Nursing care
Bedpan and Urinal Use: the nurse's role, start to finish
Written and reviewed by Dana Whitfield, RN, MSN · 5 min read · Updated September 2026
Short answer
Bedpan and urinal use requires correct positioning, a time limit on the pan, and immediate skin assessment on removal. Raise the head of the bed for a standard pan, use a fracture pan for patients who cannot lift their hips, and never leave a patient sitting on a bedpan longer than necessary. Sacral pressure develops within twenty minutes.
Indications and contraindications
A bedpan or urinal is used for any patient who cannot mobilise to a toilet or commode: post-operative patients still on strict bed rest, those with spinal precautions, unstable fractures, severe cardiac or respiratory compromise, or anyone on continuous monitoring that limits ambulation. The urinal serves male patients who can void independently in bed but need the device positioned. Female patients and any patient passing stool need a bedpan.
Contraindications are relative rather than absolute. A patient with an unstable pelvic or hip fracture cannot tolerate the hip and knee flexion needed to sit on a standard bedpan, so a fracture pan is used instead. Patients with severe orthostatic intolerance may need the head of the bed kept lower than usual, which changes how the pan is positioned. Spinal precautions after certain surgeries restrict log-rolling technique and require two staff members rather than one.
Getting the patient ready
Explain the procedure and confirm privacy: curtains drawn, door closed, call bell within reach. Ask about the patient's usual toileting pattern and whether they need to void, pass stool, or both, since this changes which device is used. Check the care plan for weight-bearing status, hip precautions, and any drains or lines that need repositioning before the patient moves.
Raise the head of the bed to a semi-sitting position where the patient's condition allows it; this uses gravity and matches the physiological position for voiding and defecation better than lying flat. For a patient with a hip fracture or recent hip surgery, use a fracture pan, which has a lower, flatter lip so the patient does not need to lift or roll the pelvis to be positioned on it. Warm the pan slightly if it is metal, and place a protective pad underneath. Gloves on before any contact.
Technique and safety checks
For a patient who can lift their hips, have them flex their knees, push down through their heels, and raise the pelvis while you slide the pan into place; the wide end sits toward the buttocks. For a patient who cannot assist, log-roll them onto their side, position the pan against the buttocks, then roll them back onto it, holding the pan flat so it does not tip. Two staff members are safer for this manoeuvre in a patient with limited mobility or additional lines and drains.
Once positioned, raise the head of the bed again if the patient's condition allows, place the call bell within reach, and leave the room or draw the curtain to give privacy. Set a mental time limit and check back within a few minutes rather than waiting for the call bell alone. The critical safety point: the patient is never left on the pan for an extended period. Sacral and coccygeal pressure builds within twenty minutes on a rigid bedpan surface, and in a patient who already has reduced mobility or sensory impairment, that is enough time to start tissue damage.
What can go wrong
Prolonged time on the pan is the most common and most preventable harm. It causes sacral pressure injury, particularly in older patients, those with poor nutritional status, and anyone who cannot reposition themselves. A patient left too long may also become hypotensive from sitting semi-upright, or fatigued from bracing against the pan.
Spillage and skin contamination are common when the pan is removed incorrectly or when stool or urine is left in contact with skin. In a patient with a hip fracture, forcing hip flexion to remove a standard bedpan can displace the fracture or cause severe pain; this is why the fracture pan exists and why substituting a standard pan for convenience is a documented error on medication and skills exams. Falls occur when a patient attempts to reach or reposition the pan independently after being left too long without checking in.
Ongoing care
On removal, assess the perineal and sacral skin immediately: redness that does not blanch, skin breakdown, or moisture-associated damage all need documenting and escalating. Clean the patient thoroughly, working front to back for female patients to reduce urinary tract infection risk, and dry the skin well since prolonged moisture on top of pressure compounds injury risk.
Note the output: colour, volume, consistency of stool, presence of blood or unusual odour, and compare against the patient's baseline. Reposition the patient off their back where possible to relieve any pressure that built up during the procedure, and reassess skin at the next routine turn. Document the time the pan was placed and removed; this record matters if a pressure injury is later identified and reviewed.
Common exam questions
NCLEX-style questions on this skill test two things: whether you select the right device for the patient's condition, and whether you recognise the time-on-pan risk before it is stated as a complication. A question describing a patient with a fractured hip who needs to use a bedpan is testing whether you choose the fracture pan and avoid asking the patient to lift their hips.
Prioritisation questions often present several patients needing toileting assistance and ask which to see first; the answer usually hinges on who has been on the pan longest or who has a mobility or sensory deficit that raises pressure injury risk. Delegation questions ask whether bedpan assistance can go to unlicensed assistive personnel: it generally can for a stable patient, but the nurse retains responsibility for assessing skin and output once the task is done.
The next step on this is the same as on everything else here: answer questions and read the rationales. Our basic care and comfort practice questions are the closest set to what this page covers.
One question from the basic care and comfort set
A nurse is preparing to feed a client who had a stroke and has mild dysphagia. Which action best reduces the risk of aspiration?
Rationale
Upright at 90 degrees with a chin tuck narrows the airway entrance and directs the bolus toward the esophagus — it is the single highest-yield positioning intervention for dysphagia. Thin liquids and straws move fastest and aspirate most easily, side-lying removes the gravity you want, and large bites overwhelm a swallow that is already impaired.
Answer: B
Common questions
How long can a patient safely stay on a bedpan?
As briefly as possible, and checked on rather than left. Sacral pressure changes can begin within twenty minutes, so the aim is to complete the task, remove the pan, and reassess skin promptly rather than leaving the patient to use the call bell whenever they finish.
When do you use a fracture pan instead of a standard bedpan?
Use a fracture pan for any patient who cannot flex their hips or lift their pelvis without pain or risk, most commonly after hip fracture or hip surgery, and for patients with spinal precautions. Its flatter, lower profile means the patient can be positioned with minimal hip movement.
Can unlicensed staff assist patients with a bedpan?
Yes, for a stable patient with no complex precautions this task can be delegated to unlicensed assistive personnel. The nurse remains responsible for assessing skin condition and output once the task is complete, and should not delegate it for a patient with unstable hip precautions or complex lines.
What skin finding after bedpan use needs escalating?
Non-blanchable redness over the sacrum or coccyx, any break in skin integrity, or moisture-associated skin damage all warrant documentation and follow-up. In a patient already at risk on a pressure injury scale, even mild redness should prompt a change in repositioning frequency.