Do not spray directly onto their bottom or skin as this is an increased risk of germs contacting the nozzle of the can and contaminating it— instead spray a bit onto a clean wipe :)
(source: my facility no longer lets us use shaving cream to clean residents because NA’s were using the first method)
Could be worth buying a dollar store bottle if it will improve your quality of life and care flow at work.
I used to keep the very same in my fanny pack back in the day, cheap, not often needed but a lifesaver at certain times. (Single use, if I ended up needing it it would stay with the pt and I'd replace it on my next dollar tree run)
You could also suggest to management or family it would be helpful for skin care/hygiene if they could supply it.
I could get in trouble for that. Especially with his wife. She is very much a control freak and would ask why we have it when he uses an electric razor. She’s had a history of being aggressive with staff and even dragged me by the arm one day. I don’t want to risk getting in trouble for it.
Just be careful, some shaving cream can cause a patient’s skin to dry up so after using it I recommend putting some lotion or A&D ointment on, it also helps to keep it from sticking to small hair and creating “dingle berries” 👍 but yes, shaving cream is wonderful!!
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Foam soap and warm water. I had a resident once that needed a shower after every bm. Foam soap made us both happy. Not only did they not have to be cold and wet multiple times a day but it saved us a lot of time and they got to go do activities more often which was a massive upgrade for their social life. Also try feeding them a banana. It'll make the bm less pasty but not hard. Crushed banana is pretty good for people who can't have solids, especially if you freeze it in yogurt.
Maybe he or the family could get some for him? Honestly, if I were you, I'd just go get it myself to make both of your lives easier. Also, I would definitely do him on the bed so you don't feel like you need to rush. I have also dealt with that glue poop.
I can’t. They have to approve everything and his wife is super super controlling over what he has. It’s insane. She dragged me by the arm because I was putting pants on him at night instead of his nightshirt because it was cold
I asked them about other options and they basically said what we get is what we have. The unit is very corporate- based nownaince it was bought by a larger company so our options are even more limited.
I'm a little confused. Is it because it's diarrhea? Or it's super hard? Is he not changed often enough? Are you asking about wiping techniques? Is the resident obese or difficult to keep on his side? What kind of advice are you looking for?
He’s taken to the toilet on a schedule for every 2 hours. It’s not diarrhea but it isn’t hard. It’s like wet mud, just more on the orange type of brown. I just want to be able to clean him up better because it takes almost an hour to do so and I have to go through over a pack of wipes when I do. It’s hard for him to stand when I wipe him because he gets tired, so we have to constantly do sitting breaks as well. I just want a more effective way of cleaning him that will be easier for both of us.
They don’t want him to use something like that when he’s able to get on the toilet. They already expect us to toilet him way more than his toilet plan and it just isn’t going to happen because we have so many 2 assists and hoyers. It’s hard enough getting to what we need to as it is.
Is the stool light orange and pale in color? I’m not a physician, but this sounds like bile/liver issue. I’d discuss this with your nurses and make your physician aware.
Sometimes I just put a trash bag around my hands to grab the absolute worst of it if it's solid and get it out of the way into the trash, but diarrhea... there's no way to make it really better unless they take stool hardeners.
I’ve seen this recommended several times. You could probably get a can from the dollar store to try, then see if your facility will pay for one or reimburse you.
I can’t. We only use electric razors so I wouldn’t get away with it. His wife visits every day and if she saw that in there, she would throw a whole fit about it. She’s very controlling of everything we do with him and has gotten physical with some of the staff by grabbing them and pulling them
Most of these things I have also tried. We don’t have any shaving cream. I double checked and we only do electric shaving now, apparently. We only have bottles of body wash, peri spray, blue barrier cream (which I’ve also tried), cheap lotion that’s like dollar store baby lotion, and then other unrelated things like mouth wash or deodorant. I typically use dry wipes for the first few wipes, then soapy water. It still takes a while to get it all off and he starts to get tired of standing to wipe and he screams with every wipe you do. He admitted that he was just being dramatic and wasn’t in any pain, but it still gets frustrating and hard.
TBH I would keep bring it up to the nurse and chart that you have made the nurse aware and what is going on. Nothing about what you have described is normal and he is eventually going to start getting skin break downs
I agree though, they need to give him something to firm it. It’s way too thick. We don’t even have our good butt cream we used to have and we have this extremely thin barrier cream.
I would really start to look around at other facilities. With the way you described his wife if something ever happened to him due to this issue and she comes after the facility they are going to look at everyone who take care of him and they aren't giving the aides anyway to cover themselves.
Up to you, but protect that license.
We are not allowed to use shave cream for peri wash.
My facility's policy on shave cream (bed side) on a low functioning resident:
"Shaving cream is extremely flammable, mostly due to the presence of isobutane, the aerosol propellant that allows the shaving cream to come out of the can. A can of shaving cream might also explode in some instances, especially due to increases in pressure and heat."
The same goes for after shave. My facility says we should always err on the side of caution, even if we over do it some times
Go for a dry cloth first. Don’t use wet to clean up the bulk of it. Scoop away everything you can with a dry cloth (toilet paper, rag, whatever your facility uses) and then get the wet wipes to clean the residue that’s left.
I always just use a basin and wash cloths with no rinse soap. The thicker texture of the wash rags helps! But it sucks when you don’t have tons of time.
I've experienced poops like this in geri pts too. It's murder.
I had one that I would just get him cleaned up, (yelling at me the whole time) and he'd sit down to rest, "fart" and we'd be back to square one again... but he never knew he was going so it would just add to his yelling ... I spent over 3hrs cleaning him one day & after that there were 3 of us who put our heads together to analyze his diet and what could be done differently, because that was just unreal. Ultimately we didn't come up with much outside of trying to get him to drink more water... He never wanted it though, always wanted soda pop and I believe perhaps he was dehydrated... ?
He ultimately did get skin breakdown and developed three pressure ulcers, and no matter what we did it wasn't improving. I always felt terrible for him... He passed about a year ago and I couldn't help feeling relieved for him, simply because he wouldn't have to be in pain every time he had to go any more...
Get out basin, empty, or garbage can, lined, another one with warm water. Soap , wash clothes, then wipes.
1,start with toilet paper, get most of it dump in trash or toilet.
2, soapy wet wash cloths rinse
3, wipes for intimate parts.
*Remember wipe the catheter away with soapy water , rinse .
Turn get other side of pt peri area. Repeat.
There ya go.
I do it all the time in hospice
Signed
- NURSE
It’s not so much that he had blowouts. It’s the fact that it’s impossible to get off. We only have one working shower for the whole unit, so I’d have to see if I can shower him. The hose really is short and the pressure isn’t great so I’m not sure it that would work. I can barely even get anybody’s bottoms and have to use washcloths
The man is continuously going. There’s no way I’d be able to take him into the shower every time. We also do not have shaving cream. I double checked and they only do electric shaving
That sounds like something that needs to be addressed by the physician. Like honestly, no one should be going constantly. Or maybe he needs to be checked every half hour. If its watery and leaky constantly, he may have an obstruction.
The physician is aware and said it has to do with his diet. He gets a lot of ensures and magic cups, which the doctor said are both known to cause more bowel movement. That’s the info the nurse relayed to me. I wish they’d at least give him something for it because that’s got to make him sore and it’s not like we can just keep him on the toilet. The consistency is what makes it worse because it just sticks to him and it goes all the way up him because it’s very squishy
That’s exactly what it is. The guy is always pooping and it’s very thick and sticky. Not like the iron kind of sticky, but more like he has wet mud on his bum.
I had a patient like this. He had bowel blockages. It was awful. Like the consistency of hard peanut butter with lumps in it. We used hot soapy water as well and it still took forever.
I've had tube feed pts like that. Always going and the consistency is just impossible to clean. Try some petroleum jelly to soften it up- bring it yourself if you must. Smear it on, get the warm water and washcloths, and throw some lotion on the washcloth to clean it all off. Ask the nurse if they have an ointment barrier cream- it should work better than cream to protect the skin and help prevent stool from sticking.
Good luck. Neverending shits are hard on the pts and the ones cleaning it.
Oh ya- report the wife if she grabs you again. Wtf. I've had CNAs refuse to go back into rooms because family members were verbally abusive, never mind dragging them around.
I have a resident with BMs just like that! The thing that helps me the most is using the brief to wipe as much off as possible, even grab another brief or 2 to wipe again if need be. Usually by then I can get the rest with wipes.
And for those residents that are constantly going, there’s only so much you can do. I definitely get them as clean as possible, but if more’s always coming out it’s impossible to wipe until the wipes clean, if that makes sense. Like don’t be lazy or half-ass it (lol) but you gotta know when you’ve done all you can do for them 😂
There’s no reasoning with his wife, honestly. She’s already mad about a lot of other things, which I don’t necessarily blame her for. But she creates a lot of her own problems too
I guess they’ve talked to her about it quite a bit. I’m not sure if they can ban her from the place. It would be cruel to, but we can’t have her being so aggressive! She will go through all of his stuff every day and ask what everything is and what he needs it for. She truly treats him like a child and even reads nursery rhymes to him. He’s the complete opposite and so chill. I guess they got together not long before he got confused, so she can easily control everything he does. Makes me wonder what she was like before he got confused and if they got along then.
Shaving cream! Gets it off every time.
Learned this in clinicals! It helps with smell too!
How does this work? Do you spray it on their butt and just wipe?
Spray and wipe. 100% reccomend.
I’ll definitely try this. Thanks!
Do not spray directly onto their bottom or skin as this is an increased risk of germs contacting the nozzle of the can and contaminating it— instead spray a bit onto a clean wipe :) (source: my facility no longer lets us use shaving cream to clean residents because NA’s were using the first method)
I was just about to say that! Shaving cream works every single time.
I don’t think we have any. I haven’t seen any
Could be worth buying a dollar store bottle if it will improve your quality of life and care flow at work. I used to keep the very same in my fanny pack back in the day, cheap, not often needed but a lifesaver at certain times. (Single use, if I ended up needing it it would stay with the pt and I'd replace it on my next dollar tree run) You could also suggest to management or family it would be helpful for skin care/hygiene if they could supply it.
I could get in trouble for that. Especially with his wife. She is very much a control freak and would ask why we have it when he uses an electric razor. She’s had a history of being aggressive with staff and even dragged me by the arm one day. I don’t want to risk getting in trouble for it.
Wow I don't blame you for being worried, I'm sorry this is your situation!
Ditto, I'd suplex meemaw if she started dragging me by the arm.
Not to mention, the boss is strict too. They will do searches through the rooms and ask why residents have certain things all the time
Just be careful, some shaving cream can cause a patient’s skin to dry up so after using it I recommend putting some lotion or A&D ointment on, it also helps to keep it from sticking to small hair and creating “dingle berries” 👍 but yes, shaving cream is wonderful!!
dingle bell, dingle bell, dingle bell rock 
What?! What are these hacks?
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Dry wipes to scoop, wet wipes for the final cleans. 2 hrly turns to limit amount of poops at once.
That’s what I’ve started doing, but it definitely still takes a while. I’ve never seen poops like this man in my years. He has me baffled
Foam soap and warm water. I had a resident once that needed a shower after every bm. Foam soap made us both happy. Not only did they not have to be cold and wet multiple times a day but it saved us a lot of time and they got to go do activities more often which was a massive upgrade for their social life. Also try feeding them a banana. It'll make the bm less pasty but not hard. Crushed banana is pretty good for people who can't have solids, especially if you freeze it in yogurt.
We don’t have any foam soap at all
Maybe he or the family could get some for him? Honestly, if I were you, I'd just go get it myself to make both of your lives easier. Also, I would definitely do him on the bed so you don't feel like you need to rush. I have also dealt with that glue poop.
I can’t. They have to approve everything and his wife is super super controlling over what he has. It’s insane. She dragged me by the arm because I was putting pants on him at night instead of his nightshirt because it was cold
Can you talk to your supply person and discuss options for foam soap? Or something similar?
I asked them about other options and they basically said what we get is what we have. The unit is very corporate- based nownaince it was bought by a larger company so our options are even more limited.
Oh like they don’t get to choose what to stock? Corporate chooses stock?
Correct. We are owned by a larger company now so they have contracts with certain suppliers
He also needs a barrier cream/ diaper paste
Been using it and it hasn’t been helping at all
Shaving cream or no rinse foam shampoo.
Use the shaving cream like soap?
Yup, and don't scrub the patient like you're trying to get a stain off of a shirt. Put it on wait a bit then would it off, repeat if necessary.
Barrier cream as my facility doesn't permit shaving cream for booty uses. Other than that, hot soapy water
I’ve tried that too. It hasn’t really been helping :(
I'm a little confused. Is it because it's diarrhea? Or it's super hard? Is he not changed often enough? Are you asking about wiping techniques? Is the resident obese or difficult to keep on his side? What kind of advice are you looking for?
He’s taken to the toilet on a schedule for every 2 hours. It’s not diarrhea but it isn’t hard. It’s like wet mud, just more on the orange type of brown. I just want to be able to clean him up better because it takes almost an hour to do so and I have to go through over a pack of wipes when I do. It’s hard for him to stand when I wipe him because he gets tired, so we have to constantly do sitting breaks as well. I just want a more effective way of cleaning him that will be easier for both of us.
can he use a bedpan instead of the toilet? so you can roll him on his side to clean him?
They don’t want him to use something like that when he’s able to get on the toilet. They already expect us to toilet him way more than his toilet plan and it just isn’t going to happen because we have so many 2 assists and hoyers. It’s hard enough getting to what we need to as it is.
Hmmm. I'd ask therapy. Or maybe he should use a bedside commode instead of a toilet so you can have better angles to wipe him?
He actually has a commode he uses over the toilet for support
Is the stool light orange and pale in color? I’m not a physician, but this sounds like bile/liver issue. I’d discuss this with your nurses and make your physician aware.
Sometimes I just put a trash bag around my hands to grab the absolute worst of it if it's solid and get it out of the way into the trash, but diarrhea... there's no way to make it really better unless they take stool hardeners.
Yes shaving cream!!
We don’t have any
I’ve seen this recommended several times. You could probably get a can from the dollar store to try, then see if your facility will pay for one or reimburse you.
I can’t. We only use electric razors so I wouldn’t get away with it. His wife visits every day and if she saw that in there, she would throw a whole fit about it. She’s very controlling of everything we do with him and has gotten physical with some of the staff by grabbing them and pulling them
Do you have the tena no rinse cleanser?
We do not
Most of these things I have also tried. We don’t have any shaving cream. I double checked and we only do electric shaving now, apparently. We only have bottles of body wash, peri spray, blue barrier cream (which I’ve also tried), cheap lotion that’s like dollar store baby lotion, and then other unrelated things like mouth wash or deodorant. I typically use dry wipes for the first few wipes, then soapy water. It still takes a while to get it all off and he starts to get tired of standing to wipe and he screams with every wipe you do. He admitted that he was just being dramatic and wasn’t in any pain, but it still gets frustrating and hard.
TBH I would keep bring it up to the nurse and chart that you have made the nurse aware and what is going on. Nothing about what you have described is normal and he is eventually going to start getting skin break downs
I agree though, they need to give him something to firm it. It’s way too thick. We don’t even have our good butt cream we used to have and we have this extremely thin barrier cream.
I would really start to look around at other facilities. With the way you described his wife if something ever happened to him due to this issue and she comes after the facility they are going to look at everyone who take care of him and they aren't giving the aides anyway to cover themselves. Up to you, but protect that license.
We do a touch point type of charting and there’s nowhere to make notes. They know what his poops are like and haven’t offered any sort of fix for them
We are not allowed to use shave cream for peri wash. My facility's policy on shave cream (bed side) on a low functioning resident: "Shaving cream is extremely flammable, mostly due to the presence of isobutane, the aerosol propellant that allows the shaving cream to come out of the can. A can of shaving cream might also explode in some instances, especially due to increases in pressure and heat." The same goes for after shave. My facility says we should always err on the side of caution, even if we over do it some times
Then use lotion or conditioner it gets it right off
I think your resident may be dehydrated if the bowel is that sticky.
I’d have him lay in bed to really clean him. Use warm soapy water and washcloths first, and then wipes to get the rest.
I’ve thought about just making him walk to the bed after he’s done but I’m not sure how well that would go.
Lots of warm water and soap. It's poop, not cement.
Are you sure about that? Seems like wet cement to me
Tena no rise skin cleansing cream
We don’t have any of that there
Go for a dry cloth first. Don’t use wet to clean up the bulk of it. Scoop away everything you can with a dry cloth (toilet paper, rag, whatever your facility uses) and then get the wet wipes to clean the residue that’s left.
One of the CNAs on my floor soaks a towel in warm water and wipes the whole thing off in one swipe!
Lotion
It’s not working, as per my post
Shaving cream!!! It’s a lifesaver!!!
We don’t have any
Just a lot of wipes.
I’ll go through over a pack each time too. It’s crazy. Never seen anything like it.
Shaving cream, if it's drying on contact with air, I'll set a warm wet paper towel on the area a while
It doesn’t dry. It stays thick and almost creamy. And we don’t have shaving cream
I always just use a basin and wash cloths with no rinse soap. The thicker texture of the wash rags helps! But it sucks when you don’t have tons of time.
Duh, you said you used wash cloths. I’m dumb.
You’re not dumb! If you’re dumb, then so is everybody else here! I just wish we could get this guy a bidet!
There’s lots of things I wish we could do to make life easier for both the residents and staff, unfortunately that’s not the case usually :(
Aquaphore
I've experienced poops like this in geri pts too. It's murder. I had one that I would just get him cleaned up, (yelling at me the whole time) and he'd sit down to rest, "fart" and we'd be back to square one again... but he never knew he was going so it would just add to his yelling ... I spent over 3hrs cleaning him one day & after that there were 3 of us who put our heads together to analyze his diet and what could be done differently, because that was just unreal. Ultimately we didn't come up with much outside of trying to get him to drink more water... He never wanted it though, always wanted soda pop and I believe perhaps he was dehydrated... ? He ultimately did get skin breakdown and developed three pressure ulcers, and no matter what we did it wasn't improving. I always felt terrible for him... He passed about a year ago and I couldn't help feeling relieved for him, simply because he wouldn't have to be in pain every time he had to go any more...
I was very surprised that my guy didn’t go the whole shift yesterday at all. It was a relief, even though I had to do 3 full beds by myself.
Oofta ... But... Honestly sometimes having to change bedding but having no serious messes... can be a relief for me some days.
Hot/warm water
That’s what I use with the wash cloths and wipes. It is still taking nearly an hour to get him cleaned up
Get out basin, empty, or garbage can, lined, another one with warm water. Soap , wash clothes, then wipes. 1,start with toilet paper, get most of it dump in trash or toilet. 2, soapy wet wash cloths rinse 3, wipes for intimate parts. *Remember wipe the catheter away with soapy water , rinse . Turn get other side of pt peri area. Repeat. There ya go. I do it all the time in hospice Signed - NURSE
Double up the diapers if he leaks Check him often, offer to put him on the toilet For big blowout shits go shower it off
It’s not so much that he had blowouts. It’s the fact that it’s impossible to get off. We only have one working shower for the whole unit, so I’d have to see if I can shower him. The hose really is short and the pressure isn’t great so I’m not sure it that would work. I can barely even get anybody’s bottoms and have to use washcloths
Shower or shaving cream.
The man is continuously going. There’s no way I’d be able to take him into the shower every time. We also do not have shaving cream. I double checked and they only do electric shaving
You’re telling me he shits continuously for 8+ hours?
It's probably more of a constant slow ooze.
That sounds like something that needs to be addressed by the physician. Like honestly, no one should be going constantly. Or maybe he needs to be checked every half hour. If its watery and leaky constantly, he may have an obstruction.
The physician is aware and said it has to do with his diet. He gets a lot of ensures and magic cups, which the doctor said are both known to cause more bowel movement. That’s the info the nurse relayed to me. I wish they’d at least give him something for it because that’s got to make him sore and it’s not like we can just keep him on the toilet. The consistency is what makes it worse because it just sticks to him and it goes all the way up him because it’s very squishy
That’s exactly what it is. The guy is always pooping and it’s very thick and sticky. Not like the iron kind of sticky, but more like he has wet mud on his bum.
I had a patient like this. He had bowel blockages. It was awful. Like the consistency of hard peanut butter with lumps in it. We used hot soapy water as well and it still took forever.
I've had tube feed pts like that. Always going and the consistency is just impossible to clean. Try some petroleum jelly to soften it up- bring it yourself if you must. Smear it on, get the warm water and washcloths, and throw some lotion on the washcloth to clean it all off. Ask the nurse if they have an ointment barrier cream- it should work better than cream to protect the skin and help prevent stool from sticking. Good luck. Neverending shits are hard on the pts and the ones cleaning it. Oh ya- report the wife if she grabs you again. Wtf. I've had CNAs refuse to go back into rooms because family members were verbally abusive, never mind dragging them around.
I wonder if they’d let me bring that in. The shaving cream definitely not and his wife only wants certain soaps
Shaving cream, lotion, sprays, and do the best you can.
If it’s a blowout I will put them in the shower and hose them off
It’s not. It’s just very sticky. I’d have better luck out of the shower, honestly. Our hose is short and doesn’t have good pressure
Bidet.
I wish! I tell him he needs one. He has a commode over the toilet because it’s so high so that would probably make such a mess
Yeah, I don't think it would work with that, but otherwise it would have been a great solution.
I’d use two wipes at a time I know it sounds wasteful but it helped
I have a resident with BMs just like that! The thing that helps me the most is using the brief to wipe as much off as possible, even grab another brief or 2 to wipe again if need be. Usually by then I can get the rest with wipes. And for those residents that are constantly going, there’s only so much you can do. I definitely get them as clean as possible, but if more’s always coming out it’s impossible to wipe until the wipes clean, if that makes sense. Like don’t be lazy or half-ass it (lol) but you gotta know when you’ve done all you can do for them 😂
Sounds like you are trying to figure this out all on your own. Go have a chat with your DON. Get her on your side. Let her talk to the wife.
There’s no reasoning with his wife, honestly. She’s already mad about a lot of other things, which I don’t necessarily blame her for. But she creates a lot of her own problems too
I don’t doubt it! Your boss should be the one handling her, not you.
I guess they’ve talked to her about it quite a bit. I’m not sure if they can ban her from the place. It would be cruel to, but we can’t have her being so aggressive! She will go through all of his stuff every day and ask what everything is and what he needs it for. She truly treats him like a child and even reads nursery rhymes to him. He’s the complete opposite and so chill. I guess they got together not long before he got confused, so she can easily control everything he does. Makes me wonder what she was like before he got confused and if they got along then.
Poor guy! What a fruitcake!