On my cardio placement, as I have previously mentioned I was on a cardiothoracic ward. However, as there are limited numbers of heart surgery patients, some of my patients are general medical, ortho and gero patients.
This particular elderly patient had been a inpatient to have a pacing wire corrected or inserted. It is a fast procedure usually normally discharged within one to two days. As this patient has been deteriorated over the past a few days. I had been asked to treat him. His treatment involved ambulation with WZF, UL and LL strengthening exercises and as well as balance exercises.
On the first day of seeing this patient, he was sitting in the chair. However as I approached him I noticed that his pants was quite wet. I did not notice any continence issue in the medical notes. As I stood him up, it became obvious that his pad were quite saturated. I informed the nurse who happened to be in the room at that time. So she changed the pad as I stood him up again.
On a later day, I went to see him as usual in the morning. He was still lying on bed waiting for a shower. So I asked him to do some exercises in standing while waiting for nurse to prepare for his shower and would later walk to the shower. He agreed pretty pleasantly. So he got out of bed with some assistance. As soon as he was in standing, he said he needed to go toilet. So I asked him if he can make it to the toilet which he replied that he needed to go at once. I didn’t worry too much as he had a pad on at that time. His nurse was in the same room helping another patient, she replied she’ll help as soon as she finishes. My patient was still standing holding onto frames, then his pants and pads fell off completely as the pads fully saturated. Luckily I had curtain drawn around when I went to see him. As I was about to pull his pads and pants back up, he started peeing on the floor. I totally blanked out, it was first time something like this happened to me. I didn’t not what I should do, if I should sit the patient back on the bed or not. His nurse quickly rushed in and put him on a shower chair and quickly wiped the floor.
Later on discharge his continence had appeared to be an important factor on returning home with his wife.
I felt very embarrassed at this, and must have embarrassed my patient too at the same time. My supervisor was in the same room treating another patient at the same time. Later she comforted me saying it happens frequently in gero.
For patients with possibly severe incontinence, I should have checked if there’s a need to go toilet as a priority and prepare for accidents like above situation, for example have a spare pad nearby.
Has anyone had similar experiences and any suggestions on preventing accidents like this?
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hey yeah i've had similar things happen to me too. i think the best course of action is to try and pretend that its nothing and that it happens all the time, and dont act embarrased. remember that whatever level of embarrassement that we feel is probably multiplied by 10 for the patient that its happening to. it can be pretty hard to do sometimes though, especially when the situation is actually really unpleasant like the one you experienced. thats about all i can offer..
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