A child rolls over in bed after having urinated on white sheets.

Guidance for Triage Nurses About Bed-Wetting Concerns: Navigating Conversations on Nocturnal Enuresis

Bed-wetting, also known as nocturnal enuresis, is a frequent point of discussion in pediatric triage. Triage nurses tend to receive calls that involve caregivers looking for advice and a better understanding about underlying causes. Read below for tips designed to arm triage nurses in these interactions. Your nurses can use them to speak confidently with caregivers, provide preliminary guidance, and reassure them about bed-wetting concerns.

Please note: These nurse triage tips are not meant for diagnosis. Please seek case-specific treatment from a child’s pediatrician.

Tip #1: Identify the Type of Bed-Wetting

In a discussion with a caregiver, a triage nurse ideally starts by identifying what type of bed-wetting is taking place. There are two primary categories:

  1. Primary Nocturnal Enuresis, where a child consistently wets the bed.

  2. Secondary Nocturnal Enuresis, where a child experiences bed-wetting after they’ve been able to stay dry at night for a period of at least six months.

Tip #2: Discuss the Underlying Causes

Next, it’s a good idea for nurses to explain the potential triggers for this condition, which can help alleviate some initial bed-wetting concerns. Triggers can include:

Genetics. A family history of bed-wetting from a child’s parents or siblings could explain why that child is prone to it.

Deep Sleep Patterns. The child may be unable to wake soon enough to urinate once they’ve entered deep sleep.

Bladder Maturation. The child’s bladder may still be evolving in its ability to hold urine all night.

Hormonal Factors. If the child’s body chemistry produces less antidiuretic hormone, this could lead to nighttime urination.

Urinary Tract Infections. It’s possible that the child is experiencing a UTI, which could be indicative of an underlying medical issue.

Emotional Factors. Stressful events or changes in the child’s environment could be influencing the bed-wetting. 

While pediatric triage protocols can aid nurses in determining symptom severity, it’s important to note that triggers like hormones and UTIs must be evaluated by a licensed medical professional. 

Tip #3: Use Empathy for Bed-Wetting Concerns

Triage nurses are instructed to use empathic listening while they’re assisting patient callers. When it comes to bed-wetting concerns, this is especially important — not only for the pediatric patient, but for the caregiver calling for advice.

There are a few things that nurses can do to demonstrate empathy. First, they can emphasize to caregivers that bed-wetting isn’t a child’s act of defiance or carelessness, and that they shouldn’t assign blame to the child for it happening. In a similar vein, nurses can dispel the myth that bed-wetting is a sign of laziness. Finally, it’s important for them to normalize bed-wetting concerns by assuring parents that many children deal with this challenge, and that it’s usually a temporary phase. 

Tip #4: Provide Suggestions on How to Manage Bed-Wetting

If a doctor’s visit is not deemed appropriate, triage nurses can provide suggestions to caregivers about how to prevent similar bed-wetting events in the future.

First, caregivers can keep an eye on how much their child is drinking in the evening and reduce their fluid consumption. They can also encourage bladder training with increased daytime bathroom breaks. 

Positive affirmations may also help. If stress or the environment is affecting the bed-wetting, the use of small rewards or words of encouragement may offset difficult emotions.

Lastly, parents can implement bed-wetting alarms. These are designed to rouse the child when they start to wet the bed so that they have more time to get to the toilet. The goal of the alarm is bladder control by teaching the child to recognize when they’re full enough so that they wake up naturally.

Nurses should direct caregivers to pediatricians if they have any questions about medicinal interventions. They should also know when to recommend that a child receive further evaluation by using Schmitt-Thompson protocols to address any other symptoms the child may be experiencing.  

Benefits of Nurse Triage

Caregivers may initially be concerned when a child wets the bed at night, but it’s often a normal phase that passes without requiring medical intervention. 

Triage nurses offer a powerful means of patient engagement for children and parents. Well-informed nurses can use their listening skills, empathy, triage protocols, and knowledge to allay bed-wetting concerns and comfort caregivers. Pediatricians may further decide explicit treatment, based on case evaluation, medical history, and a urine test as needed.

If your practice needs additional triage nurses to handle patient calls, or would like to discuss other telehealth triage services, we want to hear from you! Contact us today to get started.

About TriageLogic

TriageLogic is a URAC-accredited, physician-led provider of top-quality nurse telehealth technology, remote patient monitoring, and medical call center solutions. Founded in 2007, the TriageLogic Group now serves more than 22,000 physicians and covers over 42 million lives nationwide.