Situation: When you have to "clean up" the patient of stool.
What people think: You wipe their butt . It takes two seconds.
What the caregiver ACTUALLY does:
- gowns and gloves up to practice good infection control
- takes out all pillows so that you are able to roll patient
- rolls patient over to one side so that the butt is exposed
- wipes the butt MULTIPLE times with a dry cloth until poop is gone
- wipes butt with multiple damp soapy disposable washcloths to clean up what the dry cloths left behind
- dry off patient's butt thoroughly
- place all of the dirty cloths and toilet paper in the dirty chucks
- Roll up dirty chucks as far as patient's backside
- Change gloves from ones smeared with shit to clean gloves this is very important to protect both patient and caregiver and particularly caregiver. The caregiver is not used to whatever organism may be lurking in patient's poop,
- Apply medically prescribed ointment and powder to prevent skin breakdown
- Place clean chucks partially under patient for the next time
- Have patient roll back over to the other side
- PUll out dirty chucks while simultaneously pulling the other side of the clean chucks through the underside of the patient
- Throw out all dirty item including gloves in a covered wastebasket
- Wash hands
- wipe down bed with Clorox wipes
- Pull patient to one side or another to reposition patient in bed, making sure patient is centered
- Patient is paralyzed from waist down so cannot reposition self in bed the way healthy people can by simply shifting weight
- Pull patient up in bed
- lift legs and reposition 5 pillows under patient's legs so that heels "float" off the bed to avoid skin breakdown
- reposition one pillow next to patient to avoid patient rolling over to one side and ending up with head under tray
- reposition one pillow under head
- Wash hands again
- REPEAT steps 1-23 as often as patient poops in bed because patient can no longer distinguish when they are having a bowel movement due to paralyses
