When a Patient Refuses a Bedside Commode
"I'm not sitting on that."
This week I have a patient who refuses to use a bedside commode. He refuses to allow us to position the BSC over the toilet to increase the height. He refuses to do anything but use the toilet in his room. Many people feel the same way, although the BSC is considered an improvement over a bedpan.
There is just one problem. The patient in question has an incomplete spinal cord injury and has been chronically ill the past few months. The only way he can use the toilet is if someone lifts him on and off of it. He can walk to the bathroom. He can do a pivot. What he can't do is the sit-stand from the toilet. Between his spinal cord injury and multiple orthopedic injuries, he lacks adequate flexion in the necessary joints.
The simple solution is to put the BSC over the toilet, which would compensate for the ROM restrictions. He won't let us do it. He wants to use the toilet and expects someone to be available as a human lifting service. Worse, he complains if the person isn't available on demand because he doesn't want to have to wait.
Bedside commodes aren't known for comfort. They're designed to allow people with weakness and joint restrictions, just as this gentleman, to use a toilet with minimal assist. All I can do is shake my head. Because he requires assist to get on and off the toilet, he ends up sitting there waiting for the one person who can perform the transfer.
Sitting that long on a toilet can't be any more comfortable than sitting on a BSC for any length of time. I don't understand the logic. Is it that important to say, "I was able to use the toilet, not a bedside commode," to go through all this?