Offering the Bedpan

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity.

There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

  1. Gather your supplies.
    • Gloves
    • Appropriate bedpan
    • Toilet tissue or disposable wet wipes
    • Clean bedding (if needed)
  2. Provide the resident with privacy by closing the door or curtain.
  3. Don gloves.
  4. Raise the bed to a comfortable working height.
  5. The resident should be lying on their back (supine).
  6. Remove the top bedding to provide access.
  7. If the resident can help with the process:
    • Raise the bed to Semi-Fowler’s position.
    • Have the resident flex their knees and keep their feet flat on the bed.
    • The resident should then raise their hips.
    • Slide the bedpan under the resident’s bottom. The trough of the bedpan should be toward the foot of the bed. Do not force the bedpan into place.
    • Have the resident lower their bottom onto the pan.
  8. If the resident is immobile or cannot help with the process:
    • Help the resident roll to face away from you. This may require logrolling the resident.
    • Place the bedpan against the resident’s bottom and hold it in place as you help the resident back to a supine position. Again, the trough of the bedpan should be toward the foot of the bed.
  9. Raise the head of the bed to the degree the resident can tolerate.
  10. Lower the bed back to the lowest position and step away to give the resident privacy.
    • It is VERY important to keep the amount of time a resident is on a bedpan to the shortest time possible. The edges of the pan can quickly create pressure wounds.
  11. If you leave the room, remove gloves and perform hand hygiene.
  12. To remove the bedpan:
    • Raise the bed to a comfortable working height.
    • Help the resident clean themselves with toilet tissue or wet wipes. Female residents should always be wiped front to back.
    • If the resident can help, have them lift their bottom as they did when getting on the bedpan. Be sure to have at least one hand on the bedpan to prevent spilling. Slide the bedpan from under the resident.
    • If the resident cannot help, lower the head of the bed. Help the resident roll to face away from you. This may require logrolling the resident. Be sure to have at least one hand on the bedpan to prevent spilling. Slide the bedpan from under the resident.
    • Help the resident back to a comfortable position and perform hand hygiene.
  13. Change the resident’s linens if they have become soiled.
  14. Lower the bed back to lowest position.
  15. Note the type and quantity of waste in the bedpan. Dispose of the waste in the toilet and clean or dispose of the bedpan per institutional policy.
  16. Remove gloves and Perform hand hygiene.
  17. Document the procedure and waste per institutional policy. Report any difficulties or change in elimination pattern (ex. diarrhea or blood-tinged urine) to the nurse per unit policy.

References

Bowel elimination and gastric intubation. (2014). In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 844-848). St. Louis, MO: Mosby Elsevier.

More Resources

Logrolling the Resident

Logrolling is a technique used to roll a resident onto their side without the resident helping, and while keeping the resident’s spine in a straight line. This is especially important for residents who have had spinal surgery or injury.

Feeding the Patient

Not all patients will need help feeding themselves. Some patients will only need assistance opening cartons or cutting their food. To promote independence, always let the patient do as much as he or she can before assisting. It is vitally important that the nurse’s aide verifies that the patient receives the correct meal tray. Patients may have special diets that play a critical role in their health (i.e., pureed diet, gluten-free diet, food allergies, etc.). Feeding the wrong food to the wrong patient could result in serious complications.

Perineal Care of the Male Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis.

Measuring and Recording Output from a Urinary Drainage Bag

Accurate measurement of urination (aka, the output portion of intake and output) allows medical personnel to assess kidney and bladder function. Changes in output quantity or quality can reflect health status changes including new-onset infection or renal injury.

Nail Care (Fingers and Toes) for CNAs

Nail care of both the feet and the hands should be performed as part of the patient’s daily hygiene routine. The status of the patient’s nails can reflect their overall health. Nail issues can also lead to infection that can spread systemically (ex, ingrown nails or fungus). You should never clip a patient’s nails with nail clippers, and always review your institution’s policy about what nail care is allowed.

Using a Gait / Transfer Belt to Assist the Resident to Ambulate

Walking (aka, ambulating) helps residents maintain mobility and independence, and prevents complications. However, ambulation must be done safely so that the resident does not have a fall or injury. A gait or transfer belt, when properly used, can increase resident safety. Gait belts can vary between facilities, so make sure you know how to use the one in your facility.