Bathroom Needs N.h.pts.

[rubyslippers]

Just doing an informal survey: In our 20-station clinic we have several n.h., amputees, CVA pts. that frequently need to "go to the bathroom".

The requests, of course will come during shift change, but even not, it may require 2 staff members to assist pt. to bathroom and 1 to stay with pt. (depending how dependent pt. is). These pt. may come with a Depends on, but if it is soiled, options are limited (take off, call n.h., or try best to clean up). I have repeatedly asked what our facilty policy is in regards to this specific situation and I get no answer. Our unit is FMC - they have a "policy" for everything (I thought!) These pts. may be elderly, but are alert and these incidents are an obvious source of anxiety for them. Do other chronic units have this problem? My question is :what do other facilities do to provide for proper bathroom assistance? Really need a workable solution. Thanks, Ruby

[Hellllllo Nurse, BSN, RN]

It depends on the unit mgr. All units are different, no matter what company they are.

[Migrant_Renal_RN]

Someone needs to be in communication with the ECF!! As Nurse Manager in my clinics, I have handled this in varying degrees. I have called the ECF to come clean up the patient. I have sent the patient back to the facility to be cleaned up. If the patient is not fluid overloaded, I have even rescheduled for another day. There is no reason that patients should be sent to dialysis soiled or fresh from receiving laxatives the night before (which is common practice). Some ECFs see patients going to dialysis as a relief of their duties. I have never accepted this, as they do not get paid by the hour, but by the day. We are all in this together, and if patients are send soiled or in constant need of going to the bathroom, then conversations need to be held b/w the dialysis facility and the ECF....no exceptions.

Most dialysis clinic are not staffed to allow for this. Schedules are very tight, and toileting is not taken into account with the budget or staffing.

I even worked in one Hospital Based chronic facility which ended your treatment and sent you home if you requested to go to the bathroom. No exceptions.