Patient requesting to use adult briefs during colonoscopy, rather than cath?

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first_aid.png Patient requesting to use adult briefs during colonoscopy, rather than cath?

A patient made a request today, that they be allowed to use adult briefs during and after a colonoscopy, rather than being catherized. The PT was recently diagnosed with MS, and is completely bowel and bladder incontinent. In terms of a cognative capacity, the PT was extremely intelligent (former med student, until MS diagnosis). The PT stated that due to the fact they have a solitary kidney, they should not be cathed in any capacity for any procedure as it exaserbates infection, and have the right to refuse any aspect of treatment. What are the thoughts on this? What is your current policy when dealing with incontinent patients, procedures, and catheterization? Unfortunately, what complicated matters, is that this individual was training to be a doctor and was telling me what to do and how to do it. To me such a request does not matter, however I do not want to be cleaning up urine after an exam if briefs or a cath is not used.

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How big of a deal is it to clean up some urine, if it means your patient is not exposed to an invasive procedure that could compromise their already compromised renal system? I am somewhat shocked that you are putting your convenience ahead of their potential health. Jeez, it's just pee.

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I am not worried per se about cleaning up pee, but rather being chewed out by the doctor for taking too much time in prepping (extra clean-up) for the next Pt, or not following policy, which is a grey area.

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I have never seen a patient catheterized for a colonoscopy. I do agree with the previous post; what is a little urine if you have gloves and an absorbent pad of some type? I think it is a reasonable request.

I see your concern-do you have a supervisor who can tell the doctor what is going on? Or simply tell the doctor that, due to the patient's request, he/she may have a few extra minutes before the next patient. An absorbent pad and a blanket or two should contain any urine; any other disinfection should be routine. I've never been anywhere that caths patients for colonoscopies, so cannot address policy/procedures.

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my goodness, this pt has lost enough function and autonomy as it is.

let him have a say in this and let him use the darned briefs.

sheesh.

leslie

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Specializes in Med Surg, Peds, OB, L/D, Ortho.

I think it is a reasonable request ...one less UTI for him........just curious, why do you all cath. for scopes?

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Specializes in Peri-op/Sub-Acute ANP.

I think I would put up with a little chewing out because I took an extra 5 minutes to turn over a room if it meant doing the right thing by my patient.

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Let the man wear his brief. The doctor shouldn't even take issue with this and if he does he will get over it.

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I don't get what the issue is. First of all, I have never seen anyone cathed for a colonoscopy.

Secondly, couldn't you just put a chuck under him and if he happened to pee it would be a ten second clean-up.

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Specializes in Nurse Scientist-Research.

If it was my body I would want to protect my remaining kidney from infection.

If the patient is agreeable to it and they are available, maybe you could use a condom cath (I think you referenced a male patient)?

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I think it is a reasonable request ...one less UTI for him........just curious, why do you all cath. for scopes?

We normally do not cath for a colonoscopy, however this individual is incontinent, hence hospital policy states to cath under such conditions. I agree that a brief or chux should be used, at all phases of the procedure pre and post. Basically, what are your procedures for dealing with incontint PT's? PS Yes the pt is male.

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Specializes in Nursing Professional Development.
If it was my body I would want to protect my remaining kidney from infection.

If the patient is agreeable to it and they are available, maybe you could use a condom cath (I think you referenced a male patient)?

That was my first thought ... a condom catheter. Nothing is inserted and it would be quick and easy.

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