We’re sure most nurses would agree that handling bodily fluids wasn’t a motivating factor in their decision to enter the field. However, it doesn’t take long to discover that seeing, handling, and cleaning up a patient’s bodily fluids comes with the territory.
When I worked on an inpatient adult oncology unit, I remember pulling my bandage scissors out of my pocket for a dressing change, only to find them covered in a mushy, dark brown substance. My eyes widened in horror as I thought, “Why is there poop in my pocket?” I quickly remembered that it was Valentine’s Day; I’d placed a piece of chocolate in my pocket earlier that had since melted out of its wrapper. While this moment provided a good laugh, it also prepared me to hide my disgust in the future when messy events occurred that weren’t so funny, like cleaning projectile vomit from every surface of a patient’s bathroom as she experienced side effects of chemotherapy.
Nursing school couldn’t have prepared me for how messy nursing can be. Yet learning how to handle these moments in a professional way that upholds patient dignity, or their sense of worth, is an art of nursing that’s crucial to keeping the patient-nurse relationship therapeutic. So, let’s go over some practical tips on how to remain professional while protecting patient dignity when things get messy.
Understanding the Challenge
Let’s start by understanding the challenge that messy situations present. In healthcare, they are guaranteed to happen, but it’s unpredictable when and to what extent. In addition, the type of messy situation you can expect depends on your practice setting. For instance, a nurse in an emergency department can expect to handle blood, vomit, urine, feces, or wound drainage every shift, whereas a nurse in an outpatient clinic may handle bodily fluids less frequently and in a more predictable manner, such as for specimen collection. While it’s normal to feel squeamish during these situations, the biggest challenge lies in managing your reaction to maintain patient dignity.
The Core Principles of Professionalism in Messy Moments
Maintaining patient dignity during messy moments revolves around core principles of professionalism: care and respect. Both include practicing compassion and empathy, to ensure you’re treating your patient as a valuable human being who just so happens to be experiencing a messy situation beyond the privacy and comfort of their own home.
Remain calm and composed with both your words and body language. Remember that as a professional nurse, part of your job is to protect your patient and alleviate their suffering. Sometimes this looks like quietly and efficiently cleaning diarrhea off your patient’s legs.
Practical Strategies to Handle Messy Situations
So, how exactly should you tackle messy moments? First, mentally prepare yourself before entering a potentially uncomfortable scenario. For instance, if your patient has the stomach flu, get your head wrapped around the idea that you will need to clean vomit before entering their room.
When you encounter a mess, ensure your patient is stable, address any urgent medical needs, and then provide reassurance, especially if your patient is feeling embarrassed or uncomfortable.
When it’s time to clean, gather the necessary supplies, including personal protective equipment (PPE), disposable towels, cleaning solution, disinfectant, a biohazardous waste bag, and items for patient cleaning, such as washcloths, soap, and a wash basin. Don’t forget the clean linens and clothing, which are both necessary for health and for restoring your patient’s comfort and dignity. Put on gloves and additional PPE as needed based on the circumstances. Inform the patient about what you need to do, answer their questions, and continue to provide reassurance along the way.
Start by cleaning your patient, if necessary, which may include perineal care, bathing, or a partial bath. Involve them in self-care as much as possible to empower them and promote your patient’s self-worth. This could involve asking if they’d like a shower or assessing their ability to participate in the care. Also, use this time to assess their skin as issues like incontinence can compromise skin integrity.
To clean the surrounding areas where the mess occurred, wipe up the body fluids with absorbent disposable towels, and clean with a solution of warm water and neutral detergent. Follow this with your facility-approved disinfectant to kill remaining germs. When the cleaning is done, discard your PPE and other contaminated materials in a biohazardous waste bag and perform hand hygiene.
Once the patient and their surroundings are clean, do what you can to prevent a recurrence, depending on their needs. For instance, make sure they have an emesis bag and administer prescribed antiemetics if vomiting was the culprit. Or, for a patient with incontinence, assist them to the bathroom more frequently and consider using a bedside commode. Empty the trash bin and spray a room deodorizer if needed to minimize lingering odors. And, as always, place the call light within their reach, document your assessment findings and care provided, and follow up with the healthcare team about concerning findings.
Managing Your Reactions
When encountering a messy situation, your first reaction might be to gasp in horror, but managing your response is key to remaining professional and being respectful to your patient. Don’t forget: someday you might find yourself on the other side of the mess!
Pause, take a deep breath, and tell yourself a mantra like, “I’ve got this” to find your calm. Distract yourself if needed by focusing on something else while you clean or making small talk with your patient. Reframing, or changing how you think about a situation, can also decrease stress in the moment, which ultimately keeps your reaction professional. One way to reframe messy situations is by remaining grateful for having a job you love, even if it’s messy, and by remembering that cleaning bodily fluids is just one small part of a rewarding career.
Keep in mind that PPE is protecting you, and use it to your advantage. For instance, some who are sensitive to strong odors find it helpful to wear a mask and even apply a scented lip balm or vapor rub below the nose before putting their mask on. You can also sniff an alcohol prep pad or breathe through your mouth.
Also, don’t forget about the power of teamwork! Seek help from coworkers to speed up the clean-up, and offer to assist them in similar situations. If you find managing your reactions particularly difficult, ask your coworkers for advice on how they cope and for some solidarity.
Protecting Patient Dignity Throughout the Process
Protecting patient dignity during these encounters is just as important as handling the physical mess, and respect is at the heart of safeguarding patient dignity. One of the best ways to ensure you’re respectful is to treat your patient how you would want your loved ones (or yourself) to be treated. Consider your patient’s feelings and desires, and be intentional about looking out for their well-being. During messy moments, your patient is likely feeling vulnerable. Take care to protect their privacy by covering exposed body parts and only sharing the scenario with those who need to know about it.
Be nonjudgmental and respectful with your tone and body language, too. For example, instead of conveying disgust, show or voice your willingness to care for them during their time of need. Reassure them while you’re handling the mess to help relieve their embarrassment and use appropriate humor to lighten the mood if your patient seems receptive to this approach. Also, empower them by having them help in the clean-up process if they’re able, such as providing them with supplies to clean parts of their body they can reach.
Learning and Growing from Messy Experiences
After messy situations occur, reflect on how you handled each experience. Taking a moment to consider your reaction will help you realize what aspects you handled well and what you could do differently next time. This exercise not only builds confidence but also the resilience to handle future messy situations. Try to view messy moments as opportunities to grow professionally with how you handle the unexpected, which will undoubtedly happen regularly throughout your nursing career.
Also, consider sharing your experiences with fellow nurses to learn from and support one another in this stinky part of your job. Seek continuing education opportunities and training related to handling bodily fluids to improve your skills and build your confidence.
Turning Messy Moments Into Compassionate Care
While nothing can prepare you for handling messy situations better than experience, hopefully, reading this article has given you some practical tips on remaining professional and safeguarding patient dignity when things get messy. If you’re particularly uncomfortable during messy moments, note that most nurses find their tolerance grows over time. The most important thing to remember is you’re caring for a person, not just a mess, and it’s a privilege to have a meaningful career in nursing, even if messy moments are a part of it.
If you have helpful stories or tips on handling messy moments in nursing, feel free to share them below in the comments!
Key Takeaways
- Maintain calm and compassion to uphold patient dignity during messy care.
- Prepare mentally and gather needed supplies before handling bodily fluids.
- Use PPE properly and follow infection control protocols.
- Involve patients in self-care when possible to empower and respect them.
- Reflect on experiences to build resilience and improve future care.
About the Author
Mary Roberts, BSN, MSN, has been a registered nurse since 2011, with over 14 years of experience in the field. She earned both her BSN and MSN in Nursing Management and Leadership from OSF Saint Francis Medical Center College of Nursing. Mary began her nursing career in adult inpatient oncology but has spent the majority of her time in ambulatory primary care. She now brings her clinical expertise to Osmosis, where she enjoys researching and collaborating with others to create engaging nursing education content. Mary lives in Illinois with her husband, Brandon, their two children, and two Goldendoodles, Milo and Henry. In her free time, she enjoys spending time with her family, cooking, and listening to audiobooks.
References
- American Association of Colleges of Nursing. (n.d.). Respect.
- Fosbre, C. D., & Varcarolis, E. M. (2023). Varcarolis’ essentials of psychiatric-mental health nursing: A communication approach to evidence-based care (5th ed.). Elsevier.
- Lin, Y. -P., & Tsai, Y. -F. (2011). Maintaining patients’ dignity during clinical care: A qualitative interview study. Journal of Advanced Nursing, 67(2), 340-348. doi: 10.1111/j.1365-2648.2010.05498.x
- Osmosis from Elsevier. (2022, June 13). Hygiene – Bathing: Nursing skills.
- Osmosis from Elsevier. (2022, June 2). Hygiene – Perineal care: Nursing skills.
- Owens, R. A., Kuhl, L. M., Hagopian, C. O. P., Goodolf, D. M., Ferrell, C., Liebig, D., Howard, M. S., Weybrew, K. A., & Yockey, J. (2024). Professionalism and professional identity. American Nurse Journal, 19(9).
- Robinson, S., & Doody, O. (2022). Nursing & healthcare ethics (6th ed.). Elsevier.
- University of Kentucky. (n.d.). Cleaning blood and body fluids. University of Kentucky Occupational Health & Safety.
- US Centers for Disease Control and Prevention. (2024, March 19). Environmental cleaning procedures.
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