Bed pans

[studentnursej1]

So I had a rough clinical day today. Pt was morbidly obese, and due to her condition could not ambulate to use a commode or the bathroom, so we had to use the bedpan. I felt so horrible for this patient, since every time she used the bed pan (urinary frequency, so many times) it would usually end up on the absorbent pads instead of in the pan. Many linen changes and bed baths today, not sure if I was just incompetent or this is an issue with this population (i have never had this kind of issue before, i have spilled a tiny bit now and again but usually it goes off without a hitch...although it seems the night shift nurses before me had a similar issue).....any advice if i ever encounter this type of situation again? I cant imagine how embarrassing it must be for this patient, and would like to do my best to help this population in the future.

[mmc51264, BSN, MSN, RN]

Aim better, we have bigger, flatter bariatric bed pans. Also, sometimes putting a towel between legs helps (believe or not, when on a bedpan, some women have their stream go up). Working on an ortho floor, we have many people that cannot get up for a day or two (or more) and are larger. I have gotten better at it, but sometimes it just is what it is.

With urinary frequency are you checking for overflow incontinence by bladder scanning after? Sometimes they need flomax for retention or ditropan for urgency. Other than being on Lasix, someone should not really pee that often. We have become mini urology experts d/t urinary retention post-op

[studentnursej1]

Thanks for the advice. It was mentioned to the MD that she was having such urgency (although she was drinking a lot of fluid, also mentioned), and yes we were using the bariatric pan.

[NurseSpeedy, ADN, LPN, RN]

I am thinking this was already done but just in case I would also check for a UTI. Sometimes frequency is the first sign of a problem and not everyone will experience burning. Of course in the elderly we often also see confusion that gets worse until treated.

[DisneyNurseGal, BSN, RN]

I have never had an experience when a chux or pads put in a bedpan have made the situation better. I do 2-3 chucks (off centered of each other so they cover a bigger area - hope that makes sense), baby powder or barrier cream on the bedpan, and place nothing in the pan itself. When the patient is ready to come off, I fold the chux over the top of the now filled bedpan, one (Or more) person(s) roll the patient while one person holds the bedpan flat. Most time, using this method, I can avoid problems even with larger patients.

Its not easy for sure. Good luck!

[Wiggly Litchi]

I love that the towel method was mentioned - that's been a lifesaver for me as a CNA.

Sometimes if a pt is just too big, their thighs kinda work against them while they're on the pan. Extra chux off-centered around the pan is awesome as it does catch any urine that misses the target.

If you can find a way to keep the thighs slightly parted (this can be hard if the pt is especially large), then that usually helps exponentially - as I'm turning the pt back onto the bed pan, I'll try to move the skin/thigh in a way that creates a small gap - almost like you're pulling the buttock / upper thigh toward you slightly as the pt is rolled onto the pan (but don't pull too hard! lol, you don't wanna cause a skin tear, just create a little distance). Sometimes, this few mm of space is just enough to let the stream through.

[Davey Do]

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