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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

to ask if this is normal elder care practice in hospitals?

55 replies

bringincrazyback · 06/06/2019 12:03

So my father is seriously ill in hospital and receiving enemas as part of his condition. Ward is seriously short-staffed and I can see they're genuinely doing their best and working tremendously hard, but AIBU to ask if anyone knows whether it is standard practice after an enema to leave a patient in bed with a pad under them, which they are then expected to soil and then be cleaned up by staff afterwards? (He's heavy and hard to lift on to a commode, but this has been managed by the staff on previous days when he's received enemas, albeit it's taken two people.) This happened to my father today and the staff didn't seem to understand why he was upset by it (he doesn't have any dementia and is normally in full control of his toilet needs).

I'd rather not give any more context in case I out myself if anyone involved is on MN, as my beef isn't necessarily with the ward or hospital, who have done a great deal to help us. My beef is that the system seems to have come to consider this an acceptable way to manage someone's toileting needs. My family was left feeling very upset by this today (and, on my father's part, humiliated). It's left me wondering how normal a practice this is, because if this is really what the neglect of the NHS has done to the service, I think those up top who have been systematically trying to starve the NHS out of existence should hang their heads in shame.

Just needed to vent and wondered if anyone else had been through same, either themselves or with a relative.

OP posts:
TantricTwist · 06/06/2019 12:06

Yes it is normal practice.

Moneybegreen · 06/06/2019 12:06

Is there always 2 staff members available that are strong enough to lift him? It may depend on who is working.

KinkyHair · 06/06/2019 12:08

Yes normal practice where I work.

TantricTwist · 06/06/2019 12:09

It's normal practice because there will be leakage after the enema of which he will not have full control of as he would having a normal bowel movement.

The staff do not want him to soil the sheets because its more disruptive to your father as well as unpleasant.

It is far more pleasant that he soils the pad which is easily removed.

bringincrazyback · 06/06/2019 12:10

Is there always 2 staff members available that are strong enough to lift him? It may depend on who is working.

That was the limitation the ward seemed to be under yesterday. I just find it really shocking that this is considered normal, and feel that if that is going to happen they should at least warn the patient what to expect, he thought he was going to be helped on to the commode as this is what has happened on previous days.

OP posts:
ElphabaTheGreen · 06/06/2019 12:11

After an enema, it can come out fairly uncontrollably so, yes, they do need to be left on a pad. The act of getting up may result in an even more embarrassing situation for your dad where he goes on the floor mid-transfer to commode.

He shouldn’t be having lots of enemas, though. Is he sitting out of bed as much as he can? (He’ll often need to ask for this as it is often easier for staff just to leave patients in bed, but it’s murder on the bowels). Is he drinking a lot? Is he picking the high fibre options on the menu? Is he on regular laxatives?

bringincrazyback · 06/06/2019 12:12

The staff do not want him to soil the sheets because its more disruptive to your father as well as unpleasant.

I understand that, but they don't seem to have explained the practice to my father, so he got distressed, especially as he hadn't been made aware of the pad and thought he was soiling the sheets. So I'm as upset about the lack of explanation as anything else.

OP posts:
OldAndWornOut · 06/06/2019 12:12

It shouldn't be normal practice, as far as I'm aware, but could be down to staffing.
The best way to find out is to ask one of the staff.

Crapplepie · 06/06/2019 12:13

It can be, depending on the needs of the patient. What concerns me is that staff are lifting him? If he's unable to move himself, staff should be using a hoist, in order to maintain his safety and dignity. It also ensures staff are less likely to suffer workplace injury.
As, per your OP, he is a heavier gentleman, he should have been risk assessed, a moving and handling plan put in place, and adhered to.
HTH. Sorry your Pop is in hospital, hope he recovers well Flowers

TantricTwist · 06/06/2019 12:16

OP you should trust that trained staff know what they are doing.

This is a hospital and how things are done.

Patients toileting needs are dealt with in these ways in hospital if required.
Otherwise in the case of your father he would have shit all down his legs, bed, floor etc whilst they were wasting their time trying hoist him unneccessarily to a commode, which I assure you would be far more humiliating for him don't you agree.
Have you even through this through before writing your nasty condeming post.

bringincrazyback · 06/06/2019 12:17

@ElphabaTheGreen I get what you're saying re 'going' en route to the commode. These are the sorts of things I wish could have been explained to us somehow, though the staff were rushed off their feet and I realise they had other patients to see to.

Re your questions, all the answers are yeses, pretty much. The daily enemas were recommended by a doctor in the run-up to getting him ready for palliative discharge home which is happening soon, I think they are trying to get him as fit for discharge as his condition will allow him to be. He is finding the enemas deeply unpleasant, but then I guess anyone would really. :-(

OP posts:
Annabk · 06/06/2019 12:19

TantricTwist you are being a little harsh on the OP.

Hope your dad is on the mend soon Flowers

Namechangeforthiscancershit · 06/06/2019 12:20

Enemas are pretty bad. I've only had two days and I'm not a fan. It is all quite unpredictable. I was well enough to be in a bathroom luckily but you still have that worry of should I move, am I done...

I hope you father is home soon

bringincrazyback · 06/06/2019 12:21

OP you should trust that trained staff know what they are doing.
This is a hospital and how things are done.
Patients toileting needs are dealt with in these ways in hospital if required.
Otherwise in the case of your father he would have shit all down his legs, bed, floor etc whilst they were wasting their time trying hoist him unneccessarily to a commode, which I assure you would be far more humiliating for him don't you agree.
Have you even through this through before writing your nasty condeming post.

Have you ever thought about the fact that these are human beings the hospital is dealing with, and that they are entitled to some human dignity, before writing your nasty condemning response?
Also, if you'd bothered to weigh up my words properly, you'd see that I'm blaming the system not the ward. Unless you're personally in charge of the NHS I don't see the need for such a knee-jerk response.

OP posts:
jacksonmaine · 06/06/2019 12:21

Sounds OK to me OP but yes there should have been better communication maybe.

Also how do you describe this situation adequately to a patient?

NoBaggyPants · 06/06/2019 12:22

OP you should trust that trained staff know what they are doing.

No, you should absolutely question if you're not sure that something is being done safely, respectfully and in the best interests of the patient. Any decent healthcare professional will have no qualms in answering such a question.

The OP has not been nasty in any way. The only people she has condemned are the government that have decimated the NHS due to continued funding cuts.

LoafofSellotape · 06/06/2019 12:23

Have you even through this through before writing your nasty condeming post

It was an enquiry. The OP is worried about her dad. It's hardly dignified is it if no one has explained to him what was going on?

Ime good nurses are few and far between,there are some great ones but my God there are some I wouldn't trust them with a pet let alone a member of my family.

The OP has every right to question something that is upsetting her father.

ElphabaTheGreen · 06/06/2019 12:26

Jesus, TantricTwist - wind your neck in. I hope you feel especially big now that she’s said her dad is palliative Hmm

OP - I completely take your point about the poor communication. I don’t know if it’s necessarily being too busy, but when you’ve worked in a hospital for a bajillion years like me you start to assume things are obvious and don’t need explanation. Being a bit leaky after an enema does seem obvious to me, but I’m around it all day every day - this is something most people never have to deal with.

Just politely let the staff know that it would have been helpful to have been forewarned of the process so they know in future and don’t make the same assumptions. I would also question the multiple enemas as well. If he has one good movement, he shouldn’t need more, especially as affecting his dignity and quality of life at a time when this is so crucial. A decent laxative regime is so much more dignified than enemas, better for the bowels and effective.

NoBaggyPants · 06/06/2019 12:27

I've only had an enema once, they put a mat down and said that it was just for any accidents, if I felt I could get to the loo then to shout but if not and an accident should happen don't worry at all.

That bit of reassurance saved any embarrassment later, and let me know everything was normal and I wasn't going to be left to lie in my own shit.

Cornettoninja · 06/06/2019 12:28

Hang on @tantrictwist, anyone unfamiliar with healthcare settings can find things strange, unnerving and on occasion mortifying. Just because hcp’s see this kind of thing day in day out doesn’t mean that their patients have ever come across it before.

The OP is perfectly within her rights to question her fathers care and as shown in this thread she’s got her answer. She doesn’t have to like it but it’s there. As it happens she’s highlighted an issue with the staff on that particular ward not communicating effectively with the patient.

We live in an age we are encouraged to question the people responsible for us when we’re vulnerable. It’s worrying and frankly slightly embarrassing you need this explaining to you.

caringdenise009 · 06/06/2019 12:29

Staff should not be lifting patients even if they are strong enough. There are proper procedures and equipment for manual handling and if you see a patient being lifted without them you should raise your concerns with someone senior. The staff should have fully explained what was going to happen before they started the enema.

Italiandreams · 06/06/2019 12:36

I agree, a little communication and empathy goes along way. Just before my Grandad died his body failed him in many ways but he was still mentally completely capable. He was a proud man who had been independent for 95 years, so incidents like this were mortifying for him at the best of times. At least if things are explained your father would know what to expect. Tantric Twist what a breathtaking lack of empathy you show.

TantricTwist · 06/06/2019 12:36

OP should have politely asked the staff on the ward to explain their actions before castigating them and the NHS on MN.

ineedaknittedhat · 06/06/2019 12:37

This is normal, yes. It may appear to be unpleasant, but the person has to be left on their side whilst the enema takes effect. The pad is placed there to catch any leakage and accidents. The person is then helped onto the commode or loo once things start to happen.

Unfortunately, the body's natural actions aren't pleasant when someone is unable to attend to their own care.

Cornettoninja · 06/06/2019 12:38

Get a grip TT

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