PRN ducolax suppositories, okay to give right before shift change?

  1. We got a little sidetracked on another thread about this subject. From my point of view, it's perfectly fine for night shift to give a suppository at 6 AM, even if the next shift deals with the results. I have no problem with that. I think it's best to give a suppository at a good time for the pt. If a nurse at shift change told me that she just gave a suppository to a pt, I never would think that she was trying to pawn her work off on me. If I was working nights, I would not give a suppository until after lab had come and woken up the pt, which would mean that would be at about 6AM.

    When I worked LTC, the policy was that the nightshift checked the BM records and gave them at around 6AM or so. That meant that possibly the next shift would be dealing with the results of these oftentimes incontinent pts. I never heard any complaints about that.

    Yet someone on another thread thought that it was inconsiderate to the next shift. What do you all think of this burning issue?
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  2. 39 Comments

  3. by   Tweety
    I would rather give it myself than night shift give them right before they leave.

    It's that's a facilities policy I would accept it. But I think bowel routines should be done on day shift and early evening. Leave nights out of it. Definately do not put a suppository up someone right before I get there. We're trying to pass meds, assessments, breakfast trays and I'd rather not deal with codes browns right off the bat that could be scheduled more conveniently, because I'm busy when I get there and so are the techs.

    It's not necessarily inconsiderate, but inconvenient. Possibly inconvienent for the patient who may have to wait on staff to help because we're all in other rooms or the middle of report.
    Last edit by Tweety on Feb 19, '07
  4. by   adrienurse
    deleted
    Last edit by adrienurse on Sep 17, '08
  5. by   Spidey's mom
    hmmmm . . . .I come to work at 2:45 a.m. and hopefully my pts are sleeping. Rude of me or pm's to wake them up for a suppository.

    I'd give it after labs and breakfast for a pt experiencing constipation.

    We use alot of prune juice though . . . seems to work well and you avoid all the other interventions . . but that is off-topic.

    steph
  6. by   NextSummer
    In my floor where I worked before, it was usually day shift's job. I worked nights, and there was a particular nurse who wanted us to give supp to a certain pt at 6 am. It mostly worked well with that particular pt. But one day, poop was all over the place when the day nurse arrived (that's what I heard later), and guess what, we night shift got all the blame!!
    Last edit by NextSummer on Feb 20, '07
  7. by   caliotter3
    When I worked in a LTC fac as a CNA on night shift, the bowel program was done by PM shift. The PM nurse who worked on one station religiously gave everyone on her station enough MOM to insure excellent results for the night shift. Much of this occurred at the end of PM shift and the PM CNAs would laugh at us as we walked in the door. The residents hated it. By the time we got to the end of the station, we had to start over again, with the repeats. My personal opinion was that this was abuse. Not one nurse would discuss the matter.

    She gave the laxative to every resident, there was no need to keep a BM record, b/c she gave the laxative anyway. I always wondered what her problem was.
    Last edit by caliotter3 on Feb 19, '07 : Reason: Addition to post
  8. by   GardenDove
    I'm glad I started this thread, this is very interesting. Calioteer, that nurse sounds like she had it all worked out to protect her shift from having to deal with BMs.
  9. by   VivaLasViejas
    All I know is, if I'm ever forced to live in a nursing home and someone wakes me up at the ungodly hour of 6 AM to deliver a 'silver bullet', he or she is going to be in for a bad time. How incredibly rude to schedule such an invasion so that it's most convenient for the STAFF, rather than the resident!!
  10. by   debblynn13
    I had a patient the other day who had been taking lactulose during the day and still hadn't had a bm. So I called the doctor and got an order for a fleets enema. It was 30 minutes before shift change, by the time the order got filled by the pharmacy it was 10 minutes before the end of my shift. I did ask the CP1 (tech, nurses aid) if she would like me to do it or have the next shift nurse give it. She looked at me like I was insane and said it didn't matter to her that it had to be given sometime. *shrug*....so I gave it. But at least I gave them the option.
  11. by   GardenDove
    mjlrn--Actually, at the nursing home I worked at you'd think the residents were in boot camp they schedule they kept. They woke everyone up at 6 AM and started hustling them out of bed. I never did understand why the rigid regieme
  12. by   SharonH, RN
    Quote from GardenDove
    I think it's best to give a suppository at a good time for the pt. ............If I was working nights, I would not give a suppository until after lab had come and woken up the pt, which would mean that would be at about 6AM.

    I can't imagine that 6AM would be a good time to get a suppository. I certainly wouldn't want one that time of morning just because lab had just had a go at me. I might just want to catch a few more zzzzz's. Let's not have all the fun at once, spread it out!

    And from a nursing perspective, yes it is inconsiderate. It's rather frustrating to try to get your shift going, and before you can open a chart or look at a MAR you have to run to help someone to the bathroom perhaps multiple times depending on how well the suppository worked.
  13. by   GardenDove
    So then, it's better for nights to skip the whole thing and let days take care of it?
  14. by   KellNY
    Well, in all the LTCs I've worked for, there were a slew of 6am meds to be given anyway, and the PT is awake anyway because the CNAs wake them starting at around 5:30am.

    As per policy at every place I've worked at, if no BM by 6am, suppository would be given at that time by night nurse. In fact, days would get md if it wasn't done, because that was one more thing for them to do. (evenings would give the MOM the night before at 5pm I believe--which is, excuse the pun--a crappy time to give it)

    From what I've heard from the CNAs, they get the Pt's up so early so that it's not unfair for the day shift, because they'd complain that they did all the work. (Because then an 11-7 CNA would really not have much at all to do otherwise-save for accidents, while a 7-3CNA would have to wake, dress, feed, shower, lotions, etc.

    So it's more to even out the work load than anything else/ Also helps the LPN when passing meds. Certainly has NOTHING to do with resident preference or convenience.

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