Restroom usage requests during treatment.....

corky1272RN · May 17, 2009

In my clinic, I will allow them to get off to go to the bathroom. Though the tx time continues countdown. This may not be nice, but we do have pts coming for the chair after them and some of our pts drink during the tx. Also sometimes they really can't hold it. If it is in the last 30min I will try to talk the pt into holding it. I don't know but when someone sits there for 3-4 hrs or more, it may be hard to hold it and I would rather the pt get off to go then "mess" all over his/herself, which we have to clean up and figure out what to do with the chair. :sniff:

Lacie, BSN, RN · May 19, 2009

We stop the clock and rinse them back. We dont shorten thier time due to bathroom breaks as it can cheat them out of a full treatment they may desperately need. A pt following them in the chair isnt rationale to shorten a treatment (at least in my clinic). We also ensure to add that rinseback to the goal on return to the chair. We do b/p when they come off before going and also on returning to the machine. I have patients that will try to use this during the last 30min routinely to get off the machine early and stay off until I started ensuring they signed an AMA if they refused to go back on. Bathroom priviledges is a basic right and no patient should ever be denied thier dignity to go anytime they need to do so. So it's not something I "allow" them to do, I require my staff to do so. I have seen clinic pull out a potty chair with a screen in the unit in order to discourage pts from requesting due to the embarassement. NO WAY!! My staff know when a patient request then they are to get them off as soon as they possibly can and not to chastise a pt for the request either. Previous clinic did this and I have heard techs tell patients using diapers -"I dont have time you'll just have to use your diaper" - I also terminated that person the same day! I have seen nurses not return patients first before going and I think thats a big no-no. Seen them drop in thier steps on thier way because they didnt get rinsedback entirely. In addition - I sure dont like cleaning up the mess when they are delayed because staff dont want to slow down to take them or take the time to take them off. Anyone should in thier shoes and try to hold for 4-5 hours lol.

GeauxNursing · May 19, 2009

1st time off to go, no problem, 2nd time off to go, okay. 3rd time they need to get off is tx termination for the day. of course anyone can go whenever they want! we would never withhold someone's right to go! the pt is rinsed back, time continues to tick away while they are gone, and the goal should be changed.

lunden · May 19, 2009

Nope, once you're off you're off. We do of course offer bedpans and urinals

jb2u, ASN, RN · May 19, 2009

I made the mistake of letting a patient off the machine in an acute dialysis unit. I thought we had to if the patient insisted. We do not have a policy to state that we do not take patients off to use the bathroom. I think it should be policy to never let them off to use the restroom. First, there is an increase chance of infection due to "opening the lines for disconnect and reconnect." Second, you need to pull back the extra fluid from rinsing back and restarting. Third, needles could pull out while they are in the restroom.

akai6 · May 19, 2009

When I did work in the dialysis units we would rinse the patient back and stop the clock... While it does defeat the purpose when you have to increase the goal because you are in fact giving them an additional 500cc of fluid, if you have to go what can you do?

Now that I am working for the acutes program, we offer the bedpan or urinal because patients are much more critical and sicker I suppose. Not to mention recirculators are not as readily available as they were in the clinics..

KellyCCRN · May 20, 2009

I made the mistake of letting a patient off the machine in an acute dialysis unit. I thought we had to if the patient insisted. We do not have a policy to state that we do not take patients off to use the bathroom. I think it should be policy to never let them off to use the restroom. First, there is an increase chance of infection due to "opening the lines for disconnect and reconnect." Second, you need to pull back the extra fluid from rinsing back and restarting. Third, needles could pull out while they are in the restroom.

I'm with you on this one. RARELY will I let somone off to go to the bathroom. We offer bedpans and urinals, if ya got to go it will work. Heck it seems half of the pt's we get are incontinent anyway.

Lacie, BSN, RN · May 20, 2009

Guess it all depends on if you are asking about a chronic (non-hospital based) unit vs Acutes. Acutes yes I wouldnt allow them to get up and to the bathroom but in chronics it's a bit different. My previous response was related to chronic unit. Heck we dont even have urinals or bedpans in our supplies. Nor a potty chair for that matter so no choice but to allow them to go.