Assisting with micturition

[mobilmedic]

I have a question for you: is it appropriate for a nurse (CNA or higher), while assisting a male patient with a urinal, or standing up to urinate, to hold the patient's member for him, especially if he so requests it? It should be noted that many men ask for this due to paruria (i.e., a male may not be able to void for psychological reasons unless he is assisted in micturition).

And it is standard practice to do this when collecting a midstream catch when the patient is in bed.

[DutchgirlRN, ASN, RN]

I have a question for you: is it appropriate for a nurse (CNA or higher), while assisting a male patient with a urinal, or standing up to urinate, to hold the patient's member for him, especially if he so requests it? It should be noted that many men ask for this due to paruria (i.e., a male may not be able to void for psychological reasons unless he is assisted in micturition).

And it is standard practice to do this when collecting a midstream catch when the patient is in bed.

Firstly nurse is LPN or higher. I don't think it is appropriate to hold the patients member and most especially not appropriate if he requests it. If a man cannot void for psychological reasons he needs to discuss that with his shrink or urologist.

I have taken a urinal and placed around the member and held it in place to keep the patient from voiding outside the urinal. Some fresh post op patients and some elderly require help but I don't recall any specifically asking for that kind of help, especially not holding it.

[wooh, BSN, RN]

Why is he unable to hold his own member if it's in need of being held?

[TazziRN, RN]

If he can stand, even with assistance, he can probably hold it himself. If he's in bed and unable to, I have placed the member in the urinal opening and if needed with hold it in place so that the stream is aimed in the urinal. But to hold it because of psychological reasons? No way!!

[Rizpah]

Gee, it's been a long time since I've heard that term!

We have a couple of gentlemen like that, always wanting help, especially from the "young" staff - though this guy states he's blind! yah right!

[wooh, BSN, RN]

We have a couple of gentlemen like that, always wanting help, especially from the "young" staff - though this guy states he's blind! yah right!

When I did grown-ups, it's funny how easy it was to "cure" the men that had to have help with it by simply sending in a male staff member to help.

[TazziRN, RN]

Oh yeah! There's one guy I know who's exposing himself every chance he gets and will claim he can't void and needs a foley. The staff finally caught on and whenever possible sent a man in to do it. Never failed, he always had a sudden breaking of the dam!

[ohmeowzer RN, RN]

i wouldn't do it... i'd hand him a urinal...

[confused101]

I have put the urinal where it needs to be in the bed or helping a pt. stand up. Some men say they can't pee in the bed and have to stand up. No big deal. I hate when men expose themselves for the sake of doing it. I have put the member in the urinals in the bed for the little old sick men. It's either that or clean the bed every time. :)

[Indy, LPN, LVN]

I've met male patients who can't hold it themselves. I'll assist in those cases, and I'll wish they had a foley. I bathed a man during clinicals whose hands were so badly deformed from arthritis that he couldn't hold a washrag. He was aware of his odd situation and talked to me about church; I figured yeah, anything to not talk about the bath.

One guy with hemiparesis and chronic UTI's normally used a condom cath. Now I'll tell you it is flat out impossible to put one on with one hand and have the darn thing stay on. Thank god I read allnurses or it wouldn't have occurred to me to use skin prep. Very nice guy, he did the holding and told me what to do so the stupid thing would stay in place and we wouldn't have to keep changing his bed. His situation was one that had him tied in all sorts of psychological knots, and I pity him. He felt sorry for me by the time I got done trying to figure out how to fiddle with the thing; especially when I broke down and laughed and said, "ok really I haven't tried to do this in ages." It's possible to find humor even in embarrassing things.

Then there are the parkinson's patients who use their steady hand to hold onto the walker and the shakey hand to hold the urinal, and pee all over the floor rather than ask for help. Honestly, I've cleaned enough floors that I almost wish they'd ask.

[mshultz]

I have been wondering why some men want their member held from the first time I read about this. Public urination not being one of my talents, the last thing I want would be someone holding my member while I am trying to urinate.

Fortunately, I always had privacy for this when I was in the hospital. Being naked in front of others and the sponge bath (including peri care) were interesting new experiences. I do not have a problem with health care workers seeing and touching me. Just give me privacy when I need to urinate.

[nursesrule67]

I have been asked to "hold" the member before -- I take into account the patient's own abilities and usually will hold the urinal for them, pick up their hand and help them hold their own member -- get an order for a Texas catheter, or a foley if need be. I'm respectful but will not fall for those patients who are playing with me. I use my best judgment and find a better solution than my having to actually hold someone's member because most likely once discharged from the hospital they don't have someone at their beck and call to do it for them so I explain the whole spiel about preserving functional indepence, etc. but trust me, I've seen it all!