Emmeline22

I totally agree with your instinct. I can only imagine that the young patient woke up this morning and realized what what had happened and was terribly embarassed. I think now that the kids are throughout the ward I would take the patient aside and kindly ask if she had an accident. Maybe something like "It's quite common for patients to have accidents while in the hospital did you have one?" We aren't allowed to wash patient clothing so in my facility we would place them in a sealed belonging bag for her parents or guardian to pick up. Definitely think you should say "It can be unhealthy to have urine on your body so why don't you take a shower"

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

This is Missouri. During training we had the locked bathroom doors explained as a safety mechanism. I'm only about 3 months in so still getting oriented to the place, but everything is always explained briefly and when you ask questions they tell you they don't have time to answer. Maybe now you understand a little bit more about why our patients are often so embarrassed. At my last shift I had a 23 y/o female who was able to perform all ADL's independently come up to me at 11am and ask to use the bathroom. I was alone at the nurses station and told her I would radio. Put in the radio call for a float staff to come assist. She comes up again at 11:15, 11:30 and about 11:55 and each time on the radio I am told there is a code and to wait. She comes up at about 12pm asking again saying she really had to go. I put out on the radio again stating it was a urgent. An admin asks if it's threatening I say no but she has been waiting. So for about 15 minutes I watch her do an akward potty dance until I see the puddle forming around her feet. She begins to cry and I tell her, "It's fine." She replies "It's not fine. I am 23 and just peed my pants." I tell her "don't worry about it." She then accuses me of not trying to help her and states, "Do you really think I am going to want to live if I'm forced to pee my pants?" I try to tell her it's our fault. She then asks if she can get some extra clothes to change. I tell her that she needs to wait until a staff member can come as our policy does not allow patients to have two pairs of scrub bottoms at the same time. We also keep all bedroom doors locked during the day so she has to just sit there covered in urine for about 30 minutes until somebody comes. At this point I grab some fresh clothes and ask her to follow me to the bathroom. She then asks if she can go in alone and I tell her I have to come. While watching her remove her wet clothing and wipe herself down I don't really know what to say. So yeah maybe now you understand why it's horrible to both be a patient there and work there. If you have any ideas for what to say to patients to make it less embarassing while I work on reporting it to the appropaite people and creating change.

Our admin has told us that for urine incontinence they just need wipes and for fecal incontinence they are allowed to shower most of the time. Our admin is all about saving money and really make it a horrible place for patients. They have even gone as far as to state if in the morning we notice a wet patch in a bed to just assume that the patient spilled water and only to change linens if it smells like urine.

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.

Yeah, well on our unit it can take anywhere from 45 minutes to an hour before there is a staff member available to unlock/supervise bathroom. No, our facility is allowed to lock the bathrooms. The main problem is we are so understaffed so from the time that a patient requests the toilet to the time a staff member is actually available to unlock/supervise them 45 minutes to an hour is not unusual. We usually walk to find the patient who requested the toilet only to find that they have already had an accident.

@hppygr8ful It is adult crisis stabilization. The reason many accidents happen is that all bathrooms are locked so when patients need to go they have to get a staff member to assist. Given that we are chronically short-staffed (we are down South) this can take a while

I am about 3 months into my first nursing job out of school and have been offput by some stuff on my unit. For reference I am on an adult psych crisis stabilization. Can people either validate my concerns or tell me if I am being unreasonable. 1) There is no actual procedure in place to ensure that patients get a change of underwear and scrubs. We have been told by management not to offer new clothing to patients unless they directly ask or we see that somebody is visibly soiled. Most patients shower in the morning, but don't change clothing. Because patients don't think we have spare clothing often times I will see patients walk around with period leakage, feces stains, etc. and when asked why they didn't ask for some new clothing they report that they didn't know that was an option. I often worry that patients are sitting in their own mess for an extended period of time before a staff member notices and approaches them to offer new clothing. 2) We are only allowed to give patients one pad at a time. Management states this is for safety purposes, but leads menstrauting patients to hang around the nurses station all day asking for supplies. We also do not offer overnight pads which often leads to bloody sheets in the morning. 3)We are also told not to change sheets unless they are visibly soiled. Our average patient stay is only 6 days, but still this seems like a long time not to change sheets. Furthermore, we are told if they are wet to assume it is just spilled water unless it smells like urine and then change the sheets. 4)With instances of urinary incontinence patients are not allowed to shower. This often happens while patients are sleeping hence they are completely soaked from head to toe. To make matters worse we are required to stand and watch them strip naked, give us the wet clothing before we can give them the dry clothing. As if the patients aren't embarassed enough to begin with they must have a nurse watch them remove their wet clothing. Can people tell me if they also think this is problematic and/or I am just being unreasonable. What does your unit do differently? Thank you.

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.

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.