Phrasing - how do you ask your patients about incontinence?

[AriRN36]

I think some people have great ways to phrase questions that are uncomfortable for patients. What are some ways you ask patients about if they are incontinent of bowel or bladder?

Thanks!

[Cindyel, ASN, RN]

Do you get up and go to the restroom when your need to go? Most people will tell you at that point if they have any issues.

[CalicoKitty, BSN, MSN, RN]

Sometimes I joke a little.. Maybe say something like laughing so hard, crying down my leg.... I tend to use the word accidents. It sounds pretty blameless. Work from there.. Dribbling. Nocturia. Frequency. Etc.

[Just me.]

As general question about health history, have you ever lost control of you bowel or bladder? Do you need assistance getting to the bathroom? For those I strongly suspect are incontinent, I do respectfully ask if they basically have the problem and if they need help getting cleaned up.

[K+MgSO4, BSN]

Do you get to the bathroom on time?

Do you worry about going out if you don't know where the bathroom is?

Then the usual stress incontinence questions...

[Tweety, BSN, RN]

Be matter of fact about it but not too technical that they don't know what you're saying. "Do you have control of your bowels and bladder or any issues with dribbling urine, getting to the bathroom on time....etc.?"

We have to be comfortable discussing uncomfortable topics.

My doctor point blank asks me about sexual function, and other urinary questions (I'm 60) and I appreciate that, it opens up the topic if need be.

[LPN Retired, LPN]

I have the overactive bladder now, myself. It's just part of old age I guess. I take a pill and that helps alot . I take an oxybutnin 2 X daily, morning and night.

I still,notice that I might be gona go,out, I,get that urge and I,know I better go to the bathroom before stepping out of the house. It's like my bladder

knows what's coming up.

[Sour Lemon]

"Do you know when you need to go to the bathroom, or does it just happen sometimes when you're not expecting it?"

That's become my script over time. It seems to be universally understood, and open enough for people to elaborate if they'd like to. On the other hand, it's not excruciatingly detailed and doesn't seem to make people too uncomfortable.

I only probe deeper than that if it's a patient admitted for urology services.

[amoLucia]

As someone who has OAB/incont issues, I have NO QUALMS discussing my problems HC providers. Now it's not something I go about discussing with others in general social outings, but since I'm at a HC appt, I'm open to any discussion.

To nsg /HC folk, please DO NOT worry about embarrassing the pt. Be tactful and sensitive, no need to be delicate or using euphemisms. Incont is a major lifestyle-altering issue for many. Its occurrence is way more embarrassing in real life happenings than any DISCUSSON could ever be. You'll be opening the door for meaningful & appreciated discussion with those afflicted.

[ArmaniX, MSN, APRN]

“Have you ever *** the bed?”

[AlwaysLearning247, BSN]

I always ask “can you feel the urge when you need to go to the bathroom?” Basically most patients will eloborate from there. It is awkward at first!

[NurseJamillah, MSN, NP]

I work in a hospital, so if they are mature, I start with, "Do you usually wear a brief, like Depends?".

At all ages, I ask, "Do you have urgency or stress incontinence? That means when you have to go, you HAVE TO GO." If they say yes, then I say, do you leak a little sometimes? Do you want me to bring some pads or for me to keep a urinal nearby?"

That usually opens up the conversation. They will tell me if they need a commode next to the bed, urinal, pad, brief, etc.

Sometimes they say not to all of the above, but they smell strongly of urine, so I will bring in some extra things later with some comfort items and tell them that I couldn't remember if they said they needed the pad/urinal etc. or not.