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Staff member
I became doubly incontinent suddenly, following an accident in 2013 which left me with a spinal injury at C4/5, paralysis from the chest down and severe spasticity. I spent the first 7 months in a spinal injury hospital here in the UK, where remarkably little was achieved.
Since puberty I had worn a paper towel in my underwear to soak up any dribbles of pee or semen overflows, but really knew nothing about incontinence. The hospital never offered me any kind of incontinence wear. I had a bowel evacuation every morning, and for the first 5 months before a suprapubic catheter was installed, intermittent urethral catheterisation by nurses.
Hospital policy dictated that men's foreskins should be kept forward. I do not know the reason. It came across as another loss of freedom - although not all nurses insisted on it. I remember a regular night nurse who tried to make catheterisation a fun experience. She would flick my foreskin backwards and forwards 'to make the catheter go in more easily' she would say with a slight smile or a wink as she could see the result of her efforts. Leakages and accidents were left to chance. In the first 2 or 3 months I did occasionally leak urine via the normal route, but hospital policy preferred washing sheets to issuing incontinence wear.
For the first 7 weeks I was on 'bed rest' - I was confined to bed and turned from side to side every 3 or 4 hours, day and night. I wore no clothes. Not being a matter of choice, I did not find this a wholly pleasant experience. Some of the nurses were conscious of this. Two of them separately explained that they were nudists and visited a beach not far away - perhaps exaggerated, but it was kind and thoughtful to try and make it seem normal.
After 7 weeks I got up into a wheelchair, gradually up to about 8 hours per day. Although I wore outer clothing, underwear, including that for incontinence, was frowned upon. I guess that was to give easier access for urethral catheterisation at first, but even after a suprapubic catheter was installed hospital practice remained the same.
I got on well with one of the occupational therapists. One day, we had been talking about hospital policy on incontinence and underwear when I was practising writing (my hands are affected by paralysis). I wrote something like 'Does anyone in this hospital wear knickers?' She assured me that she usually did but sometimes enjoyed the fresh air 'commando style' when wearing a uniform with a skirt in summer. Next morning, when she was helping me to shower, I noticed that she was wearing a skirt .... I didn't ask.
Not long before I left, a thoughtful nurse intervened. When dressing me she found my pants and reinstated some kind of normality, as she said at the time, but still no incontinence wear.
Looking back, the lack of incontinence wear in this hospital was a serious fault in nursing practice. Being a specialist spinal injuries hospital, many of the patients would have become incontinent only recently and would be unlikely to know much about how to deal with it. The hospital did not prepare patients for living with it after they were discharged. I thought that their policy towards underwear, or lack of it, was unnecessary and demeaning.
I first began to wear an incontinence pad and fixation pants soon after returning home from hospital. A district nurse noticed I was wearing normal underwear which was not really sufficiently stretchy for her to pull down for bowel evacuation. 'We'll soon fix you up with some pads and knickers' she said. And so she helped me deal with what can lead to embarrassing and distressing situations put me on another step towards normality.
Since puberty I had worn a paper towel in my underwear to soak up any dribbles of pee or semen overflows, but really knew nothing about incontinence. The hospital never offered me any kind of incontinence wear. I had a bowel evacuation every morning, and for the first 5 months before a suprapubic catheter was installed, intermittent urethral catheterisation by nurses.
Hospital policy dictated that men's foreskins should be kept forward. I do not know the reason. It came across as another loss of freedom - although not all nurses insisted on it. I remember a regular night nurse who tried to make catheterisation a fun experience. She would flick my foreskin backwards and forwards 'to make the catheter go in more easily' she would say with a slight smile or a wink as she could see the result of her efforts. Leakages and accidents were left to chance. In the first 2 or 3 months I did occasionally leak urine via the normal route, but hospital policy preferred washing sheets to issuing incontinence wear.
For the first 7 weeks I was on 'bed rest' - I was confined to bed and turned from side to side every 3 or 4 hours, day and night. I wore no clothes. Not being a matter of choice, I did not find this a wholly pleasant experience. Some of the nurses were conscious of this. Two of them separately explained that they were nudists and visited a beach not far away - perhaps exaggerated, but it was kind and thoughtful to try and make it seem normal.
After 7 weeks I got up into a wheelchair, gradually up to about 8 hours per day. Although I wore outer clothing, underwear, including that for incontinence, was frowned upon. I guess that was to give easier access for urethral catheterisation at first, but even after a suprapubic catheter was installed hospital practice remained the same.
I got on well with one of the occupational therapists. One day, we had been talking about hospital policy on incontinence and underwear when I was practising writing (my hands are affected by paralysis). I wrote something like 'Does anyone in this hospital wear knickers?' She assured me that she usually did but sometimes enjoyed the fresh air 'commando style' when wearing a uniform with a skirt in summer. Next morning, when she was helping me to shower, I noticed that she was wearing a skirt .... I didn't ask.
Not long before I left, a thoughtful nurse intervened. When dressing me she found my pants and reinstated some kind of normality, as she said at the time, but still no incontinence wear.
Looking back, the lack of incontinence wear in this hospital was a serious fault in nursing practice. Being a specialist spinal injuries hospital, many of the patients would have become incontinent only recently and would be unlikely to know much about how to deal with it. The hospital did not prepare patients for living with it after they were discharged. I thought that their policy towards underwear, or lack of it, was unnecessary and demeaning.
I first began to wear an incontinence pad and fixation pants soon after returning home from hospital. A district nurse noticed I was wearing normal underwear which was not really sufficiently stretchy for her to pull down for bowel evacuation. 'We'll soon fix you up with some pads and knickers' she said. And so she helped me deal with what can lead to embarrassing and distressing situations put me on another step towards normality.