# Nurses? Ques about bedbath older male.



## ared1 (Dec 13, 2003)

OK, this will probably be really UNPC..sorry. I am a nursing student and during clinicals last week I gave my 1st bedbath to an intact male. THe RN I was working with asked me to retract him and I had a little trouble so she starting explaining how to do it. I told her I know how to retract him, both my boys are intact (not that it was important then, I just like to get that out there when I can) but I couldn't get a grip on him! On one hand, I was very releived to see that his genitals weren't hanging to his knees as so many people described he didn't have a lot of smega but he smelled awful (in general-not just there. He was brought over from a nursing home so I don't know what quality care he was receiving. SO in this case, people using that argument about old men and having to clean it can stuff it. It really wsan't bad! All that was just kind of background and my thoughts/feelings because I have never seen an intact male except for my sons. so anyway, I felt like it took me so long to get him retracted that it was bordering on being undignified. Do yuo have any tips? I certainly don't want to embarrass myself or my patient the next time this happens.


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## KMK_Mama (Jan 29, 2006)

I've never seen an intact male except for my son either. I am a future nursing student though so I would be interested in what others have to say. I guess I don't understand how it was hard to retract.....I can't picture it. I do know that my intact grandfathers care providers were giving my grandma a hard time when he had an infection and they were complaining saying it would be so much easier if he had been circumcised. I printed out a pamphlet off of NOCIRC.COM about caring for the intact ederly population that might be helpful to you.


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## Rico'sAlice (Mar 19, 2006)

Here is the pamphlet that KMK Mama mentioned.

"Answers To Your Questions About Care of the Intact Penis in the Geriatric/
Disabled Population"
http://www.nocirc.org/publish/8pam.pdf


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## Sharon RN (Sep 6, 2006)

I give all my pts bed baths. I see a fair # of intact males.

I retract, clean with water only, and make sure the foreskin is back in place. If I can't retract the foreskin well, I'll take a sterile 60ml slip tip syringe and use sterile water to irrigate the area. I never use soap.

99% of my pts have indwelling caths (foley's), so my main concern is keeping the foley clean to prevent the bugs from crawling up the tube into the bladder. Gross, I know, but urinary tract infx are the most common hospital-acquired infx.

Many of the nurses I work with know my son is intact, and will ask me for help or ?'s while caring for intact males. This is great because then I can give them proper info and techniques which will lead to less trauma and misinformation about the intact male.

And that's my contribution at work to the cause.









Feel free to PM me if you have any other ?'s. Good luck in school!


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## ared1 (Dec 13, 2003)

thanks, let me see if I can clarify. He wasn't hard to retract, he was hard to get a grip on. Every time I went to pull back his foreskin, his whole penis kinda buried itself in the fat pad and loose skin so then I would have to kind of pop it back out and try again. I don't know if it was because my glves were wet or what. I felt like I had ahold of too much of him KWIM? I will certainly read that article and thank you so much for the help and the good luck, I need it!







I quit my job to go to school full time and I am still recovering from the loss of my 4.0. I hate when people say C=R.N. Not for this nurse to be!


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## Lucky Charm (Nov 8, 2002)

Hmmm. Good question.

I do not work in long term care, I work in the ICU and the ER. In the ER, I do not give baths, but when I am in the unit, I do. Most of the patients have foley's. I do not forcibly retract, but I do gently pull back the foreskin just a bit to do foley care. We do not use soap anyway, so thats not an issue. And If I had resistance, well, I certainly wouldnt force it.

I have been a nurse since 96, most of it in critical care and the emergency department. I do not recall ever having a problem. But I have noticed with transfers from nursing homes, the odor, and how unclean some of the intact men are (unlike say a a young trauma patient, kwim?).


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## paminmi (Jan 31, 2005)

Quote:


Originally Posted by *ared1* 
On one hand, I was very releived to see that his genitals weren't hanging to his knees as so many people described he didn't have a lot of smega but he smelled awful (in general-not just there. He was brought over from a nursing home so I don't know what quality care he was receiving. SO in this case, people using that argument about old men and having to clean it can stuff it. It really wsan't bad! All that was just kind of background and my thoughts/feelings because I have never seen an intact male except for my sons. so anyway, I felt like it took me so long to get him retracted that it was bordering on being undignified. Do yuo have any tips? I certainly don't want to embarrass myself or my patient the next time this happens.

Anna:

I have had this same problem at times so I know exactly what you are talking about. The other thing that, IMO, makes things difficult is that most of the elderly men I have seen are not very well endowed, if you KWIM. Because of that there is less shaft to grasp not to mention they are softer and squishier (I hope that is not TMI). As for genitals hanging to their knees in geriatric males, I have been a nurse for 20 years and that one I have yet to see. I would say near 100% are in the small category.

I don't have a lot of personal penis experience myself but I'm guessing that as testosterone declines with aging, like women going thru menopause, there are changes that also occur in the genitals of men. I have never read any medical studies on this so it's only my personal observation/hypothesis.

Good luck with school!

Pam


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## paminmi (Jan 31, 2005)

Quote:


Originally Posted by *Rico'sAlice* 
Here is the pamphlet that KMK Mama mentioned.

"Answers To Your Questions About Care of the Intact Penis in the Geriatric/
Disabled Population"
http://www.nocirc.org/publish/8pam.pdf

This is a great pamphlet with one exception:

I try to not fully retract men with tighter foreskins but at times when retracting for cath changes I have had an elderly man get a slight erection during cleansing at the beginning (our kits usually have Betadine or Benzalkonium Chloride swabs) and the foreskin moves back to fully retract. After the Foley insertion is completed, the glans at times remains enlarged and replacing the foreskin back into it's non-retracted state becomes impossible.

When following NOCIRC's instructions to gently compress the glans with the thumb and forefinger at the corona, sometimes it still will not budge. I then take a washcloth moistened with cool water and hold over/around the glans as a compress for a few minutes. I have never had this technique fail me yet in reducing the size of the glans, allowing reversion of the foreskin.

HTH~


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