Bedpan? Why not a Poise pad?

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I work on a med/surge unit and all day long, men can lay in perfect comfort to urinate in a convenient urinal. But WOMEN with horrible injuries have to be rolled to the side in extreme pain then have to sit on a bedpan and basically pee all over themselves anyway. We even put paper chucks on TOP of the bed pans because the bedpan just sticks to their skin and we cant get it out especially with heavy women. For a women to pee, we easily will use 2 full chucks and if a drop of urine makes it way on to the sheets, we have to do a bed change too.

Please tell me why we just dont hand them a Poise pad or even a toddler's pampers diaper to urinate easily, cleanly and comfortably? I have used both in emergency situations and they work AMAZING!!! Why O why are we still using bedpans for women?!?!?!

I am honestly confused as to what people find so dignified in using a bedpan, to be honest.

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Specializes in retired LTC.
along those lines - nothing is crueler than an 80 mg dose of lasix at 6552200 in an 85 year old woman with limited mobility and no foley
I think I can tie this one - how about giving the morning Lasix and then the pt goes out with a spouse or offspring (in the family car) to a consultant doc appt, or dental/vision appt?!?!?!

Yikes!

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Specializes in Short Term/Skilled.
I was thinking the same thing. I don't think the idea is half bad. I know I'd personally rather use a baby diaper than a bed pan lol.

For me it hit a nerve because it is sadly common for staff to tell patients to just "go ahead and go". When I worked LTC especially we would put a brief on pretty much everyone who would allow it. I don't understand why, or who decided it was appropriate. I was a new CNA then and didn't know how not acceptable it was.

I would tell people it's a "just incase" brief, and sometimes they were glad they had it on but other times they would be told by staff to just "go ahead and go". There are people who think if the pt. is wearing a brief that means they should use it, which isn't ever true.

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Specializes in Short Term/Skilled.
I am truly amazed that some of you think it better to put chucks and pads and briefs surrounding a patient and have them void in the beds then to put them on a bed pan.

I agree that maybe something new could be created that should be more comfortable then a bed pan. But the last thing I would ever want it having a bunch of things waded around my private area and having me pee and still feel wet and have to be cleaned up. You'd get more urine on the patient that way. I'd feel so humiliated. To pee on my bed and then have to be cleaned like a baby. At least with bed pan a person and clean themselves up with dignity

Have you ever seen a patient with pemphigus all over their perineal area? Believe me, a chux and open brief is the only way to go in that circumstance. He used a urinal to void but this is how he had to have a BM. We'd lay him on his side and make it as dignifying as we possibly could, but there are times when it's the lesser of all evils.

I think a big thing is to really make sure the people who we're giving bedpans to *really* can't use the BSC. I had very few patients when iworked on a rehab unit who couldn't at the very least use the bsc.

Even amputees got on the bsc. Bed rail down, one side of the commode down, sliding board, two people and they're on. using a towel over the board helps a lot in sliding, also.

If you put the commode close enough to the bed, its really much easier than even a regular transfer. Also, make things easier by only making them go up/down once. Up, pants down and sit on commode when done, up, pants up and sit on bed.

(Seems obvious but i've seen lots of nurses transfer the pt, then have them stand again to remove underwear, etc. )

Havent' worked many floors other than rehab, so I'm not sure what else I'm missing. I know fresh post op patients usually get Foley for 3 days, so I would think most that could transfer to a wheelchair could also transfer to a BSC.

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Specializes in Short Term/Skilled.
AMEN! My thoughts exactly. It like telling your 95 year old patient to go PeePee. It is not age appropriate and that word has negative connotations. You are more likely to get a patient into said BRIEF if you call it such and not a diaper. Goes back to dignity.

Sorry off topic, but I had to agree.

Another way to get them into it is to put one on over your clothes.

Hey, it works. :-/

(90 something lady with dementia. We all called her "grandma"...OMG I loved that lady)

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Specializes in MICU, SICU, CICU.

The OP was specifically referring to hospitalized immobile continent females who have multiple fractures.

Another poster mentioned similar difficulties assisting females who are on groin precautions post cardiac catheterization. This means that the patient must lie flat for six hours without lifting her head and wear a knee immobilizer on the leg of the femoral approach. This is done to prevent arterial bleeding and the formation of a hematoma.

The OP's topic does not pertain to LTC or management of urinary incontinence in the elderly.

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Specializes in Short Term/Skilled.
The OP was specifically referring to hospitalized immobile continent females who have multiple fractures.

Another poster mentioned similar difficulties assisting females who are on groin precautions post cardiac catheterization. This means that the patient must lie flat for six hours without lifting her head and wear a knee immobilizer on the leg of the femoral approach. This is done to prevent arterial bleeding and the formation of a hematoma.

This OP's topic does not pertain to LTC or management of urinary incontinence in the elderly.

Right, well I wanted to explain my reasoning since I had indicated that I've done it. :-) The rest of my comment applies to the hospital setting, not LTC.

Out of curiosity, if a pt had to lie flat for 6 hours why would it be an issue to give them a Foley temporally?

PS Thank you for explaining, that was helpful in being able to understand what all happens after a cardiac cath. I

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I think about about some of these patients that you all mentioned, and can someone explain to me that if a person is so injured they can not use a bed pan why do they not have a cath instead. Maybe it is just me, but I feel if they can not use a comode or bed pan they should have a cath. It seems more dignified then to put them in a depends or have a baby diaper between their legs and have them void. It just seems so humiliating to me.

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Specializes in Med/Surg, Academics.

Out of curiosity, if a pt had to lie flat for 6 hours why would it be an issue to give them a Foley temporally?

Aside from infection risk, it adds the need to monitor post-Foley voiding. As a completely continent woman who has had a surgical Foley that had to stay in for a short period of time due to the type of surgery, I know that trying to void the first time after Foley discontinuation is a bit...weird. No need to add another dimension of nursing care if you can avoid it. At any rate, if they have to go, they usually only need to once during that six-hour period. Many try to hold it the entire time...watching the clock for about the last hour!

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Specializes in Med/Surg, Academics.
I think about about some of these patients that you all mentioned, and can someone explain to me that if a person is so injured they can not use a bed pan why do they not have a cath instead. Maybe it is just me, but I feel if they can not use a comode or bed pan they should have a cath. It seems more dignified then to put them in a depends or have a baby diaper between their legs and have them void. It just seems so humiliating to me.

Because you want them to remain continent. Post-catheter incontinence is a documented adverse effect of Foleys on previously continent patients.

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Specializes in MICU, SICU, CICU.

Medicare implemented payment reduction for hospital acquired conditions such as DVT, surgical site infections, central line associated blood stream infections, and CAUTI or catheter associated urinary tract infections in October 2014. CAUTI is estimated to cost 33 billion a year in the US. The indications for insertion of a foley catheter are now very strict and very specific. That information is available at CDC.gov and multiple other regulatory agencies. The routine insertion of a foley catheter for a short term surgical procedure is no longer an acceptable practice.

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I think about about some of these patients that you all mentioned, and can someone explain to me that if a person is so injured they can not use a bed pan why do they not have a cath instead. Maybe it is just me, but I feel if they can not use a comode or bed pan they should have a cath. It seems more dignified then to put them in a depends or have a baby diaper between their legs and have them void. It just seems so humiliating to me.

Hospitals are under a lot of pressure to minimize catheter associated urinary tract infections. The CDC has published guidelines for reducing these infections. You can read a summary of their recommendations here.

CDC - 2009 CAUTI Guideline:II. Summary of Recommendations - HICPAC

Here's a synopsis of why the CDC is concerned about the use of foley catheters:

"Urinary tract infections are the most common type of healthcare-associated infection, accounting for more than 30% of infections resported by acute care hospitals. Virtually all healthcare-associated UTIs are caused by instrumentation of the urinary tract. Catheter-associated urinary tract infection (CAUTI) has been associated with increased mobidity, mortality, hospital cost, and length of stay. In addition, bacteriuria commonly leads to unnecessary antimicrobial use, and urinary drainage systems are often reservoirs of multidrug-resistant bacteria and a source of transmission to other patients."

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