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 rooms. we received one female patient from that floor a couple of weeks ago and she is alert and oriented x 3 with physical deformities so she is unable to care for herself. she is not ambulatory but she can propel herself with one arm in the wheel chair.
anyway, she gets dulcolax suppository every three days and she likes to get it while she is sitting on the toilet chair. mind you, the toilet is low and she wants me to bend over (i'm 6 feet tall) and insert the ducolax without seeing the rectum. so the first day she was transferred to my floor, i did it her way because that's how she's been getting it from her old floor. it was very difficult for me because i had to feel for her rectum first because i could not see anything even with me bending and my face was so close to her crotch because the toilet is low and no extra room so i did it through her front. i told her afterwards that it was difficult for me and bending that low was not good for my back.
the next time i gave it to her i asked her to stand for me and hold on to the rails and i will insert the dulcolax that way. the c.n.a. was there supporting her back. i inserted it quickly and put her back in the toilet chair. she resisted at first but i've been doing it that way ever since.
i thought everything was fine but today the nurse manager on her old floor came up to my floor and spoke to my nurse manager and said the patient came to her and complained that we changed her routines. my nurse manager said to her that she agreed with me asking the pt to stand up. then the old nurse manager said she will go to the don and report this. my nurse manager said ok report.
so the old nurse manager came back and said to my nurse manager that our don said we have to follow what ever the pt wants. so when i came to work at 3pm, my nurse manager told me what the don said per the other nurse manager.
i told her i totally disagree with that and i am not going to break my back and plus suppository should be given when the pt is in bed. but no the pt wants it when she's on the toilet and exactly at 5pm. my nurse manager said she agrees with me and i should write a memo to the don.
then a couple of hours later i saw the old nurse manager and asked her what the don exactly said. she said if we have a problem go see the administration. so i explained to her i am tall and it was difficult for me to bend and i needed to see the anus so i can insert the med properly. she said i did not have to look at the anus and “just insert” it. she also said her staff did not have a problem when this pt was on her floor and why are we having problem following patient's routines.
so my questions to you guys, is it worth fighting this? should i just sacrifice my back to make the pt happy especially the don said we have to follow what the pt wants? is there a better way of giving suppository? i was taught in lpn school that i should be able to see the anus before inserting suppository and proper body mechanics dictates that suppository should be given when the pt is in bed?
am i wrong?
thanks for your advice and for reading my long post!