The nurse highlighted
the need to complete a three-day bladder diary at
the outset of training and again three to four weeks later (to selfmonitor
progress). In working together to customize
a bladder training program, the nurse and patient
knew that the most important part was agreeing
on a daytime “between-void” interval. It would likely
require eight to 12 weeks for Ms. Spencer to achieve
the goal of three to four hours between voids, so
the nurse encouraged her to break that period down
into two-week targets. For Ms. Spencer, this involved
stopping her practice of preventive, hourly toilet
use and waiting for 10 minutes when she felt the
urge to urinate. The nurse taught her to complete
a maximum of five fast pelvic floor muscle contractions
as an urge deferment technique, followed by
a distraction exercise.