Anna, the charge nurse, met with Hattie to discuss her incontinence. Hattie said she sometimes just can’t get to the bathroom in time. She said she can feel when she has to go, but sometimes she has to wait too long for staff to help her and has an “accident.” Anna assured her the team would try to figure out a solution. Anna then met with Hattie’s nursing assistant, Sherry, and the other assistant on that neighborhood. They said they wait for Hattie to call for the bathroom and they rarely offer assistance unless she asks.
Anna told me that the voiding diary was finally completed after a few false starts. Hattie’s assessment shows that to stay continent, she needs to be taken to the bathroom every 90 minutes during the day. So, the night shift checks on her beginning at 6:00 am until she wakes up and then gets her to the bathroom right away. They help her to the bathroom again right after breakfast, before 10 am activities, before lunch, before therapy, before afternoon activities and after her 3:30 pm cup of tea, before supper, before evening activities and before bedtime. Hattie doesn’t want us to wake her up at night for now. She’s agreed to try this schedule for three days and then meet with Anna and Sherry to review it. Anna’s going to give Carol, Hattie’s daughter, a call to tell her what’s going on. Hattie thought that’d be a good idea. She told Anna that Carol worries too much about her. Anna told her that everyone wants Hattie to be comfortable and dry. Hattie smiled and thanked Anna. Anna promised to check in with her and I know she will.
What systems can we use to assure bladder assessments are done? How can I get staff to individualize care versus putting people in adult briefs or taking them to the bathroom every two hours?