Sometimes when I have a lighter patient I will open his diaper, put my left arm under his knees, lift his butt, pull out the dirty diaper.

After cleaning him I will again lift his butt, put the clean diaper under and close it.

Is there anything wrong with this? Does it sound any more stressful on the patient’s body, skin etc than other methods?

Today I did this with a patient’s wife present and she ran to the head nurse complaining that pulling out the diaper might injure the patient’s skin.

He doesn’t have any special problem to my knowledge.

The traditional method of rolling the patient on his side and sticking half the diaper under before rolling him on his back is also causing friction with skin.

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Rolling avoids shearing injuries, is the point. Dragging the diaper out from under does apply shearing forces to the skin. I also shouldn't have thought the lifting would be a good idea from your back's point of view.

I 'd agree there's not much to choose between the two, and anyway if you have to wear a diaper at all it's kind of a nice detail, but your description of hoisting the patient's bum in the air is perhaps not the most dignified method.

Do you really find it significantly easier going than the rolling technique?
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Jacobstein you appear to be having several issues with your current employer.

Were you given a proper orientation period from your employer? In instances where you are unsure of policies or procedures, locate that P&P manual again and review their guidelines before proceeding.

Yes your technique could possibly create a sheering skin injury. You can use a little baby powder applied where the spoiled pull up touches the skin so the material slides off easier, but you should review your center's individual policy book.

Your facility should have a In Service or Education department- if you are unsure of procedure enlist their help. It will show your employer you care enough to want to follow procedure & do your job correctly.

I was a home care RN & if I knew I was to care for a case the next day & I needed a refresher I would contact my manager who would send me the policy via email. I would then review it until I was comfortable with what I had to do.

Use the resources available for you ie a Staff Educator. Good luck to you!
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