To pee, or not to pee

Out of the multitude of tests that we run in ER, urine dip is probably one of the simplest ones. Well, at least I think so. However, some of my patients wouldn't agree.

It seems like everyone who presents to ER gets a urine dip done. Some end up with their pee being sent for C&S as well. I have to ask my patients for a urine sample so often that I have my own little speech that I usually stick to: "Whenever you feel like you can pee, we'll need you to give us a urine sample." [Hands over a container and a biohazard ziplock bag to the patient.] "Just put it in the bag when you're done."

Simple, right? Unscrew the lid. Pee in the container. Put the lid back on. Put the container in the bag. Hand it back to the nurse. Even if I tried, I don't think I would be able to come up with things that people do when asked to provide a urine sample.

An elderly man once returned from the washroom with the biohazard bag in hand. "I've got my urine sample," he says as he hands it over. I spent the next five minutes trying not to spill any of his urine on myself while pouring it into a container. He peed right in the bag. Good thing it had a zip lock on it...

Another time, a young girl handed me her sample only for me to realize that she somehow (and to this day I keep trying not to even try to imagine how) managed to shit in the container, the diameter of which is about 1 1/2 inches, instead of peeing in it (mind you, I didn't give her a hat or anything). I had to tell her to throw that (literally) shit out and go back to the washroom.

I won't even tell you how many times people tried to pass tap water for their urine. These are usually patients that we run urine tox screens on. Right... I've seen enough pee in my nursing career to be able to tell it apart from water, you smart ass. Go try again.

After all these years of asking people to provide urine samples, it makes me think that it might be helpful to come up with some sort of an illustrated step-by-step instruction sheet. No words, just pictures. Multicultural-friendly. Like those Ikea instructions you get with your $15 put-it-together-yourself side tables.