helping patients feel less embarrassed?

[Emmeline22]

Hi, just got my first job out of school working in a adult psych unit. Have already had a few patients very embarrassed by having nocturnal enuresis and not sure how to approach this in a way that makes them less embarassed. Most often young adults who have never had accidente before coming to me in the middle of night. Also facility policy is to just change sheets with no shower, but that seems strange. Any advice appreciated.

[CharleeFoxtrot, BSN, RN]

Well, over the years I have learned to not act embarrassed, I.e. drop my voice, don't make eye contact and whisper like you are ashamed of/for them. Nor do I raise my voice in an attempt to normalize things. I just maintain the same clinical face as I would if were asking about pain or some other clinical symptom. Project empathy not sympathy in a professional way.

["nursy", RN]

There are certain psych medications that can lead to enuresis.  Also certain lifestyle habits such as drinking too much before bed.  The main thing is to act like the occurrence is routine....."OK let's get you cleaned up  and meanwhile I'll check on your medications to see if any of them can be causing this, it's not unusual for this to happen in this environment."   Later on, they can be approached in a neutral environment, and you can discuss decreasing fluids at night, or even setting an alarm to void at night to prevent further enuresis.  If they are on one of the meds that can contribute to the problem, then bring it up to their provider. 

[Jedrnurse, BSN, RN]

My experience is that if you're calm about something and present the patient with low-key situational "fixes" I.e. getting them clean and comfortable as privately as possible, that they will be less embarrassed. 

No shower? Sounds like a human rights issue to me...

[Crystal-Wings, LVN]

Act like it isn’t a big deal. Like another poster said act like the occurrence is routine. Since they aren’t allowed to shower afterwards, offer a basin with warm water and soap. Don’t ask, just bring it prepared and give them a towel and washcloth. That’s appalling they don’t allow them to shower after having an accident!