Page 182 - Nursing: The Philosophy and Science of Caring

a dmi ni st ering sacr e d nu rs i ng a ct s
Human need for elimination:
“toileting” / BatHing / Personal aPPearanCe
If there is one major metaphor associated with being a nurse, it is the
association of bedpan. The word “nursing” is often reduced to the lay
association of “emptying bedpans,” which is seen as a degrading act
or a low level of service to another—perhaps the lowest level of work,
second only to being a servant to another.
The basic need for elimination and for assistance with this need is
one of the most basic bodily biological functions, but it is often laden
with embarrassment, invasion of privacy, exposing of body parts, vio-
lation of one’s integrity, and so on. Often, even to ask for or require
help with this need is a source of anxiety, stress, inconvenience, and
vulnerability for a patient.
This need not only includes the external environment required
for meeting this basic bodily function but also encompasses subjec-
tive feeling states such as privacy, body image, self-image, toilet habits,
patterns, and so on. However, this is a basic biological need related to
health and survival. It is a necessary part of human existence.
The personal meanings associated with this broad need affect the
way patients will ask for and expect assistance, when required. For
example, they may delay asking for assistance; they may resist and even
resent being dependent on another for help with this most basic biolog-
ical function of the body. The subjective associations with this matura-
tional need include issues of blame, guilt, money, power, and control,
as well as creativity and ethical honor in relationships (Myss 1996:97).
Different cultures respond differently to basic bodily needs and
functions. In the United States, social reticence is associated with this
need; privacy and embarrassment are often present. Other cultures
are often more open and receptive to the normal functions of the
body and are not shy about needs for defecating, urinating, and sexual
gratification.
A parent or an entire culture may establish values and norms
related to gratification of the elimination need. As a nurse, it is help-
ful to understand the emotional meaning and habits of the patient in
order to assist him or her. Indeed, the inner subjective feelings and
meanings associated with this need may affect the normal function

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