Feeding and toileting

CapeCodMermaid, RN · Oct 31, 2005

Aprons and gloves to feed people? What kind of aprons? We NEVER wear gloves when feeding anyone. Come to the table with your hands washed just like your mother told you and all will be fine.

lovingtheunloved, ASN, RN · Nov 1, 2005

Aprons and gloves to feed people? What kind of aprons? We NEVER wear gloves when feeding anyone. Come to the table with your hands washed just like your mother told you and all will be fine.

I asked the state surveyor last year about wearing gloves while feeding, and she more or less said what you said.

nurse_elyse · Nov 1, 2005

I can't believe the administration would rather their resident’s sit in their own urine/feces and try to eat a meal, along with others around their table, and feel that it's ok to do that. Obviously they have never had an accident while out shopping or going about their daily routines and know the embarrassment these people feel when this happens. They can't help it, when nature calls you got to do what you got to do, either ask for help to go or just go right there. Which I think would bring up a contamination issue...just my opinion.

dian57 · Nov 2, 2005

At our facility, rounds are done immediately prior to all meals. Technically, all residents should have emptied their bladder, had their BMs and be clean, dry and ready to eat. The reality of it is many times the staff finds a dry Attends or cleans and changes an incontinent resident who immediately following the process, urinates or moves their bowels. Then starts the frustration (on both ends) of the resident saying, "I need to go to the bathroom," and the aide saying, "You just went and I have 39 others to care for."

What to do? I wish there was an easy answer. Naturally, a cognitively intact resident who is requesting toileting has to be retoileted or they won't be able to eat the meal, regardless of how inconvenient this is to the staff.

Perhaps a 2-3 day observation of the pre-meal rounds and mealtime process will reveal a pattern of people who consistently ask for retoileting during meals. The manager can then consider altering their toileting pattern (instead of ac, it can be prn/on request) so the resident is toileted when the actual need arises.

With the new incontinence regulations coming in our state, the focus is more on individualized toileting needs rather than the standard 2-4h and prn.

Long story short--no matter when they say they gotta go, we gotta take them.

LoriAlabamaRN · Nov 2, 2005

Wow- I have never even HEARD of this one! At my LTC facility, if someone needed to be toileted, that would take priority. After all, another CNA can finish passing out trays or feeding while one takes someone to the bathroom. After all, how many residents are going to eat well with a crying lol with BM in her pants sits among them? I can't even imagine what the rationale is here. We use alcohol sanitizer after washing our hands, so there is no germ transfer risk any higher than if someone wasn't just toileting a resident.

Lori

califgal930 · Nov 3, 2005

Hi, I have been a state surveyor and how the state interpreted the regulation had to do with getting the trays passed out first so they would not be sitting on the hall getting cold. You can toilet someone before you start feeding them. Another issue has to do with the stiring up or odors during residents meal times. It can be sited as a dignity issue if someone complains of odors during their meal, if it happens consistently. It can be addressed from many different tags. If everyone is assisted before the meal then there should not be a big problem. Everyone can have a comfortable meal time.

NicInNC, CNA · Nov 5, 2005

The facility I just left recently implemented a policy that under no circumstances was a resident to be toileted when there were still trays to be passed out or residents needing to be fed. How are things done at your facility?

That's fine as long as whoever made the policy will come in and clean that particular resident when they mess all over themselves.

I'm telling ya....these "policies" that places make up are just ridiculous sometimes. I'm glad my place of employment is so laid back. Then again, all our residents eat in the dining room unless they're not feeling well. If they need to go to the bathroom during the meal, we take them right away. If their food has gotten cold by time we get back, we heat it up. Pretty much all common sense. Maybe you should remind your facility to bring common sense back into the picture.

Plagueis · Nov 8, 2005

The facility I just left recently implemented a policy that under no circumstances was a resident to be toileted when there were still trays to be passed out or residents needing to be fed. How are things done at your facility?

This is an odd rule. If a resident needs to use the toilet, we have to take them where I work at, even during meals. If a resident has to go, how can we say "no"? I know, they should be toileted before meals, but that doesn't always mean a resident won't have to go during meals. How many of us have had residents loudly announce during meals, "I have to go to the bathroom!"? Are we supposed to ignore those residents? Is there any legislation that covers this specific topic? I don't see how a state surveyor could punish a nursing home because someone took a resident ,who says he/she has to go, to the toilet during meals. :confused: Wouldn't it be considered abuse not to take a resident who has to go?

mysticwater · Nov 10, 2005

I just had this debate at our facility. Here it is again. Our current DON was a state inspector and according to her there is no rule stateing you can't stop feeding and cover the tray and help some one to the toilet, complete that task, wash your hands and arms, dry them and return to feeding. My problem with that is someone's meal time is being interrupted. I love the way life never gives us a easy alternative. I like th answer where the facility actually has an aide on the floor to take care of the toileting, however most facilities do not have the staff to do that.

Mysticwater

cantoo · Nov 12, 2005

Where I work we do indeed have CNA's that stay on the floor to toilet residents and answer call lights when needed. I believe it would be cruel to tell a resident they have to wait until everyone is done eating. Our bodies just aren't made that way. AND WHAT'S WRONG WITH THE NURSES HELPING OUT????? We are all busy, no doubt. But having to toilet takes priority. Leaving someone in a soiled brief will cause break-down lickety split. Not a good idea, besides the dignity issues involved. We have sinks, water and hand soap to take care of infection control.

FossilRN · Nov 12, 2005

I don't know, makes perfect sense to me. Leave someone sitting in a sh___y

diaper while you feed someone else oatmeal. Sounds like JACO logic.

Marie_LPN, RN, LPN, RN · Nov 13, 2005

If they have to go, they have to go.

This rule encourages incontinence.