The day I left my patient in a urine soaked bed.

Some time ago an article in our local paper described the anguish of a family of a patient who alleged they were left in a urine soaked bed for several hours.
I make no comment on this  particular incident as I do not know the details around it.

There is no doubt that leaving a patient in such a state is deeply demeaning for the person involved as well as multiplying the risk of pressure injury and skin breakdown.

But the judgement inferred by the report picks uncomfortably at something from my own past. So let me tell you a story I am not proud of.

On a very busy evening, not that long ago, I left an elderly lady laying in a urine soaked bed.
I cannot recall how long exactly, for time tends to compress when it is busy in the emergency department. But it could easily have been two hours.

I knew she was wet.
She had asked for a pan and I had gotten it for her straight away. A minute to the pan room and back.
Which was too late. She told me so with a deep flush of embarrassment. Her dignity breaking with her voice.

Im so sorry Carol, I’ll get a fresh change of sheets and help you wash. A couple of minutes and you will feel much better.

This was the moment my next patient arrived. By ambulance. A middle-aged man with cancer of the lung. He was suspected to be neutropenic. Hot and breathing hard.
He came with a suck of urgency, a clutch of problems that required immediate attention in order to increase his chances of survival. Time critical we call it.

Staff were busy everywhere, but another nurse slid over to help.
Oxygen, observations, IV access, bloods, IV antibiotics. One sentence that takes seconds to write on a standing order, but easily 30 minutes to complete in task. Maybe more, ’cause when you are dealing with a human being at the other end of your list, nothing is linear.

Half way through all this my third patient arrived. Chest pain.
As soon as we connected him to the monitor you could see he was infarcting.
Another queue of time critical priorities as we controlled his pain and prepped him for cardiac catheterisation.

I escorted him to the coronary care unit, and returned.
A new patient had already taken his place. Another chest pain to be quickly assessed. History taken and ECG attended until it became evident that there was no real urgency here.

Finally, I returned to Carroll.
The bed had drawn damp through. Sticky with the amonia smell of stale urine.
But even then there would be further delay as I searched for someone who was free to to help out. To turn, and wash and spread new sheets beneath.

Carrol’s apologies for being so helpless and such a nuisance collided uncomfortably with my own.

I do not think I am a bad nurse, and think most of the time I deliver a very high standard of care. But not always.

Sometimes the complex entanglement of things happening within a hospital mean that I must make difficult decisions. In reality the frequency with which things like this occur means they are not really difficult decisions at all.

It is just what must be done.

Nursing requires the knowledge and skills to deliver high quality, evidence based care to our patients. Doing so without abandoning attention to essential, basic nursing care and compassion.

Sometimes this is not possible. Sometimes nursing just sucks.


 

Featured image via: zoe J

5 thoughts on “The day I left my patient in a urine soaked bed.

  1. I was patient in a private hospital sharing a room with an elderly woman who had had a spinal procedure that day, it was nearly 9pm and evening staff were going to handover,she rang and asked for a pan,the staff member came and said we are too busy at moment, so if you can’t wait just do it in the bed and we will clean you up afterwards!! She was very upset and me a RN ,was horrified hearing all this, she couldnt wait so had to suffer the indignity of a soiled bed and being cleaned up after the staff finally got to her!

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  2. Unless you have worked in emergency setting i don’t think you can understand how things like wet beds happen. Ie, once had a person ask how much longer they were going to have to wait to see a doctor. The fact that we were doing cpr on an arresting pt on the floor on the waiting room at the time just wasn’t a concern for them.

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  3. I had an incident in a hospital i was working in many years ago where a patient was wanting a bed pan i passed it on to tge nurse aide on the ward who,s answer was she can wait i,m off to morning tea.when i returned over an hour later i heard the patient being berated because she,d wet her self .not a busy emergency centre just a ward in a large geriatric hospital

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    1. I think the authors point, particularly as she mentioned in the first sentence that she did not know the full details of the article and could not comment, is that sometimes there is an explanation, even if its not ideal. She’s not excusing poor care based on laziness or disdain for patients, in fact quite the opposite. But oftentimes people reach for the most negative explanation and start attributing blame to staff where it isn’t warranted. And when readers see articles like this and immediately tar all staff members of all hospitals with the same brush, it helps build up this “us vs. them” mentality. I’ve seen it so often, where families come onto wards, absolutely bristling and confrontational because they believe the staff member is ‘the enemy’ or at least treat and speak to them that way.
      Its important to highlight pressures on staff, realities of the job, and the care that most of staff display for their patients. And i think she did, with this article.

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