'Patients who put nurses before themselves need putting straight'

Posted by:

6 August, 2012

An elderly woman said to me recently that she wore incontinence pads because it was easier for the nurses.

She needed to be hoisted in and out of bed so had to ask two nurses to use the hoist to put her on the commode or toilet. However, she said that she did know at least half of the time that she needed to use the toilet so with support and reassurance from the nurses could have maintained her dignity by using a commode or toilet.

Patients who are in hospital for a long time or who are being cared for in a nursing home can lose sight of their rights as an individual as part of being institutionalised. They start to put the nurses before themselves and try to do what they think the nurses find easier. Maybe it’s in some way like a prisoner trying to please their captors. And who wants to be unpopular with the people you depend on!

Ward and nursing home routines can rob the individual patient of their autonomy. However, nurses can try and find flexibility where they can to allow and encourage the patient to be an individual. If a patient likes to stay up late watching TV, nurses can position and settle them later rather than doing so just because the clock says that it is time.

Patients who have previously been independent do find it hard to accept that they need assistance and have to ask for help. Reassurance from nurses, that the assistance they offer is their job and that the patient is entitled to it, will need to be offered regularly. Nurse can help patients find their way by treating every patient differently because let’s face it, they are.

Readers' comments (24)

Anonymous | 6-Aug-2012 11:02 am
patient/residents often feel when they enter an establishment they surrender their"right " to autonomy" rubbish!I agree with the article
As nurses we should empower them so chioces can be made. I know it is often busy on hospital wards.
i also acknowledge that nurses on thesewards also try to help their patients as much as humanly possible
However many times in the course of the time I have worked within the care home sector I have found continence "management " is through the use of a catheter.As the article states try and spend some time with your clients.People are individuals and not a condition!
Unsuitable or offensive?
Juggling Dog | 6-Aug-2012 11:21 am
I agree entirely with Kathryn, and she explained this very well.
Unsuitable or offensive?
Anonymous | 6-Aug-2012 3:27 pm
Yes, very true I've come across a lady in her 80's on the ward who actually limited her water intake as she didnt want to bother us nurses with the requests of the commode!! Obviously I educated the lady on her need for fluids and the fact she was no bother at all - as we want a good urine output. Very said when patients worry about our workload than their own selves, obviously we came into nursing well aware & prepared to deal with feacal/urine output & incontinence.
Unsuitable or offensive?
Anonymous | 6-Aug-2012 5:26 pm
Im not writing anymore posts as i dont want to bother those who have to read them!
Unsuitable or offensive?
Anonymous | 6-Aug-2012 5:41 pm
So will it be okay when I am admitted to hospital next month for me to get up and go to bed when I want, watch tv or use my laptop as long as I want without using headphones as they make my ears itch, take my tablets when I want, eat and drink when I want and have as many visitors as I want?

Also, if I am bored can I go out for a couple of hours with my visitors?
Unsuitable or offensive?
Anonymous | 6-Aug-2012 6:53 pm
5.41 pm

that's right! be assertive about your own personal needs, put them before all else, remind everybody that you are an individual and wish to maintain your personal autonomy and you will be fine! Best of luck.

I think most nurses are aware of treating their patients as individuals, with respect, with empathy and with unconditional positive regard! N'est pas?
Unsuitable or offensive?
Phillipe Cook | 8-Aug-2012 7:17 pm
This is all very well .... all very humanitarian ..... ticks all the empowerment boxes which wicked, lazy nurses and carers will be tempted to infringe. Staying up late and watching TV at all hours is one thing but hoisting a client to the commode every 15 minutes? What level of staffing exists in this marvellous ward/care home where nurse and carers are standing by to instantly respond to the needs of individual clients without regard to either the rights of other clients or the practicalities of doing so??
Unsuitable or offensive?
Anonymous | 8-Aug-2012 8:00 pm
the million dollar question!
Unsuitable or offensive?
Anonymous | 8-Aug-2012 9:56 pm
I think there has to be promotion of the individual within the limits of the community,like any functioning society. A ward or care home is just a microcosm of society as a whole and there has to be some acceptance of the need to confornto the overall needs of the community.
Unsuitable or offensive?
Jane | 9-Aug-2012 8:54 am
Phillipe, would you like to pee in a pad when you could use a commode or toilet with assistance?
I understand from working on wards that numbers of nurses on duty is an issue and also time. It is down to you to put incident forms in if you are not able to assist someone to the toilet because of time and nursing numbers.
Unsuitable or offensive?
Anonymous | 9-Aug-2012 9:09 am
homes are supposed to be an extension of one's own home where one might have spent a whole life. the only difference should be that there are the added benefits of care, services and community living for those no longer able to live on their own. however, residents should be able to continue to live with the same dignity and right to respect they previously enjoyed and with some limited adaptation which staff must make as easy as possible for them. they should not be expected to alter their own life's habits unless this is of some benefit to them.
Unsuitable or offensive?
Anonymous | 9-Aug-2012 10:56 am
Dear Kathryn, your article says that this woman knew 'at least half the time when she needed the toilet'. Does that mean she didn't always know and in that case was it so bad that she wore a conti pad? What was the alternative, should she have been put on at set times of the day in case she wants to use it and how often should she have been offered the commode.

How would you have dealt with this situation yourself.
Unsuitable or offensive?
Anonymous | 9-Aug-2012 11:48 am
10.56 am

potty* training! for those who do not understand the needs of the elderly that is!
by definition (see below) this could be highly motivating and very beneficial for all concerned.

*from the Oxford English Dictionary

"potty1
n adjective (pottier, pottiest) informal, chiefly British
1 foolish; crazy.
2 extremely enthusiastic about someone or something.

DERIVATIVES
pottiness noun

ORIGIN
C19: of unknown origin."

potty 2, in my view needs no further clarification!
Unsuitable or offensive?
Anonymous | 9-Aug-2012 4:21 pm
Do we know;

- why she needed to be hoisted
- was she independent prior to being in hospital
- did she have bladder or bowel problems
- if so, had they been investigated, if so...
- had she seen a continence specialist and ...
- did she have a continence care-plan
- did you offer the staff an opportunity to give their side of this story
- where did this happen - hospital or care-home?
- has this been discussed with the manager and any changes (if necessary) made

without the above it is a rather simplistic and unbalanced article
Unsuitable or offensive?
Anonymous | 9-Aug-2012 5:40 pm
Do we have any evidence that this discussion even took place between Kathryn and this 'elderly woman'? Why is it important to have stressed that this was an elderly woman?

Unsuitable or offensive?
Anonymous | 10-Aug-2012 3:21 pm
Incontinence pads are there for a reason. Does it matter whether it is easier for the nurses or not? There is a huge hype over which pad you should use, for whom, and for what purpose? This is all about commercial gain. As long as the person feels fine about it, it is not for us, as nurses, to get omnipotent about it all.
Unsuitable or offensive?
Anonymous | 11-Aug-2012 6:36 pm
I am a district nurse working in the community and patients have been discharged home with a referral for supply of pads not for continence assessment with no reasons for the request. I sometimes phoned the ward to inquire and I have been told that catheter was instituted due to procedure. During assessment some of the patients were continent prior to admission and that they were given pads because the nurses are too busy to help them to the toilet especially at night according to some of them.patients..
Unsuitable or offensive?
Anonymous | 11-Aug-2012 9:19 pm
so patients go into hospital for care and nurses tell them they haven't time for them. the carry out invasive procedures for their own benefit and not for that of the patient. they probably don't even know or understand the risks involved in the procedures which are normally only carried out if required and there is no other suitable clinical alternative! is this what people undergo intensive nurse training for?
Hello, is this nursing care?
Unsuitable or offensive?
Anonymous | 12-Aug-2012 4:03 pm
When are we going to stop 'putting patients right' and 'educating' patients.
How dare we be so disparaging.
One day we might become person-centred, but personally I doubt it. How sad!!
Unsuitable or offensive?
Anonymous | 12-Aug-2012 4:25 pm
more appropriate if patients 'put nurses straight' sometimes. I agree with the above this is totally disrespectful, but knowing what NT do with their headlines it probably has nothing to do with the writer or content of the article.

NT should leave the original titles submitted by the author which are usually more relevant to the content of the article, appropriate and honest but of course they may not be as eye catching to get readers' attention. but at least then readers would be presented with subjects that really interested them. after all we wish to read informative material related to our profession and not comic- or newspaper style material.
Unsuitable or offensive?