Personal Hygiene

Unfortunately, for a lesson to be learnt, an uncomfortable or awkward situation generally must emerge. Hopefully, by sharing this story, you will be able to take on board this advice to prevent it happening to you!
Whilst on my neuro placement, I had to assist a physiotherapist and physiotherapy student in their treatment of a heavy patient at the physiotherapy gym. As this was not my patient, I was not entirely sure of his clinical history, but was aware that he had a severe stroke. This patient was reluctant to participate in physiotherapy, and required much prompting and encouragement to relieve his anxiety.
The focus of the treatment session was to improve his ability for sit to stand, and required 3 person moderate assist. To facilitate standing, the physiotherapist and I were required to place our ‘ungloved’ hands beneath his ischial tuberosities to encourage lifting of the buttocks. As you would be aware, a common sequelae of stroke is incontinent bowel and/or bladder, and as a student, I find it to be a common problem I overlook when treating a patient. Unfortunately, as we progressed to stand, his pad became loose (maybe due to our handling?) and combined with his anxiety, he progressed to perform a bowel action. As it was of copious amounts, we were all left with it being over our hands and all over the plinth. Apart from feeling physically ill, I did feel sorry for this patient as it must have also been an uncomfortable and probably humiliating experience for him. Therefore, we still continued to approach the patient in a professional manner and did not let our inward emotions be portrayed to the patient. Even though it is difficult to do this, it definitely does make the situation less embarrassing for the patient. Needless to say, I have now thoroughly disinfected myself and have resultantly never been cleaner in my life!
Fortunately in this scenario, the physiotherapist was in the room. However, if it were just the other student and myself, we would have found it extremely difficult to support this heavy, full-hoist patient whilst trying to search for cleaning equipment (e.g. gloves, towels, cloths, blueys, air freshner, cleaning detergent), as the gym was located on a different ward. In addition, it was fortunate that this patient was not a high risk infectious patient, as contact with bodily fluids predisposes one to infection.
My suggestion is to make sure you are always are oriented to where such equipment is kept on every ward, and if the patient has an incontinent bowel/bladder, have those supplies within close range. Also, if the patient does have a history of incontinence, always wear gloves when treating the patient! Infection control is an area that can be easily overlooked, especially as students, but by considering simple principles such as wearing gloves, you really are minimising the risk to both you and your patient. Unfortunately, I had to learn this lesson the hard way, but I now know that when I read in a patients notes that they have been incontinent overnight or throughout the day, I definitely will be gloving up and orienting myself to the equipment on every ward!