Most likely, you went to physical therapy to avoid body fluids. You are into moving people and not into moving excrements. But if there’s an instance when you are faced with a patient needing some cleaning at the back end, will you do it?
As physical therapists, bladder and bowel management is right up in our alley. It is part of our scope of practice. That is where pelvic floor physical therapy comes in. From behavioral techniques to timed voiding, pelvic floor physical therapists have it in the bag. And I am not just talking about older adults who are not able to make it in time or cannot hold it in, I am also talking about kids who frequently go or having difficulty going.
But then again, we are not talking about bowel and bladder management. What we are talking about here is if you see your patients and they ask you to help clean them up, what would you do?
Technically, it is not part of our job as physical therapists to clean them up. It is not a skilled intervention. Occupational therapists, on the other hand, may have toileting and self-care as one of their therapeutic goals, and may assess and assist patients in cleaning themselves.
Let us take this as an example. You work in a skilled nursing facility. One by one, you go see your patients. You get into one of your patient’s room, greeted him and asked him if you could start with therapy. He tells you, ‘I can’t. I need someone to clean me up.’ You could hit the call light to notify your patient’s certified nursing assistant (CNA) but you know very well that the CNA is busy at that moment and might take more than 20 minutes before she can attend to him. You can leave the patient and come back for him later. Then, you'll have to decide - clean the patient up and go on with your treatment or leave the patient and return once he's ready.
Another example, you are in the middle of your patient’s exercises when he suddenly tells you that he needs to do number two, badly. You figured, you needed to see him navigate the toilet for his coming discharge and you want to make sure he is safe and observe safety precautions. Again, the CNA is busy, and would take time before your patient can get attended. What would you do?
How about if your patient's diaper is full and you need him to get up and walk? What about emptying a patient's urinal so he can empty his bladder before your therapy session?
Mini_apple’s physical therapist assistant (PTA) preceptor, had a great answer for that. In a reddit thread, Do PTs have to clean up poop, the PTA answered, ‘Forget about what kind of therapist you are. What kind of person does that make you?’
That PTA dropped the mic there. You must think of what type of person you are. Think of what you would like to be done to you if you are in your patient’s place. Think of what it would be like if that was your parent or grandparent. Do not get me wrong. I am not saying that if you do not help out, you are automatically a bad person. No. I am just asking you to consider those things and others, like your time, patient load, and most especially, patient’s needs.
So, short answer, cleaning up poop is not part of a physical therapist’s job description. However, as someone in the care industry, you are welcome to do so. Your patients will appreciate it, the CNAs will be grateful to you, and ultimately, you will build relationships.
