Patient NOT a nurse with a ???

Sour Lemon · Aug 21, 2016

Patients are sometimes found unconscious, on the floor of the bathroom, bleeding from their heads. People often say they're going to call for help before attempting to ambulate, then do not. Falls are a HUGE deal and it is ALWAYS the nurse's fault ...even when it's not.

Yes, you deserved more consideration, but I understand why you did not get it.

tokmom, BSN, RN · Aug 21, 2016

Some patients will strain to the point of passing out and falling off the toilet (google Valsalva). Some people will stand up and pass out. Others will trip and fall. As noted above, the nurse ALWAYS takes the blame if a patient falls and injures themselves. We know you can't poop with an audience, but we can't take the risk of leaving you alone without checking on you.

Erythropoiesis · Aug 21, 2016

You're under their care and they are legally obligated to make sure you didn't fall out on the floor on their watch, or its their license on the line. It's not the most considerate, but I can see why it's done. It's a nice touch to knock first.

Dany102 · Aug 21, 2016

Hello JWFeell,

No, you were not being overly sensitive at all as far as I know. Privacy is expected (except in some circumstances) when one uses the toilet. Even as a patient. And while I can see the impetus for your nurse(s) wanting to check on you, I wonder why they felt they had a right to walk in on you. Unless the facility you were in had soundproofed toilets, a simple knock and a "doing okay in there, Mr. JWFeell?" would have been sufficient. Of course, a lack of response would be justification enough to walk in. But not until then. This is borderline harassment.

I take it this happened to you more than once? You must be more polite than me because I would have put a stop to this real quick. Hopefully this did not sour your stay at this facility too much.

Dany

Editorial Team / Admin · Aug 21, 2016

I'm curious as to how long you were left before the interruptions occurred. Are we talking 2 minutes? 10?

As others have said, falls are a big concern. It could be that it was so long since they assisted you to the toilet that they were concerned about you having tried to get up and walk back to the bed yourself. They could have been concerned you had a vasovagal response (that's the Valsalva mentioned earlier) and had issues from that, including passing out. Patient safety is an absolute must.

heron, ASN, RN · Aug 21, 2016

Some patients will strain to the point of passing out and falling off the toilet (google Valsalva). Some people will stand up and pass out. Others will trip and fall. As noted above, the nurse ALWAYS takes the blame if a patient falls and injures themselves. We know you can't poop with an audience, but we can't take the risk of leaving you alone without checking on you.

In fact, straining at stool and the resulting vagal stimulation has been known to trigger fairly dangerous heart irregularities - not common but potentially deadly.

brownbook · Aug 21, 2016

I agree with everyone. But like Dany102 I don't know why a nurse couldn't just knock, maybe open the door 1/2 inch if they couldn't hear through the door, and ask if everything was okay?

psu_213, BSN, RN · Aug 21, 2016

This is borderline harassment.

A bit overdramatic, perhaps? :sarcastic:

I tend to agree with you, that in many cases, the nurse could stand outside the BR, and knock periodically to check on the pt.; however, if I am outside the room and hear something (such as the pt. grunting to produce a BM, something dropping on the floor, etc.), I am going to give a quick knock and go right in and not wait for a reply.

In addition, in my facility--per facility policy--a nurse, tech, etc., must remain within arm's length of a pt. in the bathroom if that pt. is a fall risk. This is written as policy. If that pt. falls because I left to give the pt. time to his-/herself...well, it's my butt on the line. I feel bad if it "hampers" his/her efforts, but it is really not up for debate that a staff member must be in there.

Anna Flaxis, BSN, RN · Aug 21, 2016

I do not wish to complain I have found most nurses the most kind, sensitive, caring, people I have ever known. I want to know if I'm being overly sensitive or if my nurses (this time) were a bit out of line? I was in a rehab hospital for a hip replacement. Getting from bed to commode to toilet was an issue, but once there I had grab bars and felt myself quite safe. I assured the nurses that I would obey the rules and not get up on my own. I was extremely constipated and wanted some time and privacy to force a bowel movement. Time and again I had to specifically ask that the nurses leave and close the door. Often I was popped in on and asked how I was making out. Quite frankly the interruptions stopped the process in its tracks, I had to ask the nurse to leave, to close the door and begin my efforts all over again.
Am I being an overly sensitive prude or did I deserve a little more consideration?

Hi there! As others have stated, it is reasonable and prudent to check on a patient who is on the commode. However, I would knock on the closed door and ask how it's going through the closed door. If I didn't hear a response, then I would open the door to visualize the patient.

I'm more concerned here that you were constipated and wanted to force a bowel movement. One should not force a BM. As others have suggested, this can cause a vaso-vagal response where you lose consciousness and fall to the floor, potentially complicating your surgical recovery or suffering new injuries. You should have been receiving stool softeners and other interventions such as Miralax, glycerin suppositories, and if those things failed, an enema.

Glycerine82, LPN · Aug 21, 2016

This is common practice in a rehab setting. When you're medicated with heavy duty narcotics such as after a hip replacement and especially in the middle of the night, you're much more likely to fall if you do get up as well as much more likely to forget to call for help, so we are often just outside the door until physical therapy has cleared you to transfer independently.

Irish_Mist, BSN, RN · Aug 21, 2016

Falls are a huge concern. You were a major fall risk so the nurse(s) were likely much more concerned about you falling than your desire for privacy. Of course, knocking is the prudent thing to do. Your desire for privacy is understandable but just be thankful you had nurses who cared about your safety.

Secondly, I strongly encourage you not to "force" a bowel movement.