permitting a patient to urinate in bed versus holding it in

NURSING POST

I'm wondering if any of you have any thoughts on the following situation:

A bedridden female geriatric patient, while undergoing a lab test, has an intense urge to urinate and insists she cannot wait. The lab tech, who is physically not capable of lifting the patient, calls for another tech to bring a bed pan. The nurse urges the patient to wait for the bed pan to arrive, but the patient continues to say that she cannot wait and needs to urinate at that very moment. Finally the first lab tech reassures the patient that if she absolutely cannot wait, she should not be ashamed if she needs to urinate in the bed, the staff will clean the bed. This is a lesser evil situation; what would be the best approach? Are there any nursing standards or articles that might shed some light on this question? Any insight would be greatly appreciated.
Sorry -- your learning will be greatly enhanced by researching the components of this scenario yourself ... and asking the question on a message board does not constitute "research".Good luck with your studies.

Here is my insight, for what it's worth:A bedridden pt should always have a bedpan within reach. Why was a bedpan not in the room to begin with?It is unnatural to urinate in the bed. We were trained early in our lives NOT to do this. There is a stigma of shame and embarrassment associated with bedwetting, no matter the circumstance. The lab tech was only trying to comfort the pt by telling her that she should pee in the bed if she couldn't wait. However, the pt is no doubt completely humiliated at the thought of having to pee in the bed. The pt is already feeling helpless simply from being bed bound. Can you imagine how completely defeating it must have been for her to pee in the bed? She LIVES in that bed. I doubt there are any nursing articles or references that you can look up regarding this situation. It is simply common sense to have a bedpan in the room for a bedridden pt.

Possibly the reason there would not have been a bed ban is if the patient was transported down to the radiology department for a test. I know that when I was with a patient I was assigned to as a student nurse a few clinical rotations ago, I went down for an X-ray with him. While he was down for the x-ray he told the x-ray tech that he had to go to the bathroom, she told him that she was "unable" to get him out of bed for him to use the bathroom. He insisted that since his "nurse" was with him he could go. I remember looking around the room, wondering who he was talking about.....Yup it was me, his STUDENT, nurse....I don't think that I was really supposed to be getting him out of bed so he could go to the bathroom; however the x-ray tech was giving him no choice. Oh I forgot to mention, I asked her for a urinal for him 1st as I was supposed to be keeping I&O on him and they did not have a urinal down there, I went over to the ER as it was down the hall, and guess what I was told there.....No urinals???

bedridden patient should always have a bedpan within reach. a lot will also have foley catheters. but i'm going to take the situation for what it is...i'll admit, i HAVE permitted a patient to urinate the bed. She had a draw sheet and it was this little old lady who needed to go and could not be left alone (a 1:1 observation). I cannot turn my back on her for 1 second, she is QUICK and terribly unstable. So when she tells me, i put on the call light and im waiting and waitng and waiting for someone to come help me move her to the commode. She is up with 2 and pivot, sometimes a ceiling lift so i CANNOT move her myself!! Nobody is coming, i can't leave her since she is 1:1. I briefly poked my head out the door- nobody.She is yelling "I CAN'T HOLD IT I CAN'T HOLD IT"....gave her permission to go and we would clean it up. One of the CNA's finally showed up. My remark "well since nobody came i just let her go on the bed. Going to help me clean it up now?"Luckily it wasn't alot. Buuut you do what you gotta do in certain situations. I wouldn't urge all patients to urinate the bed everytime they have to go. but i definitely don't wan't this lady to be uncomfortable and mad at me for "not taking her to the bathroom" i cleaned her up good and still set her on the commode while i cleaned the bed. Apologized for the situation and told her what iwas going to do to correct it. Since we hadn't been using a bedpan with her, we didn't have one in the room but i kept it in there for "emergencies like this"Maybe another nurse would have handled it differently but i felt i was acting in the best interest of the patient. Who cares about the bed and the linens?

A patient should always be encouraged to urinate in a way that feels natural and comfortable for them. If that means a toilet, a urinal, or a bed pan, that's what should be encouraged. However, if the patient does have to urinate in the bed (some people really can't hold it) the patient should be reassured that it is okay, not a big deal, etc. It makes the patient feel a little better in a very uncomfortable and embarrasing situation. This reminds me of a labor and delivery situation. Many women in labor feel that the urge to push in very similar to the urge to have a bowel movement. When pushing, the same muscles that are used to defecate are also employed. It's not uncommon for laboring women to have a bowel movement during labor. Sometimes the woman knows this is going to happen, but getting her up to the bathroom isn't a realistic option. The labor nurses, when I have heard about these situations have always told the patient that this was fine, acceptable, happens a lot, they were used to it, etc...

Quote from Ashley, PICU RNA patient should always be encouraged to urinate in a way that feels natural and comfortable for them. If that means a toilet, a urinal, or a bed pan, that's what should be encouraged. However, if the patient does have to urinate in the bed (some people really can't hold it) the patient should be reassured that it is okay, not a big deal, etc. It makes the patient feel a little better in a very uncomfortable and embarrasing situation. This reminds me of a labor and delivery situation. Many women in labor feel that the urge to push in very similar to the urge to have a bowel movement. When pushing, the same muscles that are used to defecate are also employed. It's not uncommon for laboring women to have a bowel movement during labor. Sometimes the woman knows this is going to happen, but getting her up to the bathroom isn't a realistic option. The labor nurses, when I have heard about these situations have always told the patient that this was fine, acceptable, happens a lot, they were used to it, etc...

Eek! I can't imagine telling a patient to wet him or herself.

My thinking is why didn't someone toilet the patient before transporting them? Prevention is preferable.

.......... O_o This sounds like a homework assignment to me......

Quote from whichone'spinkeek! i can't imagine telling a patient to wet him or herself.

Back when I was an EMT it would sometimes take a long time for us to extricate a patient and transport them to the hospital. If the patient was immobilized (C-collar, KED and longboard), we would let them pee into a large trauma dressing that would absorb quite a bit while covering them with a blanket. This gave them much-needed relief with minimal embarrassment. You do what you have to do in an emergency. Still, it's not a good thing to do as a habit.

Just a question - but why is it every time somebody poses a question, it's automatically assumed the poster is fishing for answers to school questions? I've got to say, it's been awhile since I was in school (coming up on 30 years), but half the time they don't sound like any questions I was ever asked to answer. Why not just answer the posters question or remain silent? I don't 'get it'.