Alright, so that probably wasn’t the best way to phrase what I’m going to be talking about in this post, but it’s definitely what you probably searched to find this information!
Maybe you’re starting nursing school clinicals, or maybe you’ve been away from the bedside for a while and are going to start caring for patients again, and need to brush up on how to effectively clean a bed-bound patient who has defecated. Well, you’re in the right place! Let’s get into it! (The details, I mean…)
Table of Contents
How To Clean A Poopy Patient
Let’s go through the practical steps to complete a bed change on a patient who has been incontinent.
Quick tip: I go through a video demo of this nursing skill (and many others) in this online course that was designed specifically for new nursing students.
1. Gather Supplies
First, take a look at the patient and assess the situation. Is this a full bed change (meaning we need a gown, incontinence pads, and a full set of new linens), or do we just need a new pad and some wipes?
Checking first is especially important if the patient is in an isolation room and running out real quick to grab something isn’t a fast process. You also don’t want to take in a bunch of unnecessary supplies because they pile up quickly.
You likely will need another person, as turning a bed-bound patient is almost always a 2-person job. The only time it’s a 1-person job is when the patient has enough upper body strength to hold themselves on both sides (which doesn’t happen a lot!).
Prior to moving the patient, it’s helpful to get your clean linen in arm’s reach and a trash can nearby as well. Grab your gloves (and possibly double glove!) and let’s get started!
2. Roll The Patient
The patient will have to roll side to side while each of you take turns cleaning and rolling out the dirty linen, and placing new linen on the bed. Therefore, each person needs to stand on either side of the bed. Sometimes, it’s much easier for a patient to roll to one side the other (in particular, stroke patients who have hemiparesis).
If the patient is verbal, ask them which way they prefer. The first time they roll to their side will take the longest.
Let’s say you’re going to be the first person to clean. Roll the patient away from you and have your coworker stabilize and hold them on their side. You can have them bend the leg closest to you 90 degrees, turn their hip towards your coworker, and pick up their shoulder, turning them on their side.
Tip: if the patient is able, have them hang on to the side rail
Another tip: If the patient is pretty dirty, wait to turn them. Sometimes feces can sneak through to the front, especially if patients have diarrhea. If the is the case, clean the front first before turning. If there is a lot, you can push it down to their backside in between their legs and place a towel or more clean wipes on top of it to prevent it from getting dirty again while the patient rolls. Cleaning the front first is helpful because it’s hard to do that with a patient on their side. If the patient is able, you can also “frog-leg” them, which exposes more, thus enabling you to clean better.
Make sure your coworker is stable and has a good grip, and then get to work.
3. Clean The Patient
First, use your wipes to clean all excrement off of their skin. Feel free to put your dirty wipes on the dirty pad because you’re going to throw it away anyway. (Don’t do this if you’re using washcloths, though!)
Clean. Clean. Clean. Once their skin is clean, you’ve got to make sure it won’t touch the dirty pad or linen as they turn. Ensure the skin is dry. (Using a clean washcloth is helpful!)
If you need to change all of the linen, you’ll then pop the corners of the linen off of the mattress. You will tightly roll the dirty linen and push it under the patient. If the pad isn’t too dirty, you can roll it so the dirty stuff is completely covered up and the only thing touching their skin is the back of the pad.
However, this may not be possible due to the quantity of feces or where it is. If so, grab a towel to place in between their clean skin and the pad, then roll it up.
Roll all of this up and push it as far as possible under the patient while they are still on their side.
(In the below video, I walk through how to put a patient on and take a patient off of a bedpan. The movements are very similar, so if this explanation is at all confusing, make sure you check this video out for a demo!)
4. Put On Clean Linens
Now grab your clean fitted sheet and pop it on the corners of your side. Push the clean sheet as far as possible under the patient. Then get your draw sheet, disposable pad, and/or brief (sometimes referred to as a diaper) and place it on the patient halfway, and pull it up in between their legs.
From your side, you should see: The patient’s clean backside, the sheet attached to the two corners on your side of the bed, the sheet halfway covering the bed and flat out, and a disposable pad, rolled up and under the patient.
5. Turn The Patient Again
Now, it’s time to turn the patient toward you, and have your coworker finish up. Tell the patient they’re going to roll over a big bump, and slowly roll them towards you.
6. Repeat On Other Side
Now, you will hold the patient in a comfortable position on their side. Your coworker will pull out all of the dirty linen, carefully as not to dirty the new linen. They will clean any additional skin that is still dirty. Then, they will pull through all of the clean linen, attach the sheet corners to the bed, and flatten out the pad. Then the patient can be laid on their back.
7. Make Final Adjustments
Once the patient is flat on their back, then change their gown. (If it was visibly soiled in the beginning, you’d want to remove it earlier and wait to put the new one on until they’re all squeaky clean.) They will naturally have sunk down into the bed and will need to be boosted up.
Boost the patient, ask if they want just a sheet over them or also a blanket, place pillows where they would like, and spray some deodorizer if necessary.
Some people feel bad spraying deodorizer, but let’s be honest – the patient knows they had a bowel movement, knows you just cleaned it up, and spraying a little room deodorizer isn’t going to be what makes them upset or feel bad. They typically appreciate it. (And they probably don’t want to smell it either!) This is especially helpful if you have to ask guests to step out, and you know they’ll be back in the room. Do what you can to make it seem like you didn’t just do what you did. This may include taking out the trash as well.
Before you leave, make sure they’ve got their call light nearby, bed alarm back on, and all necessities within arm’s reach.
Tips to Prevent Patient Injury
Patients can make unpredictable movements, or you can be in an uncomfortable position, or they can be quite heavy. It is CRUCIAL that you take the necessary steps to prevent injury. I know multiple nurses who can no longer work at the bedside due to an injury sustained at the bedside.
Adjust the Height of the Bed
Adjust the patient’s bed, so it’s at a comfortable height for you, ensuring you’re not bending over the entire time and straining your back.
When lifting or moving patients, use proper ergonomics – lift with your legs and do not twist. We do not want an injury!
Use Assistive Devices
If you have lifts or assistive devices – USE THEM.
Remember, injury is never worth it. Protect your back and your health. If you get injured while caring for a patient, don’t try to stick it out. Go to employee health and get it taken care of as soon as possible. Don’t be a hero!
Use Barrier Cream (if indicated)
Many patient will benefit from a barrier cream on their coccyx to prevent skin breakdown. This isn’t always appropriate, so check with the primary nurse if you are unsure.
Now you know how to clean patients after bowel movements!
Frequently Asked Questions
Here are some answers to questions people might ask. If you have more questions, let me know, I’m happy to answer them.
How do you clean an elderly patient after a bowel movement?
Cleaning up a bowel movement for an elderly patient follows the same guidelines outlined above. Since the elderly often have fragile skin, pay close attention to this and execute the procedure with the gentleness required to prevent skin tears or injury.
How do you clean a bedridden patient?
Generally, only bedridden patients will need to be cleaned. The steps outlined above will help you fulfill this task. If a patient is not bedridden and requests a nurse to clean this, it requires additional investigation. There may be legitimate reasons, but generally, you need to encourage a patient to perform as many ADLs (activities of daily living) on their own as they can.
Do nurses clean poop?
One of the most surprising things for many nursing students is that nurses clean poop. Nursing students will often encounter many opportunities to clean feces. However, not all nursing specialties routinely do this. If you work in an office, perioperative, or other ambulatory settings, it decreases the likelihood that you’ll have to clean it up, but never say never!
Do CNAs or certified nursing assistants clean poop?
Yes, they often do. However, it depends on which nursing units the CNA is working on. CNAs who work in regular hospital units like med-surg, ICU, cardiology, orthopedics, oncology, as well as in nursing homes and skilled nursing facilities will. However, CNAs who work in settings like outpatient clinics likely will not.
Which nurse jobs do not clean poop?
School nurses, operating room nurses, public health, outpatient dialysis, infusion, case management, and outpatient nurses typically do not clean up after incontinent patients. Advanced practice nurses (APRNs, like nurse practitioners and CNRAs) do not as well. While APRNs can and know how to do this, they are typically not providing directly care and are functioning in a provider role which would not include cleaning up patients.
How often do nurses clean poop?
If you work in a hospital or nursing home, you likely do this every shift.
Do you have to clean poop in nursing school?
While everyone’s clinical experience is different, this will likely be part of your nursing school education.
More resources for nursing students
- Head to Toe Assessments vs. Focused Assessment – blog post
- 10 Mistakes Nursing Students Make (And How to Avoid Them) – free 26 page ebook
- Medical Administration Basics for Nursing Students
- Pharmacology Tips for Nursing Students – From a Nurse!
- How to Pass Nursing School Exams
- How to Survive Nursing School Masterpost
Getting ready for nursing school clinicals, but feeling unprepared?
Nursing Skills Refresh from FreshRN is a self-paced video course for both new and experienced nurses. Whether you’re preparing for your first clinical experience, or need to brush up on your nursing skills, this course is for you. Each lesson walks you through the basic tasks and concepts you will experience in the clinical setting. Once completed, you’ll feel comfortable in a hospital setting, understand the basics of what the bedside experience will feel like, and know insider tips and tricks that will make you feel confident and in control.