Patients not being helped to use toilet in hospital

[rammakken]

There's a BBC story today that is specifically about the indignities suffered by dementia patients not being helped to use the toilet in hospital, but I think it's likely to be a much wider problem. My mum was in hospital, in the terminal stages of leukemia, unable to walk, and was also not being helped to use the toilet, or commode. She was being pumped full of potassium fluid, which made her bladder fill more quickly. She wasn't incontinent, but was told by the nurses to pee into continence pads which quickly filled up, and often tore and leaked. A horrible, undignified experience for her, and no doubt many others with mobility issues who are treated the same way. She eventually asked for a catheter to be fitted, knowing the infection risk, and it contributed to her decision to end her chemo treatment at the same time, so she could be tranferred away from the undignified hospital ward to a hospice, where she died 2 weeks later.

Aibu to think that helping continent patients to use a commode or toilet is a basic requirement that should be met by hospital staff?

Its a huge problem. Older people are being routinely catheterised because the wards don't have sufficient staff and falls are increasing for all age groups as they try to get to the toilet themselves. My dad ended up with a permanent catheter after being admitted with pneumonia. He was continent all fine on admission but is physically disabled. 10 years on, it was left way too long and they were unable to reverse it and he has blockages and constant UTI. The whole thing is a disgrace

I work as,a nurse in an elderly ward and we don't have any issues like that here. We all assist patients to the toilet regularly if they're unable to ask, we just wouldn't tolerate people thinking incontinence pads are just there to pee in.

I think it's a problem mostly across the board.

Our hospital had an independently commissioned report about 5 or 6 years ago. The 10 recommendations were along exactly those lines: make sure patients are helped to the toilet, make sure they are fed, make sure they are hydrated and have water available, etc.

I really despaired that it took an independent report to tell us to make sure our patients got food and had a drink 🤦🏻

As a nurse I agree with previous poster, this does not happen on my ward and I have not met a HCP that thinks that's acceptable. I have however, raised this issue many times at work in relation to staffing levels, whereby patients are incontinent because we cannot get them to the toilet on time as not enough staff to do this.This is very undignified and one of the reasons I am looking to leave.

Have not seen the documentary but if this is accepted practice it is appalling.

I'm a healthcare assistant and spend lots of time helping people to the toilet whether it be commode, bedpan or proper toilet depending on their condition and mobility.
Promoting continence is very important.

My mum broke her arm on an orthopaedic ward after a hip replacement, she was told to use the frame to go to the loo, she lost her footing and broke both bones in her forearm. I was beyond angry at the time!!

I clicked YABU, because it's due to lack of staff. If every ward was properly staffed on all shifts and there were healthcare assistants available to take every person to the toilet every time and help them to drink enough and to eat their food, etc, then British hospitals would be a far better place for everyone. But they aren't and railing about this single issue is like saying 'someone needs to stick their finger in this leaking dam'. The whole health service is on its knees and there simply aren't enough doctors, nurses, midwives, healthcare assistants, radiographers, physios, mental health professionals, you name it.

The bottom line is that the UK hasn't trained enough HCPs and support staff for years. Pre-Brexit we were able to attract a decent number from the EU to paper over the cracks, but now it's hopeless and the Covid pandemic exacerbated it. In order to plug the gaps we need to train thousands of new people, which will take years. In all honesty, in the meantime we need the Indian model, where the family take it in turns to be with the person in hospital, feeding them, washing them, taking them to the loo, etc and doing all the personal care, because there aren't enough staff in hospitals to do that.

It's a staffing issue - there just isn't enough staff to go around, I work on a ward and quite often on a 13 hour shift there will be 1 HCA to 30 patients and I literally cannot split myself into enough parts to get to all the patients when needed, do the obs before they turn red, I hate it as much as the patients and their relatives which is why this week is my last and I am leaving.
Unfortunately toileting can come below observations on a critically ill patient - we don't get more staff even if they need obs every 30 mins, or we have 1-1, dying patients on their own - all need staff and there just isn't enough.
oh and when by some miracle we do have enough staff someone will be moved to another ward to plug a gap there so I literally cannot remember the last time I worked a shift fully staffed.

It’s staff shortages, there literally aren’t enough of them, either qualified or support workers. It will only get worse.
Don’t vote Tory is the only advice I can give.

My dad was on a neurology ward to have a PEG fitted. He couldn't move at all without help, also couldn't speak so very vulnerable. He was left for hours after ringing his call bell, and spent much of his stay in great discomfort (and hungry and thirsty as his food and drink was left on the far side of the room where he couldn't reach it - he basically didn't eat for 2 days). It is unfortunately very common (and not new - I remember my grandmother going through a similar ordeal 20 years ago). He was clear after that that he would rather die due to lack of medical care than risk going back into hospital again. My mum (who was only allowed reduced visits due to covid) was so traumatised by what she saw that she has now drawn up a DNR refusing medical intervention except in some circumstances as she is afraid of being left alone and without dignity like my dad was and says she would rather die.

So YANBU.

Sorry I don't always agree it's a lack of staffing. I'm afraid in many circumstances the patients needs come last, it is all set up for the convenience of the staff.I was on the ward for 6 days after giving birth because of infection (probably hospital acquired according to my GP) and some of the practices were extremely poor.

It shouldn't happen. I think the staffing issues have just helped to normalise it, making it easier for staff to get away with it. The fact that anyone would click AIBU "because it is due to staffing" demonstates that perfectly. The staffing issues may be unreasonable, but I am not being unreasonable.

It's not something we practice on my ward. But it's something I hear some of our bank/agency staff say sometimes (and obviously immediately re-educated). As someone else said, if we thought patients weren't going to the loo be abuse of the pads we'd be having a strong word with them.

I've also never known someone have a catheter inserted just for staff ease.

When I was in hospital there were a few support staff who were fabulous at helping patients to the toilets, making drinks,help with feeding and doing basic observations.
This was back in 2015 though.
It freed up nurses time, shame we haven't got more of these support staff is that because of money? Or there isn't enough people that would want to to do this job?

Not talking about continence experiences specifically but there was a distinct sense that patients were being troublesome to staff by not staying in their beds all day, asking for help, ringing their buzzers, wanting privacy.

I had a cannula fitted as I'd needed IV antibiotics and had an awful allergic reaction to the dressing and it took staff over two days to listen to me and get someone to remove it by which point my arm was horrific. The lady in the next cubicle to me begged for pain relief for 12-24 hours - staff didn't believe she was in labour and then there was a sudden realisation that the baby was almost there and all hell broke loose. There's more but I find it very difficult to talk about because the lack of care was pretty appalling

@Fml1980

It's a few different reasons. They're highly skilled HCAs and need a lot of training to do the job. The pay often works out less than a job at your local supermarket and can be backbreaking over a long 13 hour day.

In my experience it's not so much as there's wildly less HCAs. It's that since the new doctors contracts protecting the amount of hours a junior doctor can do, everyone had stepped up. So now nurses are doing what would have been seen more similar to the most junior of doctors 20 years ago, this means our HCAs are doing more nursing aspects of the job, which leaves a gap at the bottom. Add o this an aging population who have much more advanced needs than before simply because we're all living too long, and bucket loads more paperwork and it's easy to see why standards have dropped.

I agree with a PP. I saw wards definitely been run for the benefit of the staff. Awful behaviour from staff. A couple of HA’s were working on my Mum and talking in their own language. They didn’t see I had come in at the start of visiting time and Mum was asking what they were doing to her. They completely ignored her.

Yes the lack of staff in the NHS (it’s at crisis point), is unreadable. So direct your anger at their employer- this Government.

This is rarely the fault of the nurses there, but is the outcome of years of austerity and Tory cuts.

You can blame staffing and cuts all you like but this is not a new issue. When my dgf was in hospital over 25 years ago he lost a drastic amount of weight in 2 days, weight that he could ill afford to lose. We were told that the ‘busy’ hospital staff had no time to feed him (he had Alzheimer’s and Parkinson’s and was unable to feed himself so had to be spoon fed). There was a lovely African hca who was very kind to him and when she was on shift she patiently spoon fed him. She was the only one who gave a toss. My dm and her siblings had to insist that they be allowed on to the ward at mealtimes to ensure he ate as he was deteriorating rapidly. This was begrudgingly agreed to when legal action was threatened and they got him out of there as quickly as possible.

I’m no fan of the Conservatives but this is not a staffing issue, it’s a cultural issue. Lack of staff is no excuse for the shoddy treatment of elderly patients and anyone who thinks there is any excuse for not supporting elderly people to carry out this most basic of functions is an utter disgrace.