Cleaning patients after bowel movements.

[Kidsrablast]

I hope this is not a stupid or idiot question. But, how do does a nursing staff member clean after a bowel movement using a bedpan, or from an accidental soiling of his or herself? Do you use like super strong and thick paper towels the size of bath towels?

[TriciaJ, RN]

3 hours ago, Crash_Cart said:

Fourth degree,

???

I think that's when you put a sign on the door "Abandon Hope All Ye Who Enter Here".

[Dean Uguan]

1 hour ago, TriciaJ said:

I think that's when you put a sign on the door "Abandon Hope All Ye Who Enter Here".

Agency CNA here. Sometimes cleaning the patient's bowel movement seems to stimulate additional bowel movements.

[K+MgSO4, BSN]

5 hours ago, Crash_Cart said:

Fourth degree,

???

I think I have told this story before here. Paraplegic with a bowel obstruction. Family super deluxe irrationally anxious re PI. Bring in their wizz bang air mattress from home. In charge OKs the use of it despite not tested / tagged.

I gather 4 people to help me once mattress has inflated. Use the electric hoist to get him up in the air, whip the standard mattress out....just about to get the air mattress on and I hear plop, plop, plop. Look up to see poop just flowing from this guy backside through the gap in the sling onto the exposed bed frame. Someone dashes off to grab wipes and everything else needed. Initially just everyone standing there hoping it would stop. It does not stop but increases in furore. I grab the spare bin bag that the cleaners leave hooked on the back of the bin and just hold it over his backside. The 5 other patients in the room can only here the sound of pooping, the yelps and distress of nurses and the horrific smell of old poop coming out.

So I am there leaning over a bed frame holding a bin bag under a man's backside, one nurse is holding onto the hoist as per policy. The 2 HCA are scrubbing the bed frame. The other nurse is panicking about putting an incontinence pad on this guy.

Finally get the bed cleaned and the wretched air mattress on it. Get the patient onto the bed and comfortable. He says " I feel so much better, can I have dinner?" I think the other 5 guys in the room would of gladly given their dinners away.

Had to call the after hours manager to authorise us to use the theatre's showers and hospital scrubs as most of us were covered in splashes.

Surgeons turned up and hour or so later. Blasted the resident for admitting him as his belly was now soft and lax until I spoke up and explained what had happened. Surgeon responded with "well as he had recurring obstructions lets try a good hang in the hoist as first line of treatment. But nurse, maybe over a bed pan?"

[Crash_Cart]

I know they can't help themselves but daym...

[RK694]

On 7/29/2019 at 9:43 PM, Kidsrablast said:

I hope this is not a stupid or idiot question. But, how do does a nursing staff member clean after a bowel movement using a bedpan, or from an accidental soiling of his or herself? Do you use like super strong and thick paper towels the size of bath towels?

How long have you been doing this kind of work?? Are you new to the field? Despite what others here say to the contrary, your question is that of someone who is very new to the nursing field. And from reading your other posts, that's not the impression you seem to want readers to believe.

Also, I can decipher from your question that you're asking about cleaning the patient; however, I had to read it twice because it actually asks how a nurse would clean herself after she (or he) has had a bowel movement in a bedpan, or after she defecates on herself.

Lastly, is there such a thing as, "super strong and thick paper towels the size of bath towels?"

[RK694]

Unfortunately, you have to call these guys to handle these kinds of jobs.

[CharleeFoxtrot, BSN, RN]

On 8/2/2019 at 6:56 PM, Daisy4RN said:

Or Fifth degree ???

1. Pretty sure i have had a few of those as well.

That's when the ostomy bag explodes.

[Mkakids]

On 8/2/2019 at 5:56 PM, Daisy4RN said:

Or Fifth degree ???

1. Pretty sure i have had a few of those as well.

Right? This is when the pool of liquid feces (g tube feedings, anyone?) not only squishes up to near their shoulders, it also reaches their ankles, soils a brand new surgical dressing from their very recent left hallux amputation, and is covering a large portion of the bed frame in addition to all linnens.

Ahh... that was fun times as a CNA to see the look on the brand new RN's face as she walked into her first situation like that, lol!

[Mkakids]

Ok, so a real answer for the OP.

Generally speaking, at my facility, we have 4 cleaning options. Toilet paper, disposable wash clothes which are good for mostly formed or kinda mushy/thin, but not sticky poops (these are like thin, soft and strong paper towels - they can be used dry or with soap and water, but they cannot be flushed), wash clothes and soap/water - best for sticky/peanut butter consistency or particularly foul/messy poops , and pre moistened disposable antimicrobial bath wipes (which we are not technically supposed to use for toileting, but they do get used occasionally - mainly when there is already an opened pack in the room because its better to use them than to let them go to waste). All disposable items get put in the trash, and washable linnens get put in a soiled linnen bag, which is then tied off and tossed down the laundry shoot on the floor.

My personal preference is to always use a wash cloth with soap/water for all poop that isnt perfectly formed. I feel that it cleans better and is faster. So I generally go to a room for a code brown and immediately fill a basin partially with warm water and soap (we have foaming body wash that can be used on all body parts), grab a few wash cloths and a linnen bag and then get started.

Here are your options for patients who are immobile.

Patient A - bed bound, but can turn themselves onto their side.

Patient B - bed bound and unable yo turn themselves. Very similar to this, but the second RN/CNA would roll the patient just to position the pan and then again to remove the pan. Usually, changing the sheets isnt necessary. The same goes if the patient was incontinent, you roll them like in this videa and change the soiled disposable pad under them, clean them, and roll them back.

Patient C - bariatric patient that is too large for people to roll/hold on their own for a long period of time. We position a sling under the patient (like in this video), which is then used to help roll the patient on their side. Once the patient is on their side, multiple people (deoending on the size of the patient it can be 2 to 6 people total involved) hold the patient on their side while 1 or more people clean them.

Patient D - immobile and wearing a diaper. Generally, I cut the sides of the diaper off because most adult brands do not have tabs like infant diapers (they are designed more like pull ups). Then while the patient is still on their back, i pull the front of the diaper down and fold it overhead so the soiled part is not exposed. Then tuck as mucho of that under the patients leg nearest you as you can (this makes it easier to pull out from under them). Then turn them and remove/clean/change.

Patient E - can stand for a few minutes, but isnt very stable or needs assistance. If they are wearing a diaper, I cut the sides off once they are standing, and pull it from between their legs. Once they are done on the commode, i put a new diaper on them by putting their feet in it and pulling it to their knees before they stand up. Once they are standing, i finish pulling it up. Sometimes you need 2 people to help a patient to a commode. Once to hold the patients arm and make sure they dont fall, and the other to help them wipe/replace the diaper. It just depends on how stable they are.

[RK694]

Going into the excruciating detail about bowel movements is absolutely mind-numbingly boring. Those of you who find this kind of topic fascinating by writing long, drawn-out paragraphs about it... Sorry, but I must ask: What’s WRONG with you??

[NurseSpeedy, ADN, LPN, RN]

On 7/30/2019 at 8:44 PM, Kidsrablast said:

For heavens sake, what is PSW101. I came for help with what I thought was a reasonable question. All I wanted to know is how it is done. That's it. Please.

If you can take the time to respond back and forth on a forum that you think is being too harsh I’m sure you can enter the question into the internet browser and get a ton of information on both questions.

As usual, make sure sources are checked for credibility, but the basics are the same and as wonderful as Internet forums are, do you really want to ask for advise from a group of people who you’ve never met and can’t be verified. I am a nurse with 20 years experience in cleaning soiled patients (truth), but for all you know I could be Bob the Wally World Greeter (nothing wrong with Bob but not the best clinical source) or Mickey the medical marijuana and other natural treasures store owner (who may have an entire list of non-advisable ways to help with a clean up). I’m just saying, there are better reliable sources out there.

[NurseSpeedy, ADN, LPN, RN]

On 8/2/2019 at 6:56 PM, Daisy4RN said:

Or Fifth degree ???

1. Pretty sure i have had a few of those as well.

I’m pretty sure that’s where the shower chair and detachable faucet hose come into play if status permits (assuming they are well enough physically to be able to shower).

years ago the chair left another trail of code brown on the way to the shower room-hind sight I think the poor guy thought he was sitting on a rolling toilet. This was back in the days when rehab units had one large shower room for the whole 20 bed floor.