards the pan a bit. Also , I don't think you sounded condescending about her weight. I agree chux or at least pink pads would be nice in this case

nursephillyphil, BSN, RN

Specializes in Medical Oncology, ER. Has 5 years experience.

well, the time you spend getting her to and from the commode may be the same or even less than you'd spend struggling to get place and remove the bedpan and replace the bed sheets. On top of that, you are also promoting ambulation, circulation, allowing skin to breathe and relieving pressure from areas prone to bedsores, and it allows you to spot anything that you may want to alert the nurse of. Simply choosing to have her ambulate has the potential to improve her results during her stay and reduce length of stay.

Straight No Chaser, ASN, LPN

Specializes in Sub-Acute. Has 5 years experience.

Make sure its positioned correctly, a small amount of powder on the outside will help it slide more easily, but check with the nurse to make sure you can use powder and the pt doesn't have any open wounds. You can try a fracture pan which is smaller but easier to maneuver, and make sure when helping her off of the pan you hold the pan in place while she is turning.

but really she just needs to get up and use the commode. It takes far less time to transfer than to change the linens, not to mention it's better for her.

Make sure its positioned correctly, a small amount of powder on the outside will help it slide more easily, but check with the nurse to make sure you can use powder and the pt doesn't have any open wounds. You can try a fracture pan which is smaller but easier to maneuver, and make sure when helping her off of the pan you hold the pan in place while she is turning.

but really she just needs to get up and use the commode. It takes far less time to transfer than to change the linens, not to mention it's better for her.

I totally agree with you on holding onto the pan while the pt turns. You'd be surprised on how small things like this that we may forget can be a huge help! Also, as you stated, if you have briefs use those to line the underneath/sides of the pan when you're placing it so that the brief catches anything that may spill out (if you have to measure I&O then lining the inside of the pan is not a good idea). Also, try to have the pt bend the leg opposite the direction she is turning. This will help the pan to turn less, and help her get over more when turning. (turning left, bend right knee). Hope this helps :)

Try placing a towel between the legs of the patient do nothing sprays out of the bed pan in the front. Keep the towel in place until the bedpan is removed or you can use the towel to grab onto the bedpan as she is turning so it doesn't spill.

If a patient is lying down and legs together while using a bedpan, the urine will sometimes run down their legs. Try putting the front part of bedpan a little farther down the the patients leg, with legs spread slightly and while ensuring that they still have proper back space coverage in case need to have a bowel movement. Make sure to hold the pan as they turn so you can remove bedpan. Have them lie flat while placing the bedpan and raise the head of the bed slightly after as it helps patients urinate and have bowel movements easier. In my opinion sitting slightly upwards ( if patient able) helps the urine flow downwards instead of dripping down the legs or back. Make sure to lower the head of the bed before removing bedpan.

Edited by cdsavannah59

Missingyou, CNA

Specializes in Long term care. Has 20 years experience.

We have plastic bed pans for most patients but, for the larger patients we have the metal pans which are a bit larger, deeper and the edges wider to better hold the urine when rolling. It makes a world of a difference. We (the CNA's)have to specifically asks for these bed pans and most of the CNA's don't even know they are available... so ask around at your facility.

I also keep the head and foot of the bed slightly raised when any the patient turns so the urine stays in the pan. I push down on the pan as the patient rolls to their side so the pan won't tip as she rolls.

Luckily we have soaker pads to put on the bed. I always put enough down so it covers the entire area. If no soaker pads (chuck pads) are available, I'd use a brief placed whereever we have the most problem with spilling so the brief will absorb it.