Changing a patient's diaper while they are standing ?

Nursing Students CNA/MA

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I am a Future RN student (one more semester of academics WOO HOO) and I am currently completing my clinicals for my CNA. I just started my rotation at a local LTC and OMG it is awful. Not the job I am doing, but the care the residents are recieving. Residents are divided among the CNA's 19 per CNA and if a call light goes off each cna only takes care of her own. I see them spending most of their time sitting down together. But every patient I walk in to help has a dirty diaper, dried secretions on their eyes or under their nose. (care seems awful) but what really freaked me out and the reason for this post was the fact that a veteran CNA was making a man stand up lean over and hold himself in a standing position while I cleaned his bm. I could not clean it fast enough and told her i was laying him down to clean him properly as his face was turning red (i was scared he was going to fall over and wanted to clean him well) Has anyone ever heard of changing a w/c using patient in this manner. It seems soo wrong :angryfire???

Donald

I'll definately stand a person if they are strong enough and it's appropriate to do so. I've found that standing people is faster and quite a bit cleaner than putting them in bed. I'm always afraid of missing a spot when I clean someone in bed.

What happened with this shouldn't have happened. Someone should have been supporting this man. Whether it be a second aide or you if the patient is small enough.

Word.

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FYI- It's very degrading to say "diaper"- please call them attends or briefs. ;)

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Hello

I havent been on here in a while but the post are just as interesting as before my comment on this is yes I am A CNA and a goodone I might add. Yes, I have stood res. that are capable of standing to change them. But only iff they agree to it. They are always changes in a bathroom to give them the respect that is greatly needed. Res. in long term care need there diginty because you have to aks yourself how would you feel if you were in there postion. I think all long term care facility need a monthly survey on how they (res) and family members are treated because the staff can also abuse the family members by ignoring them. I must admit that long term care facilities need to be look into more because where I work I have res they see me when i come in and they tell me everything that has been done to them whether it be good or bad. I have some just tell me thank you for coming to work cause I really missed you. This is the reason as to why I have decided to continue my education so that I can help more in someone's life. I love my job and yes it can be very stressful but just one thank you and several smiles sends that away.

Love and respect is a greatly appreciated to those in need of it.

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i have asked the patient/resident what they prefer, because i have done it both ways. last week i had a man who knew when he had to go, but he wore a brief in case of an accident. on the way back from the bathroom he asked if i could put his brief back on while he stood at the bed. i think it is easier if the patient is steady on their feet, and their dignity should always come first.

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Calling a diaper a diaper is a good thing. Maybe not in the presents of the one who is being changed, but in general we all need to call them diapers.

When our lawmakers hear that we are changing "briefs" or "undergarments" they think of something washable, and

not a disposable diaper. That is why DIAPERS are not paid for by Uncle Scam.

I help take care of a few older people who live near by me, and after a life time of working and paying into

the system, they have to choose between DIAPERS and good food.

The sooner people quit calling a diaper a "pad" the sooner Uncle Scam will understand that they are necessary part

of keeping someone clean and dry, which is DIGNITY.

A pad is something a menstruating women wears, a brief is something a guy wears, and an undergarment is a tee shirt or bra, panties are something women wear....

A diaper is a diaper, so lets call them that, and hope that Uncle Scam will start to pay for them!

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Specializes in LTC.

I don't see what's so bad about changing a brief standing up. It's no less dignified (or should I say, it's just as undignified) as changing one in bed or while sitting on the toilet.

We were taught not to call them diapers. We do have one guy who's walkie talkie, and normally not incontinent, who comes out into the hallway and asks us to get him a diaper everytime he gets MoM. I think he's afraid he won't make it to the bathroom in the middle of the night. I was caught off guard the first time he asked me.

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Specializes in Med/Surg, Well-Baby Nursery, NICU.

I've changed a patient while they were standing up. I think it's okay as long as they are steady enough to hold themselves up while you clean them. It also helps if you can get another aide, nurse, etc. to assist you (one of you steadies the patient while the other cleans his bottom). I usually only clean a patient up in this manner when they're already OOB sitting in a chair..I'll realize they've had a BM when I stand them up to get them back into bed.

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I don't see why it's wrong. If the patient is strong enough to stand, it makes it easier to clean him/her up and put a new brief on. And it's hard for 1 CNA to have 19 patients. That's TOO many patients. The facility needs to hire more people.

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Specializes in Emergency Nursing.

I know that this has been said 1000 times but I will say it again. I my mind babies wear diapers and adults who are incontinent wear briefs, that's it in my mind. As far changing briefs goes here are my thoughts; if the patient/client is able to get out of bed and ambulate to the bathroom/commode then we clean up at the toilet with them standing after they have been allowed to sit on the toilet/commode so they can get a chance to use the toilet like an adult should be allowed to and they can stand when they are done to be cleaned up either by the help of another staff member or by themselves with support from the hand rails or a walker. If the patient/client isn't able to get out of bed then they get cleaned up in bed. I always remind patients that it won't take very long and that it is for their comfort which is usually enough to calm their fears and it makes the whole situation a lot easier.

!Chris :specs:

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Specializes in Acute Care, Rehab, Palliative.

Pts deserve to keep as much of their dignity intact as they can. Calling a brief a diaper is degrading. I also call the devices they wear around their neck at mealtimes aprons, not bibs.

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We call them diapers and pullups, so do the residents all the time. I've said the word brief and they don't understand.

Changing either standing up is by far preferable to rolling back and forth in bed to get one on. We've had people who have since lost the ability to stand and miss the old way. They ask when they can go back to it.

A pad where I work is what we put under them to keep from changing the sheets all night. Day ratio is one to five or less. Nights its 1-22 or 1-36. And most of them have to be gotten up with help in the morning. Standing and doing it makes the job so easyyyy.

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I too have the resident stand if they are able. If it's in the bathroom, they hold onto the rails, and if it's beside the bed, they hold the bedrail. I have one resident who sleeps in a recliner and he likes to stand up and hold onto his dresser to be changed. You just have to do what's easiest for the resident and for you.

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