Feeding and toileting

Specialties Geriatric

Published

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?

Specializes in Gerontology, Med surg, Home Health.
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.

Where I work, EVERYONE helps pass out meal trays...the CNA's, the floor nurses, the business office manager, the activities people ...EVERYONE. It's called All Hands On Deck and it was started to make tray pass easier and quicker so people get their food when it's hot. With all those people around, it's usually not a problem if a resident has to go to the bathroom. The CNA's are supposed to stop morning care 10 minutes before the trays are on the floor to get everyone to the dining room or sat up in bed with their tray tables cleaned off. However, since we started All Hands, they keep doing care and let the rest of us pass trays. It might be petty of me, but I find it immensely aggrevating to have to stop what ever it is I might be doing to hand out trays when the CNA's aren't doing what they're supposed to be doing....or if the floor nurses sit at the desk writing "one more note" while the rest of us are getting the trays passed out.

Specializes in Gerontology, Med surg, Home Health.

yikes!!! PASSED out...typos typos typos! Tried to edit the original ...

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.

I wonder if the inspectors that advance this logic have ever worked in an LTC facility. It sounds so easy; "just" assist them before the meal. As other posters have indicated, residents don't always perform on cue. And say you have twenty residents, the first one to get toileted in the bunch is going to have to urinate again before the meal is through. As far as odors during a meal, which is worse, someone in the dining room with a soiled incontinence product throughout the meal, or an odor possibly coming from a bathroom for a short period of time? I will never understand the logic of some of these rules. You are truly damned if you do and damned if you don't.

The All Hands On Deck idea is a good one. If it really is all hands, I wonder why the DON who is supervising the aides and nurses who are late to pass trays doesn't enforce the all hands policy?

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

One place i worked at had the All Hands policy, after one of the nurses pointed out "It must be easy to sit in a leather office chair and give orders instead of getting on the floor to help out."

Specializes in Gerontology, Med surg, Home Health.
One place i worked at had the All Hands policy, after one of the nurses pointed out "It must be easy to sit in a leather office chair and give orders instead of getting on the floor to help out."

:lol2: :lol2: Oh my goodness! I HAVE to laugh at and respond to that comment. If all y'all think management does nothing all day but sit at their desks, then y'all don't work where I do. I haven't had time to actually sit at my desk in the last 3 months.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
:lol2: :lol2: Oh my goodness! I HAVE to laugh at and respond to that comment. If all y'all think management does nothing all day but sit at their desks, then y'all don't work where I do. I haven't had time to actually sit at my desk in the last 3 months.

Do not assume that "y'all" thinks this.

I never said management sits at their desk all day doing nothing.:rolleyes:

The particular person the nurse was refering to did, however.

(And wound up losing their job, since it was found they had way too much free time to cruise websites all day and shop at work.)

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?

I would think that leaving someone in a mess during a meal would be neglect.

This has been the policy at every nursing home I have ever worked at and I am almost 100 % sure it is a nursing home regulation. Meaning that if the state were to see you leaving while feeding to toilet someone it would be a violation. The rational behind this is you are mixing feeding and passing clean trays of food with possible body fluids. Now before you start flaming me to death , I dont agree with this. I think we work hard to keep our residents on a toileting schedual and making them wait just causes a increase in incon. We take everyone to the restroom just prior to meals but everyone knows that you have to tinkle after you eat. Plus if you have ever attended a micro class or nursing school you will know that you can scrub your hands all day long and never remove all the germs. So there is no way to be germ free while you are passing trays , feeding or anything else... Just leave it to the state to develop orifice backwards rules.

I wonder...............would the state people like sitting in urine or feces themselves while eating? I'm sure they get up during meals if they need to go, so why can't the residents have the same opportunity.

Specializes in nursing home care.

When you gotta go, you gotta go. Imagine being told to hold it in until old Betty (the slowest of all eaters) finishes her meal, I'd be suicidal! There should be enough staff to allow someone to assist the resident in question to the toilet whilst others temporarily take their place in the dining room.

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