Proper way to give suppositories - page 2

hello allnurses! i need your opinion on something. i am an lpn in ltc. we have several floors or units in my building. one floor is being renovated so that floor is dispersing its patients to any floor that has available... Read More

  1. 4
    Wow! Talk about micro managing! The old manager shouldn't undermine your manager's authority for something so petty and she should police her own. The reasoning is silly. It's not ergonomically correct nor is it proper biomechanics to perform it her way. It's also pretty nasty to stick your hand past her vagina and blindly insert the suppository with your face near her crotch.

    I was always taught the the PT should be in Sim's position. I would think the toilet method wouldn't be effective because you wouldn't have the wrist leverage to slide the suppository close to the rectal wall; thus you'd insert the suppository into the fecal mass. Not desirable. I'd probably tell the old nurse manager that you won't discuss the pt's care due to Hippa rights. If the old nurse manager wants to break her back; stick her arm halfway in a toilet and place her face close to someone's crotch I'd give her the green light.
    morte, agldragonRN, sunnycalifRN, and 1 other like this.

    Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  2. 2
    Wow, this is another example of "the patient is always right" gone wild. You should not have to put yourself at risk of injury to insert a suppository. Maybe you could mention to the patient that the suppository should be inserted prior to sitting on the toilet for optimal effectiveness?

    We had a similar situation with a chronic patient who came in to the unit. The patient's wife/caregiver presented nursing and the ICU team with a three page long, typed list of care requirements for her hubby. The list included minute details such as when to turn on the TV, to what channel, how many volume "bars" and also what order to give his oral meds (9 pills on days), 1st ASA, sip of water (no ice!), next lisinopril, etc. The ICU team just typed up the entire list and put it in as a nursing text order (they don't have to do it!!!). We took it to our nurse manager who just laughed and said to do our regular nursing care and let the wife take care of her "list of demands".
    agldragonRN and Emergency RN like this.
  3. 1
    Quote from sunnycalifRN
    . We took it to our nurse manager who just laughed and said to do our regular nursing care and let the wife take care of her "list of demands".
    Yay!!!! good for her, for standing up for the ridiculous list of customer service junk many of us do on a daily basis
    agldragonRN likes this.
  4. 1
    Why would someone want a suppository inserted while they're sitting on the commode? Doesn't make sense to me.

    It seems like the suppository would just squirt out immediately, how does she hold it in?

    Anyway, I would refuse to insert it in the way she is requesting. It's against the 'Nurse Practice Act' for us to perform or administer anything other than the way it is correctly to be done.
    agldragonRN likes this.
  5. 2
    except for the awkward ergonomics, i'm not understanding the big deal.
    and i'm esp not understanding why/how your face is near the pt's "crotch"?
    wouldn't you be standing on her side, using the closest arm/hand to palpate and insert?
    and speaking of palpation, what is wrong with doing it blindly?
    it's not anatomically challenging to find the anus.

    fwiw, elderly often are prone to bowel/constipation problems, so when they find a routine that works, they stick with it.
    i like the suggestion about sticking to the p&p manual (if it's even addressed).
    but other than that, keep your face away from her crotch and see if you can insert it before she sits down on the toilet.

    hope everything comes out ok.
    heh.

    leslie
    systoly and agldragonRN like this.
  6. 2
    Quote from RedhairedNurse
    It's against the 'Nurse Practice Act' for us to perform or administer anything other than the way it is correctly to be done.
    now, that's a stretch.
    it's not as if he's inserting it up her nose.

    leslie
    sharpeimom and Tait like this.
  7. 2
    Quote from leslie :-d
    except for the awkward ergonomics, i'm not understanding the big deal.
    and i'm esp not understanding why/how your face is near the pt's "crotch"?
    wouldn't you be standing on her side, using the closest arm/hand to palpate and insert?
    and speaking of palpation, what is wrong with doing it blindly?
    it's not anatomically challenging to find the anus.

    fwiw, elderly often are prone to bowel/constipation problems, so when they find a routine that works, they stick with it.
    i like the suggestion about sticking to the p&p manual (if it's even addressed).
    but other than that, keep your face away from her crotch and see if you can insert it before she sits down on the toilet.

    hope everything comes out ok.
    heh.

    leslie

    she is in the toilet (with toilet chair) in a small confined bathroom, no space for me to go on either side or the back, only through front. i am 6 feet tall and the toilet is low.

    she likes the suppository to be inserted when she is sitting already on the toilet chair so inserting it before she sits down is deviating from her "routines".

    i know where the anus is. i took ap i & ii and i have my own as well. the problem is me bending so low and my face near her crotch and blindly inserting it.

    caliotter3 and leslie :-D like this.
  8. 0
    Quote from redhairednurse
    why would someone want a suppository inserted while they're sitting on the commode? doesn't make sense to me.

    it seems like the suppository would just squirt out immediately, how does she hold it in?

    anyway, i would refuse to insert it in the way she is requesting. it's against the 'nurse practice act' for us to perform or administer anything other than the way it is correctly to be done.
    i heard from agency nurses that come to my floor who took care of this pt previously that sometimes the dulcolax would squirt out as soon as you put it and she would ask you to insert a new one.
  9. 1
    ah, ok...

    then yes, i would refuse just by reason of its inappropriateness.
    esp being different genders.
    heck, i would never insert it on a male pt, from a frontal position.
    never.

    seriously, see if it's addressed in your p&p.
    or, if the toilet is movable, move it elsewhere.

    eek.

    leslie
    sharpeimom likes this.
  10. 4
    I find it kinda funny that I am posting to a suppository question - as, thankfully, air transport sort of eliminates the possibility of ever using them - but, strangely enough we have some tylenol ones on the helo.

    I think this is a simple issue of medication administration. Follow the P & P to the letter and then Standards of Administration to the letter. (I would think that the "bearing down" that takes place on the toilet alone would make that position for insertion of a medication that should be retained for a certain time - UNSUITABLE). Anyway, unless you can find a guide to administration that details this "position" as suitable and the P & P do not detail the same - then just follow the written rules.

    As for the position issues that you note due to your height - well, those are real. I am concerned that you would not have a basis (or they will have a defense) for any resulting back injury that you may sustain while doing "anything the patient wants, anyway they want" - all the while the administration notes "informally" (as in tells you) for you to - just do it!

    The biggest issue that I see - is if you hurt your back they can note that you were not administrating the medication in the proper position, not using proper body mechanics. You lose. The defense that they "said" just do whatever - others do it, you should too - is absurd.

    As for the poster that notes a psych issue - that may be a component, or it could be less the suppository that is making her go as it is stimulation of the anal area while on the toilet (that statement seems disturbing once I typed it :eek ). Momma cats lick kitten bottoms to stimulate them to poo so that is my mindset - not that the mental image is improving.

    I say - FOLLOW THE RULES.

    IF you were to have an injury (or exposure due to "crotch" vicinity - this is getting worse, sorrry) the only thing that will save you is that you were hurt despite following good positioning mechanics and following some standard of care.

    Good Luck.
    Emergency RN, sharpeimom, Virgo_RN, and 1 other like this.


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

A Big Thank You To Our Sponsors
Top