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.
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.
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.
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.
I agree with PP. If the patient is able to get up to the commode, she should. BUT as far as tips go....I don't really have any for getting patient on the bedpan but I learned that putting baby powder on the rim of the bedpan can help with sliding the bedpan out from under the patient without spilling the contents everywhere 😊
When I have a bariatric pt who uses the bed pan, I try to make sure they spread their legs apart so their thighs are not touching. Then if I need to I will take a towel and place between their legs to catch their urine. That usually stops me from a full bed.
Just curious, dies the pt have a Bariatric bed pan?
nursephillyphil, BSN, RN
325 Posts
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.