1-16. URINAL AND BEDPAN ASSISTANCE
a. General. Although bed patients realize the necessity of eliminating body wastes, they sometimes feel embarrassed when the need arises to ask for and use a urinal or bedpan. Medical personnel should reduce the unpleasant aspects as much as possible and assist the patient to maintain proper elimination with the least exertion. The urinal or bedpan is provided promptly anytime one is requested. In addition, bed patients are usually offered one before meals and before visiting hours. After each use, the patient and medical personnel must wash their hands.
b. Use of Urinal. Following are the proper procedures for handling a urinal for a male patient (figure 1-15).
Figure 1-15. Urinals.
(1) Raise or level the bed as necessary. For example, some patients may desire to have the head of the bed raised. Others may require the knee part of the bed to be lowered or level.
(2) Bring the urinal to the patient inserted in a paper cover. Screen the patient and give the urinal directly to him, placing the cover on the seat of the chair.
(3) Assist the patient as needed; for example, adjust his pajama trousers or position the urinal. Instruct the patient to signal when finished. Be sure that he understands that he must never place the urinal on his bedside cabinet. This is for esthetics and sanitary reasons.
(4) On signal, return promptly, bringing a basin of warm water. Remove the urinal from the bed. Assist the patient to wash his hands.
(5) Note the color and amount of urine before discarding it. If an output record is kept, measure and record the amount and time voided on DD Form 792, Intake and Output Worksheet. If the appearance of the urine seems abnormal, save a specimen for the doctor to observe.
(6) Follow the routine procedure for cleansing and storing the urinal.
c. Use of Bedpan. Following is the proper procedure for handling a bedpan for either a male or female patient (figure 1-16).
Figure 1-16. Bedpan.
(1) Bring the patient a warmed bedpan inserted in paper cover, rinsed in hot water, and dried.
(2) Provide privacy.
(3) Place the covered pan on the chair seat and prepare to assist the patient as necessary. Lift the bed cover; remove any supporting pillows; and lower the knee rail. Pull the pajama jacket above the waist, and the pants to below the knees. Tell the patient to bend his knees, press his heels against the bed, and raise hips. Slip one hand under his back, and place the pan under the buttocks. Ask for assistance if the patient is heavy and unable to assist in lifting. If the patient cannot raise his buttocks, roll him to the near side of the bed, place the pan under his buttocks, and then roll him back on the pan. Check his position on the pan.
(4) Elevate the head of the bed. Place toilet paper and signal cord within patient's reach, and leave patient alone unless there is a requirement for constant attention.
(5) When the patient is through, answer his signal promptly, bring a basin of warm water. When removing the pan, support the patient in the same way as when the pan was being placed. If the patient is unable to cleanse himself, turn him on his side off the pan and cleanse him with paper. If necessary, wash the anal area with soap and warm water; dry thoroughly.
(6) Place covered pan on chair. Readjust pajamas, bedding, and patient's position. Remove the screen. Air the area by opening a window, if possible.