[mitzicat]

Hello...this is my first posting! Lately on our rehab unit we have been initiating BID Bowel Programs (ie- bisacodyl supp p breakfast & p dinner). We have been doing this with our patients who have bowel incontinence..."to get ahead of the incontinence". I'm not real crazy about these programs. It seems like we are not giving the gut time to reabsorb water from the stool and these patients often develop loose stools. We do these programs just on our CVA patients. I would love to hear what my fellow rehab nurses say about this. Also, does anyone have a somewhat reliable bowel program for their CVA patients? I look forward to hearing from you!! Thanks........

[MT RN]

I have floated to the rehab floor in my hospital a few times, and they do the same thing. Like you, I don't necessarily agree with it, but it apparently is a long standing policy and the regular nurses .on the floor don't see it as a problem

[mel1977]

I have been in rehab for ten years-as an aide, unit sec and now an LPN. My mother has been a rehab nurse for 25 years and is a primary who actually writes/initiates NBPs and never to this day have I seen her or any other nurse ever write to give a Suppos twice a day. They should be once a day in conjunction with other methods. Even our spinal cords DON't get them BID. am or pm.

[MS._Jen_RN]

Ours is once per day or even every other day, even those with neurogenic bowel. I don't know many "healthy people" who "go" twice a day. Besides, bisacodyl is a stimulant/irritant laxative, just because you went after doesn't mean that you "had to". It causes the gut to move, ready or not. (Hence the comment about runnystools) I would think it may even cause greater issues with consitpation being harder to relieve down the road. Just my .
~Jen

[TAMIMI411]

HI all .
im working in rehab center since 2 years , we never give dulcolux supp twise a day , we are doing that once every other day half hour before pathing the patient at evening time , so patient can attend his therapy at morning time comfortable , in case if the paient didnt pass stool after tow hours of isertion the supp we are giving him another one with rectal stimulation by the finger .
thanks...

[TREY8]

Hi all,
We try to never use dulcolax supp., instead we use a water soluble supp. (Magic Bullet).
Question: does your hospital even check to see if the pt. has a BCR? If so they could be placed on a DIL program. It sound like your hospital isn't considering what will be beneficial for the pt. in the long run. I work on a sci rehab floor and it would be insane to attempt to give a pt. a bowel program twice a day. When are they supposed to do therapy?

[weesyanne]

It seems to me with the BID bowel program that the patients wouldn't have time for any therapy because of having bowel movements all day and evening. Unless the person is extremely constipated, I wouldn't think it would be advisable.

[silvergirl]

ONly once have we given BID, this was a guy who would have huge results for me on 3-11 but would be invol alot at 0900 so they started doing it bid. This was very difficult cuz he would be sent off to TX after the 9am one and become more invol there. Ended up Doing them all qd at 9am and skipping the eve one-which was okay with me being on the SCI team and having 3or 4 more pts programs to do each night. I guess they thought I wasn't doing any good with mine at noc! just kidding. Heh they shoulda been there to see how much he went. I just felt bad for the pt--poor guy all that time spent waiting to go when he could be in txs