Continence: my conscience is clear!

24 April 2014

Dipti Samani is a speciality trainee registrar in Geriatric Medicine working in Leicester.continence2

As NHS Change Day approached I thought about what I could do to help raise awareness about the issues that affect my patients. I was in the continence clinic at the time and wondered if it would be too crazy to consider wearing a continence pad for the day… Continence is an important issue as it can cause much distress to patients, not to mention the impact on the health services. Patients often tell us they ‘suffer in silence’ because they think no one is interested, or that it is a ‘part of ageing’. But much can be done to improve matters – starting with an awareness of the impact, a diagnosis and a will to avoid evil urinary catheters! Continence assessment should be part of any holistic approach to caring for frail older people. So, I ran my idea past Janet and Sally, our continence nurse specialists, who, to my surprise said they would do it too. After sending some emails around the department I had a small army of geriatricians volunteering to wear a continence pad for the day on March 3rd 2014. We obtained supplies of the pads and net knickers from non-NHS sources and I brought green ribbons to wear to show that we were doing something different on the day. The Leicester Mercury attended the event in our hospital and mentioned our pledge in their article. continence1My main reason for wanting to do it was to empathise with my patients and to raise awareness about the importance of continence. I wore the pad for 11 hours on a busy Monday on a ward which was new to me as I had just changed rotation and teams. It was quite difficult to get on and off and felt strange, uncomfortable and I felt self-conscious all day (despite wearing baggy trousers to avoid the “does my bum look big in this” feeling). Janet and Sally manned the NHS Change stand in the canteen all day and they wanted to do it properly so decided to ‘use’ the pad and pass urine into it. They said this was psychologically difficult to do and so went to the toilet to do it ‘just in case’. All for one and one for all… but I have to confess, I waited until I got safely home later that evening. Initially the pad felt wet, but then the urine soaked in and it didn’t feel wet (or smell) at all. It felt a bit heavy and we were conscious of what we had done, and felt sure others would know too. The pledge gave us a good insight of what wearing a pad would be like for our patients, and reminded us all that identifying the issue and treating the cause are much more preferable to a lifetime of pad and pants! I hope this can be repeated in the future and some colleagues are talking about doing it for World Continence Week 23-29 June 2014, I would encourage everyone reading this to try it with us - clear your conscience!


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