Patients not allowed to shower after accident

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Hello I work in a crisis psych unit and I have a question for other units about how urine and BM accidents are handled. If our patients experience daytime incontinence issues that are just urine or have an accident overnight they are not allowed to shower. We simply take them to the bathrooms, for safety reasons we must stand and watch them, have them us hand us their wet clothing and they are given a wipe, then they put on dry clothing. For BM accidents they are allOwed to shower but we must watch them. I’m not sure if I am just crazy for thinking this is weird as this is my first job out of school or if other psych wards do things differently. Patients are very embarassed by us having to stand and watch them change clothing as it does not give much dignity for them. it also doesn’t not seem sanitary for them not to shower after accidents? Especially hen this happens overnight they can be soaked. We also don’t provide them a different scrub top if it happens overnight even though they often get wet. I don’t want to make a big deal out of it to management if it is normal but it seems inhumane.

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Specializes in Psych, Addictions, SOL (Student of Life).
On 11/19/2020 at 2:32 PM, Emmeline22 said:

Patients are very embarassed by us having to stand and watch them change clothing as it does not give much dignity for them. 

In my own humble experience most of my psych patients are truely grateful when a staff assists them in this way. A few get embarrassed for sure but they mostly appreciate our efforts. 

Ask your self if you believe the patients are embarrassed or if you are embarrassed. If such changes are handled in a calm matter-of-fact way that allows for some preservation in dignity that's great but we do have self harmers that can't be trusted alone in the bathroom and all functions including toilet and showering are done under direct within arms reach supervision of a staff member . 

Hppy

 

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On 11/20/2020 at 6:46 PM, hppygr8ful said:

In my own humble experience most of my psych patients are truely grateful when a staff assists them in this way. A few get embarrassed for sure but they mostly appreciate our efforts. 

Ask your self if you believe the patients are embarrassed or if you are embarrassed. If such changes are handled in a calm matter-of-fact way that allows for some preservation in dignity that's great but we do have self harmers that can't be trusted alone in the bathroom and all functions including toilet and showering are done under direct within arms reach supervision of a staff member . 

Hppy

 

Since I am new I would love to get some pointers about the exact language that you would use in the following scenarios.

 

1) A pt comes to the nurses station at 2am stating that they have wet themselves. We have been told to ask, "Why didn't you wake up?" and then tell them if it happens again they will have to wear depends.

 

2) You notice a patient sitting watching TV in the common area and it looks like they have soiled themselves. We have been told to always directly state in front of the other patients what we are doing but I find this embarassing. I will usually state, "Hey, can you come up to the nurses station for a minute?" Then address it.

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Specializes in Psych, Addictions, SOL (Student of Life).

OK scenario 1: Ypu cannot threaten a patient in any way shape or form. This is a big patient's right's no no. Plus many patients take night meds that make it difficult for them to wake.  What staff should be doing in this instance is help the patient to clean-up emergently. Then do bedding in case bedding is soiled as well.

Scenario 2: Your instincts are correct. We should not be shaming patients in from of their peers on the unit 

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Specializes in Critical Care.

Generally speaking, what type of facility is this?

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39 minutes ago, MunoRN said:

Generally speaking, what type of facility is this?

Psych crisis unit of 20 beds in large room hospital (roughly 600 beds)

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It sounds like you are being asked to shame patients who are already emotionally fragile. Fortunately, you have the compassion and common sense to see that it's wrong. I would be looking for a new job. If the ppl in charge are trying to teach nurses to humiliate patients into not being incontinent, they are either very ignorant or enjoy degrading others. 

Not allowing pts to change or shower after incontinence episodes may contribute to skin breakdown as well as being terrible for their self-esteem. Also, are these all geriatric psych pts? Seems odd that there is so much incontinence going on- what are their meds like? With mgmt like that, I wonder if they are using meds as chemical restraints rather than therapeutic benefit.

As for the pts feeling embarrassed, I agree with Happy that your outlook and attitude can be a factor. It gets easier with time- I can chat about the weather with a naked pt while cleaning their poop off the floor like we're sitting there having a cup of tea LOL. 

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23 hours ago, SeeThruFaded said:

It sounds like you are being asked to shame patients who are already emotionally fragile. Fortunately, you have the compassion and common sense to see that it's wrong. I would be looking for a new job.

And as usual, quitting is the answer - NOT!!!  

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