Who cleans the poo?

[leilo0, BSN, RN]

Providing hygiene care when a patient soil themselves is a given but what happens when poo appears in public areas or shared spaces?

The other day, I had a patient lose control over their bowels warning, graphic description* This patient stood up and proceeded to leave formed stools on the floor leading to the bathroom and painted all over the toilet bowl. I was told by the cleaners that there shouldn't be any visible poo before they can come in to surface clean the area. As per their union policy, they are not to be exposed to bodily fluids, etc.

So, my buddy nurse and I gowned up, double gloved and rid the area of feces using towels because as usual, all the CNA's are on break and there's only one running around for 65 acutely ill patients.

The cleaners finally came with mops and appropriate cleaning equipment to finish off while we had to get over the nooks and crannies using our feet and pick up stool while keeping an ear out for our patients who might be crashing and I wonder if this is something I can bring up to union to influence policy change. It took nearly 45 minutes to clean the place without the right equipment but should we be given mops and take on a cleaner's task when we have our own nursing responsibilities to take care off? It just didn't seem like an appropriate use of nursing time and I also would like to know if this is standard policy elsewhere?

[psu_213, BSN, RN]

I have never worked anywhere that housekeep could not clean up fecal matter, but, then again, I have never worked in a facility where housekeeping was unionized. However, I would probably clean up the large areas of formed stool...there is no reason for it to sit around for housekeeping.

Plus, based on what PPE you were required to don to clean this , it sounds like more than what housekeeping can manage.

[VivaLasViejas, ASN, RN]

In my experience, it's usually "if you find it, you own it". In other words, if a patient makes a mess it's up to nursing to clean them up and housekeeping comes in after to disinfect the area. It does seem like a waste of the nurse's time, but most housekeepers in hospitals belong to unions and those unions have all sorts of rules which protect them. Heh...wonder what would happen if a nurses' union insisted that *we* not be exposed to bodily fluids? How far would we get with that? LOL

[leilo0, BSN, RN]

Plus, based on what PPE you were required to don to clean this , it sounds like more than what housekeeping can manage.

The patient was not on any isolation precaution but it was everywhere and I wasn't going to risk making contact. lol, I don't mind clearing a good part of the mess but I feel its' almost unreasonable to ask that no evidence should be left behind

[leilo0, BSN, RN]

In my experience, it's usually "if you find it, you own it". In other words, if a patient makes a mess it's up to nursing to clean them up and housekeeping comes in after to disinfect the area. It does seem like a waste of the nurse's time, but most housekeepers in hospitals belong to unions and those unions have all sorts of rules which protect them. Heh...wonder what would happen if a nurses' union insisted that *we* not be exposed to bodily fluids? How far would we get with that? LOL

Haha. I have not heard of that phrase but will have to use that on my coworkers! I think one of the issues we have with our profession is how broad our scope of practice is and we can't set firm boundaries as a result. As nurses, we'd be hard pressed to fight against exposure to bodily fluids (how i wish) but as a cleaner in a hospital setting, I'm not sure what the expectations are when applying for a job in a place that does involve body fluids. It just proves though that their unions are much better negotiators than ours. It's just not this case though, even porters are prohibited from helping out with patient transfers and that's added task on top off the ones that allied health heap on to us. All this while being responsible for critical aspects of patient care.

[NICU Guy, BSN, RN]

As per their union policy, they are not to be exposed to bodily fluids, etc.

How can you clean a bathroom without being exposed to bodily fluids?

[Sour Lemon]

I've only worked in three hospitals across two states, but none were unionized and all three had the same policy. Nursing was responsible for cleaning those sorts of messes. Housekeeping came along afterwards to disinfect.

I want to say it's insurance related, but I'm not 100% sure.

[KelRN215, BSN, RN]

I never had this exact situation but I seem to recall that, if patients vomited on the floor when I worked in the hospital, we had to clean up the chunks and whatnot before housekeeping would come in and mop.

[psu_213, BSN, RN]

The patient was not on any isolation precaution but it was everywhere and I wasn't going to risk making contact.

Then all the more reason for the RN to initiate the cleaning. Plus, I'm would not want it to just sit there on the ground while waiting for housekeeping to arrive.

[OrganizedChaos, LVN]

Housekeeping is not unionized down here (Texas) so they would clean up.

[Pepper The Cat, BSN, RN]

45 mins for 2 people to clean up formed stool on the floor? Something does not make sense here. Add in the fact that you felt the need to double glove leads me to think there is more to this story then you are sharing.

I also find it amusing that you want to double glove to protect yourself when you know the medical history, but find fault with the cleaners who don't have that knowledge from coming in and cleaning things up

[Persephone Paige, ADN]

I have no problem cleaning up poop. I had my children and then had a couple of grandchildren to look after, so poop seems to be my inheritance. That being said, it seems pointless to hire housekeeping in a hospital and not train them on biohazardous waste clean-up. I dread getting old. The thought of formed stool randomly falling out of my rectum is horrible.