Daniel's story: catheter and bowel care, done with dignity
About this story: this is a composite story based on situations our team commonly supports. Names and identifying details have been changed to protect privacy.
Daniel is 31, works from home as a graphic designer and lives with a spinal cord injury. He needs help with catheter care and a daily bowel routine. What he didn't want was a revolving door of workers who didn't know what they were doing.
"I was teaching my own workers"
Before coming to Good Nurse, Daniel had used a provider that sent whoever was free. "Half the time I was explaining my catheter to someone who'd never seen a suprapubic one," he says. "I'd be lying there walking them through it. That's not support, that's me doing the training."
Under the NDIS, catheter management and complex bowel care are high intensity daily personal activities. They carry real risks, including urinary tract infections, skin breakdown and autonomic dysreflexia, a sudden and dangerous rise in blood pressure that people with higher-level spinal injuries can experience when something like a full bladder or bowel triggers it.
Building a plan around Daniel, not the roster
Our Registered Nurse spent two hours with Daniel at his first assessment. Most of that time was listening. We wrote his support plan with him, covering:
- His bowel routine: timing, positioning, the medications he uses and how he likes it done
- Suprapubic catheter care, bag changes and how to record output
- Exactly what autonomic dysreflexia looks like for him, the first steps to take, and when to call 000
- His preferences: male workers for personal care, music on, and no small talk before 9am
Training workers on Daniel, not just "catheters"
We matched Daniel with a core team of three support workers. Each one completed general training in catheter and bowel care, then a session with our RN at Daniel's home using his own equipment. Nobody worked with him alone until our nurse had watched them do it and signed them off as competent.
Our RN changes Daniel's suprapubic catheter on schedule. That's a nursing task and it stays with a nurse.
The night it mattered
A few months in, one of Daniel's workers noticed during the evening routine that he had a pounding headache and was flushed and sweaty above his injury level. She recognised it from his plan straight away: sit him up, check the catheter for kinks and the bag for fullness, then check his blood pressure.
The catheter tubing was kinked under his leg. She straightened it, the bladder drained, and his symptoms settled within minutes. She called our on-call nurse, who talked it through, and we followed up with his GP the next day.
"She didn't panic," Daniel says. "She just did it. That's what I'd been wanting the whole time."
What to look for in a high intensity provider
- Registration: they should be registered for High Intensity Daily Personal Activities (registration group 0104) and approved for your specific supports.
- A plan written with you, overseen by a qualified health practitioner, that includes emergency steps.
- Training on your equipment and routine, not just a general certificate.
- A small, consistent team, so you're not training strangers.
- A nurse you can actually reach when something changes.
Read more about how we deliver NDIS high intensity support, or call us on 1300 457 557.
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