Double diapering alert patients who ask? I think it's neglectful. However...

[Surfin USA]

The manager (who is apparently also not a nurse, but a CNA like myself, even though she measures insulin and passes meds!! Wtf kind of place is this!!) says it's okay if they're alert and oriented, and request it. She said as long as the wings are removed from a diaper u can use it as a diaper liner for "heavy wetters."

The way I see it, these people who are alert and choose to not go to the bathroom when prompted, are bound to get soaked either way, and the only thing a double liner really does is protect their clothes and furniture. I think it keeps them in a wet brief longer and does nothing for their well being. I have seen this person wearing DOUBLE FULL PULL UPS not one and a liner, but just one over the other. Today, it was a diaper liner. She does fine if she's toileted every hour and a half or so. Totally dry.

There are actually two patients that the staff are doing this to, and both are alert, but their (the patients') only reasoning for a diaper over or an insert, is one wants it at night and says she will be soaked if it's not done (which seems like she's not getting changed enough)

and the other one told me once (I'm new here, actually I think I'm fired for explaining resident rights to these same people, wowwww) that she has agreed TO it but she also said she feels more comfortable in a single pull up and that she feels like she's got a big load in her pants wearing the diaper insert as well. Thats the one I saw double diapered!! The other lady said that the CNA that passes meds also, and is a manager, was putting "the blue thing" on her which she said she "can't tape up" so I really think maybe I need to call an ombudsman. Oh and the CNAs here all call this woman a liar. She hasn't lied yet. Maybe her perception sucks and she's a bit abrasive, but she's no liar. She does tell the truth.

I have an application in for a home health care agency and have an interview already scheduled since this morning, so I'm fine with not working there. It's just those patients have rights and I really hate how poorly these old people are treated!!!

If this was your facility, would you report it?? What would you do??

[TruvyNurse]

As an aside, it may not be the best course of action to come on a public internet forum and bash your current manager when using a selfie as your avatar.

Vanilla bean I could not have said it better!

[Orion81RN]

As an aside, it may not be the best course of action to come on a public internet forum and bash your current manager when using a selfie as your avatar.

Ha! I didn't realize I used the same wording. Wasn't intentional ;-)

[EGspirit]

A lot of people are coming down hard on the OP, but I sympathize. When I first was a CNA, I ended up working at a dungeon of a nursing home. I quit when I started nursing school, and I started nursing school, because I knew I needed greater power to take care of patients--given the neglect I had seen by lazy incompetent nurses there. One LPN used to come to work in white scrubs that had food stains all dripped down the front. She would only round on her patients once a shift. So, I know what some of these places can be like.

Did I report the place? No, Hurricane Katrina leveled it to a cement slab, so, no more problem. But I did give a comprehensive report to a PI who was working for a lawyer who was suing the owners--and while I was there, I did everything I could for my patients. So, my conscience is clear.

But the whole reason I'm an RN is because of the PTSD of working at that dungeon. So, I sympathize with the OP.

[Julius Seizure]

You made it clear that you are not interested in hearing from people who don't think that these practices are necessarily abusive. So, what are you looking for OP? Agreement that you should report this facility? Then report them. You, having firsthand knowledge of the situation, would certainly know the situation better than anyone who is simply reading your post on here anyway.

[Tenebrae, BSN, RN]

T If she refuses,

If she refuses.... Guess what OP is the patient is alert and orientated she has every dam right to refuse.

If the alert and orientated patient is refusing to be toileted, it makes sense on a practical level to have double padding.

Im not interested in comments from people who double diaper as a way to lighten their workload.

You posted on an internet message board where nurses from all over the world post. Once you hit post you will get opinions from everyone. There are some incredibly experienced nurses here which you could learn loads from if you choose to let go of your preconceived conceptions and thinks 'heck, perhaps there is more than one way to do this'

Personally I'm about meeting the needs of the patient and if a double diaper on a patient who refuses to be toileted stops that patient from developing incontinence associated dermatitis or even worse a pressure injury, I'm all for it.

I could care less if my former employer sees my face on here

This is a public message board that is searchable by google and other search engines. You may not care whether your former employer sees what you have wrote. Given that one of the first things potential employers do is a google search leading to this post which with the attitude displayed in your posts could stop you being successful in other jobs

[Crush]

I am going to agree with the others that IF the person is alert and oriented x 3 and requests double diaper then that is their choice.

Public forum = any new employers/or potential employers can also see this.

As far as reporting them, do what you feel like doing as you know firsthand what is or isn't going on there.

[Purple_roses]

The risk is skin breakdown, which you can very politely educate a patient on, but if the patient is alert and oriented and requests two *briefs* then at the end of the day, two briefs it is.

When im old and gray I'll be demanding my whiskey and heaven help the person who says no to me on that, let alone how I request my briefs.

[Purple_roses]

There's two patients.

OK let's get a few things clear, here.

1: I just got let go on the basis that I said inappropriate things to residents. Not something the admin substantiated or could give an example of. I informed one of these residents of their rights as a resident, after she said she prefers ONE pull up. Apparently this facility does not like residents knowing their rights. I haven't been there long, and am extremely sweet to the patients, and everyone was shocked that they let me go.

2: Again, there are two patients. The first patient is very alert and oriented and simply occasionally refuses to be toileted. She said she prefers a single pull up. This was passed on at report, yet she was still put in an added diaper liner anyways. She had on a double pull up the other day, despite this. We do the patients laundry ourselves, so there is no worry about someone running out of clean clothes, due to having a linen service wait time. We do the laundry ourselves on site. She needs to be toileted every hour and a half, and she will stay dry. I have witnessed this myself. If she refuses, and goes more than three hours, she will almost definitely have incontinence. Having to change her pull up and clothes due to her refusal to toilet, is not the issue. The issue is she is not being toileted often enough and instead is getting double diapered, for the staff to not have to toilet or change her as often. I see this as neglect. She also doesn't like wearing the pull up and inner brief liner and says it's uncomfortable.

The other patient has some brain damage and was telling me what she needed to not be soaked in her bed. I've never worked at a facility that used two diapers as a means of caring for incontinent patients.

We change their clothes, use a chuck, change their chuck, and entire bed, PRN. And their ONE brief/pull up. So this particular patient also doesn't wet heavy, and is just asking for what is usually done, because it sounds like she and her bed are not going to get changed if she wets overnight. She also specifically asked for the same manager to do "the blue thing" that she can't tape herself, the same manager that said they don't do a full double diaper. That's a lie.

Im not interested in comments from people who double diaper as a way to lighten their workload.

I could care less if my former employer sees my face on here. I seriously doubt any of them are on here anyways, since they use CNAs to pass meds, and it's not done with any sense of privacy or even within the scope of assisting in self administration of medication. There's a memory unit and CNAs are feeding meds to patients. Its like wow.

This place is a joke. And now I'm seeing that neglect is a standard of care that many people think is perfectly acceptable. I do not.

I honestly think you may have been let go because you're on a witch hunt. Every single facility on the planet is doing at least something wrong, and I'm not saying you shouldn't advocate for what's right, but it's how you do it that matters. I have actually reported a coworker before for negligence and it went well for me. It's important to remain calm and state only the facts-how you feel about the situation emotionally isn't relevant. Be professional, be polite, don't place blame-just state facts. It always helps to get other professionals' opinions on the matter before you go reporting as well.

As far as CNAs passing meds, are you sure they weren't QMAs (I think that's the acronym)? I have no idea if your facility's practices are legal or ethical; at your next job, ask to shadow for a few hours so you know what you're getting yourself into.

[Amethya]

I'm not a CNA or a nurse, but if I was in her situation I would honor the request if the patient is able to request it. I worked 7 years of retail, and as they all say, "The customer is always right" in customer service, and that's basically what it is (Unless it's something completely unethical or impossible to grant). The customer (patient) is requesting it and you are the service (nurse).

If I was the patient and asking for double layer, then do it please.

[NutmeggeRN, BSN]

And the OP is MIA.

[audreysmagic, RN]

Nutmegge says:

And the OP is MIA.

Do we get to count this for flounce bingo? :)

[Tenebrae, BSN, RN]

Nutmegge says:

And the OP is MIA.

Do we get to count this for flounce bingo? :)

Absolutely