Who cleans the poo?

Nurses General Nursing

Updated:   Published

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?

Specializes in NICU/Mother-Baby/Peds/Mgmt.
Could be worse. When one hospital I worked at "re-engineered" (management fad at the time), we lost housekeeping staff on the nursing units. Nurses and techs became responsible for housekeeping. They sent us to training--I remember being taught the "7 steps for cleaning a room." We had cleaning solution, mops, etc. That lasted for a while until I think they got too many complaints from patients who were understandably upset at seeing their nurse cleaning a toilet one minute and passing meds to them the next. (I will say our unit was much cleaner when we cleaned it than when housekeeping did it.)

I have never understood why housekeeping could not be trained in bodily fluid precautions. But maybe they wouldn't get anyone to take the jobs if that were part of it.

And yes, I've been asked to empty a hamper that was deemed "too full" by housekeeping. But then we nurses can do anything, do anybody else's job, etc.

When I think about how much better off I'd be financially if I got paid their share of the job on top of my nursing pay....

My first job in a level 2 nice we emptied trash about 04-0500. No big deal, only 2 big trash cans, but yeah, we then went back to patient care. Fast forward 20 years and I'm orienting to peds and my preceptor teachers me to empty the desk area trash at the same time. I did it while on orientation but not after that, unless it was overflowing. That's how we nurses have gotten stuck with all the extra crap we have to do....

Specializes in orthopedic/trauma, Informatics, diabetes.

Our policy is that we are to clean up as much bodily fluid as we can. Then EVS will sanitize. I don't mind cleaning up. Anything to keep the pt form feeling embarrassed or self-conscious. It's part of the job .

I think I want that job! The nurses are already overloaded and now we have to do the job of the cleaning people?!

Specializes in Psych (25 years), Medical (15 years).

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I remember reading back in the days nurses were evaluated by how clean they kept the ward/hospital... mopping and everything... maybe that was appropriate back then given that germ theory and connecting clinical outcomes to sanitary measures was relatively new. But now, not a good use of nursing time... it can fade away with the other old timie things nurses did.

At my hospital system it is nurses or aides. It doesn't have the be immaculate but the majority of the feces/urine/blood/vomit needs to be cleaned up. These housekeepers are often scrubbing filthy toilets so it isn't like they aren't dealing with it on the regular.

Housekeeping is a hard and low paying job. I have no issues with me having to take the 1-5 minutes to do a cursory pickup for them especially since I don't know when they can get up there.

Although I do agree with the person who said every thing falls to nursing. Why do I have to be on the phone with IT for 20 minutes trying to figure out why the patient meds are still on a MAR hold from surgery. I mean how is the doctor not equally responsible for making sure the patient has orders? Or playing middle woman between doctors because they would rather waste our time than get on the phone with each other and talk for 5 minutes. Or being the one to walk a patient's dog and cleanup after it.

Finished reading others comments and I guess our housekeeping is pretty great. A trash bag is never too heavy. We can toss soiled bedpans in the trash. Hell, they even remove the tubing/bags from the IV pump and toss it. They also do an amazing job cleaning and sanitizing patient rooms after discharge. Maybe that is why I don't resent helping make their lives easier when I can.

I'll remove trash from a full can but I absolutely would not sort trash because the bag is too heavy. Nor will I strip linens from a checkout room. For the most part our housekeeping department is useless. We have few good ones. I am not going to let admin think that nursing staff will just pick up general housekeeping duties in addition to the ridiculous ratios and lack of support staff we put up with. As for the original question, nursing staff is responsible, making it pointless to even call them after the fact.

I have never had this happen but once I was a student on the childrens' ward and this poor wee dude threw up everywhere in the playroom. Turns out I needed to clean all the visible vomit up before I got the cleaner to do a proper clean. Something about they wouldn't actually clean the vomit but would disinfect the room after I'd done it.. I was a bit miffed because I was the nurse trying to comfort the boy and hold his hand while finding him some hospital clothes to wear. I had to leave him to clean it up. Hmm.

1 Votes
I agree with this. I think there's a big general idea of "it's okay, nursing will do it." Physio not available to walk the patient? Nursing will do it. The phlebotomist is backed up? Nursing will do it. No unit clerk available this afternoon? Nursing will put the charts together. Porter's on a break? Nursing will bring the patient down to x-ray. Everything, in the end, falls to nursing. I don't even work in acute care and I see this all the time. In a primary care office, the physician wants the client to be referred for dental work? That's tasked to nursing to figure that out. A client needs help getting to and from an appointment - task it to nursing. A client doesn't have a phone and needs a message sent to them from the doc? Ask the outreach nurses to run it over. I'm actually working hard in our office at the moment to push for non-nursing tasks to go to non-nurses, but it's hard, because our providers are very used to just asking nursing to do it.

Sigh, really feeling burned out bc of this. REALLY BURNED OUT. I appreciate your efforts though.

This is exactly what I'm getting at. It's the small things that culminate to a lot of things. The onus is always on the nurse and you're pulled away from doing your actual job. And so, in paper you are a nurse but a good part of the day, you're a porter, housekeeping, phlebotomist, PT etc on top of being a nurse. At the end of our shifts we wonder why we stay longer to finish up charting, didn't have adequate breaks, missed a critical lab value, making a med error OR handing over a non urgent treatment to oncoming shift, a good part of the reason is the never ending tasks. And to pay me to do portering duties on a nursing wage doesn't sound like a good business strategy either. As long as we accept these terms then we can complain about staffing and workload issues and nothing will change. Sadly, this is only the tip of the iceberg for our profession :)

So perfectly said.

I find it rather amusing that there has been so much discussion about "who" cleans up poop! Sorry, but in the old days, from which I hail...the nursing staff, RN's, LPN's, CNA's cleaned up everything and anything. Housekeeping did the disinfecting. As much of the visible soiling was cleaned prior to housekeeping even entertaining the idea of cleaning it up! We also had to clean beds for admissions during the night when housekeeping was not available. I too wonder why on earth did you use "towels" to clean up solid poop? Pick it up with TP and flush it. Or even use a disposable bed pad, pick it up and toss it. I envision more time being wasted over discussing who will clean it up than it would actually take for someone to just get in there and clean it up, not rocket science people. I get rather prickly when I hear and read that nurses have other things to do, more important ways to utilize their time. Well, consider this as part of your shift assessment...how did the patient ambulate? You can actually verify the patient moved their bowels. What color stool did they have? It could go on and on. I'm sorry, to me, it is all just part of the job.

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