I was visiting my friend in the hospital and she had to pee. Walking to the bathroom was not an option: She’d been told not to get out of bed, she felt weak and lightheaded, and she was attached to an IV and a monitor.
She pressed the call button and stated her problem. A voice: They’d let her nurse know. A few minutes later, I stuck my head outside the curtain and scanned the empty hallway, feeling guilty that all I could do was share her frustration.
Then someone pulled open the curtain and smiled in at us. "I need the bedpan, we’ve already called twice," my friend said. The woman in scrubs, who turned out to be one of the doctors, said she’d take care of it. My friend and I sighed with relief.
But the doctor slipped back out. Taking care of it meant finding someone who knew how to do it. When she returned a couple of minutes later and saw that still nobody had showed up, the good doctor offered to do it herself. She fetched a bedpan and awkwardly slid the pink plastic container under my friend, the whole time apologizing that she didn’t know which end was up.
The current U.S. nursing shortage includes licensed practical nurses and certified nursing assistants, the people who usually manage bedpans. And so hospitalized patients feeling the urge to urinate may have to wait longer than is possible.
If you’re thinking this is a minor issue, think again: Holding one’s urine can set a patient up for a urinary tract infection; the physical discomfort can be a stress on an already sick body, driving up blood pressure and pulse; and waiting with a bursting bladder is a mental stress, too.
As a doctor myself, I was embarrassed that I didn’t know how to help. I didn’t learn bedpan basics in medical school.
The alternative isn’t any better: Consider the shame and discomfort of lying in cold, wet sheets until someone can change them, plus the serious health risks that include skin breakdown and infection. For patients who already have pressure sores, these complications can be life-threatening.
As a doctor myself, I was embarrassed that I didn’t know how to help. I didn’t learn bedpan basics in medical school, or at any other time during my training. I would guess that most doctors, like me, would rather volunteer to hunt for someone else to do this than just getting the job done.
No, it isn't rocket science to place a bedpan, but it’s easy to bumble by making a mess, leaving the patient in an uncomfortable position, exposing and embarrassing, and so on.
Doing it right involves quite a few logistical steps, including knowing when to wear gloves (and when not to), lowering the head of the bed, instructing the patient to lift her hips, or, if it’s a patient who is less mobile, helping her to roll onto her side (which may involve pulling the so-called pull-sheet under the patient, just so); slipping a disposable pad underneath; draping the sheet to maintain maximum privacy; leaving toilet paper and the call button within reach; and, before leaving the room, remembering to raise the head of the bed, because it’s not easy to do one’s business flat on one’s back. (See the video below for illustrations.)
To be sure, medical students and residents have enough on their plates. If they learn how to do this, one might argue, what’s next? Changing sheets, bathing patients?
To be sure, medical students and residents have enough on their plates. If they learn how to do this, one might argue, what’s next? Changing sheets, bathing patients? Time-consuming lessons in the art of moving patients safely?
In many instances, though, helping a patient wiggle onto a bedpan is a pretty straightforward task, and medical school — perhaps during the very first hospital-based experiences — is the place to teach it. This is when medical students are eager to get hands-on experience, when having a task to accomplish is exciting and can make them feel worthy and useful.
Imagine the ripple effect, as these students advance to residency and beyond. Being willing to occasionally wedge a bedpan under a patient’s behind might show, perhaps more than anything else, that they are truly there for the patient. (Even if the next step involves finding a nursing assistant to remove the bedpan and help clean things up.)
I am not suggesting that assisting patients with bedpans should become a regular and expected duty of hospital doctors (or medical students). But in those cases — like with my friend — when a doctor (or medical student) happens to be in the room, and there’s nobody else around, the expectation should be clear. We can wait for years for the nursing assistant shortages to be solved, but there are plenty of patients at this very moment who really need to go.
Anna Reisman, M.D., is an associate professor at Yale School of Medicine and a Public Voices Fellow with The OpEd Project. The video below explains bedpan procedures.