I just had to know what all nurses think about this order. Long story short. I work in long term care and as you know, there will always be offensive odors whether in the halls or patient rooms. Anyway, one of our physicians go into a patient room to assess or examine and noticed a foul urine smell. This particular patient urinates on herself inspite of nursing staff assisting her to the toilet; she is ambulatory with some dementia and she is not incontinent so she can urinate at anytime with out us even knowing. So, I am checking physician orders and the physician writes an order stating: "make sure patient room is cleaned twice a week, there is a foul odor and increase her baths. First of all, as a healthcare professional, this order was insulting to me as a nurse who is use to seeing medications, PT or etc written on legitimate physician order sheets, not this mess. The doctor could have mentioned the odor to nurse manager or supervisor but why write it as an order. Also, the rooms are carpeted which harbors foul smells, this was not a good choice to make so far as the floors. My final thought is that if you can not take the foul odors as a doctor, then maybe you need to find another career.
working acute care we frequently get orders like "Please get pt sandwich (at midnight)", "Please help pt hook up DVD player in room (since when was I trained in electronics?!?)" "Please add physician order sheets to chart (really because what are you writing on?)" etc. I just figure that it's probably going to be the easiest order to complete, and even hooking up the DVD player was more enjoyable than working my way through a 5 page order for a dressing change.
Have yet to find a pristine smelling LTC facility.
Actually where I work does not smell. Of course when someone starts stinking up the place we start sniffing around like dogs to find who it is lol..and I keep a little body spray handy to mask any odors.
Actually where I work does not smell. Of course when someone starts stinking up the place we start sniffing around like dogs to find who it is lol..and I keep a little body spray handy to mask any odors.
Yeah. If I walked into a LTC for a job interview, and it stunk, I politely followed through, and didn't go back. Peppermint extract also helps....even a couple of drops on a mask can get through a malabsorption code brown with minimal gagging :)
I love it when administration thinks carpet is a good idea in hospitals.
I worked a big inner city level 1 a few years ago and the powers that be decided to drop some money in the ER lobby, new paintings, flat screen tv's all over and carpet on the floors, light grey. ROFLMBO. 1st or 2nd night the homeboy ambulance service dropped some guy off at the door that got some kinda bad beatdown, bleeding all over that pretty grey carpet. They had to postpone the ribbon cutting so they could rip up the carpet and put tile back down.
Yeah. If I walked into a LTC for a job interview, and it stunk, I politely followed through, and didn't go back. Peppermint extract also helps....even a couple of drops on a mask can get through a malabsorption code brown with minimal gagging :)
That stuff will even fight off a lower GI bleed. Hey, also a little strip of Iodoform inside your mask works great and hand 6-8 inch strips in the room and will take away the odor.
That stuff will even fight off a lower GI bleed. Hey, also a little strip of Iodoform inside your mask works great and hand 6-8 inch strips in the room and will take away the odor.
Yep....and gangrene as well.... a few drops on a cotton ball in a 30cc med cup set over the vent in the room doesn't hurt either :)
carpet, at least partially, is a fall prevvention intervention. When liquid is spilled on carpet it is absorbed/spread out and the carpet surface is not slippery as would be a wet solid surface floor.
Getting back to the order.....my advice..get over it. You will have docs that love to write crazy orders like that. "Brush res teeth after meals" "soak dentures at hs" "extra blankets when cold" I've seen my share and just laugh.
I would make sure the DON knew of the order.
How does a LTC get away with carpet in the res rooms? We need an infection control policy for fall mats beside a bed...is there one for carpet cleaning?
As far as this resident...I would def be making sure she stays on a toileting plan. Even if she refuses..you have to try it.
Febreeze is your friend. Since it is in the carpet, you would need the stuff for fabric freshening. I'm sure they have an industrial deoderizer like febreeze to use. Housekeeping should be in that room alot.
We are not permitted to use air fresheners, but I keep a bottle of febreeze spray for touch ups. I don't care what you do..there will still be odors on occasion..we all have them at home. I let the CNAs use it in the rooms if they are semi privates and need to freshen the air during changes.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I see your point, but let me remind you that this resident is ambulatory, she fights the nursing staff when they try to help her change her underwear. We can't put in a urinary catheter, she would pull it out and besides this fact, she is alert. This resident moved her bedside commode out of her room. How about over night, no one can watch her every minute. I believe that she waits too late to go to the bathroom and urinates on herself which in turn goes right into the carpet and her bed. So, what can be done to keep her from urinating on herself, the toileting program that she is currently on, is not successful. Any ideas?
Purchase pull ups. After talking with family or POA ask to remove and "buy" new underwear. She may also need a urine culture or other culture's to check for UTI or vaginitis. I agree the MD order is weird and in a long term care setting probably a dig on his part, but he looks like the jerk for writing it. He may have had an altruistic reason but that is doubtful like you said he spends a few moments every couple of weeks. I am sure the carpet is the culprit but it is also a way to decrease falls. It's really a difficult situation to rectify. I like the spray Ozium......LOVE THIS STUFF......it really eliminates odors! I am a big no smell person and a weak gag reflex so I was always ready with peppermint or Vicks for my nose but this spay is a miracle worker. I always bought it my self but then I didn't have to share...
LouisVRN, RN
672 Posts
working acute care we frequently get orders like "Please get pt sandwich (at midnight)", "Please help pt hook up DVD player in room (since when was I trained in electronics?!?)" "Please add physician order sheets to chart (really because what are you writing on?)" etc. I just figure that it's probably going to be the easiest order to complete, and even hooking up the DVD player was more enjoyable than working my way through a 5 page order for a dressing change.