Saw my first disempaction yesterday!

MICU RN · Apr 22, 2003

And your why there is a nursing shortage?

Mimi2RN, ASN, RN · Apr 22, 2003

We had a newborn, with feeding problems, we knew the plumbing worked. She had a barium swallow and became impacted. Glycerin supps didn't work...rectal stimulation had been tried, a couple of days went by, no poop.

Finally I was able to start things moving with a thermometer probe cover.....got out chunks of barium, she didn't cry, just kept trying to bear down......she was much happier afterwards, and so was her doc!

Scavenger'sWife, RN · Apr 22, 2003

Yep...used to think that it would bother me too. Now, after working a few years, I don't think much bothers me at all. I once got called out in the night to the assisted living place I was working b/c a LOL needed dis-impacted. Do you think I could find any silicone? or Vaseline? arrrrgghh... Finally had a brain cell fire: I went into the kitchen and got out a gob of Crisco. Went to the LOL and it worked like a dream! That became our code word: "The lady might need Crisco'ed!" hee hee

The only time I thought I was gonna lose it was with a deceased hospice patient. I turned him to clean him up before calling the funearl home and a HUGE amount of green ....."junk".....came out of his mouth, nose, rectum,every orifice. EEEEEeeeeaaaaaccckkkk!! But I kept my cool. Thank God I always got the families out of the room before I washed the bodies. Think if THAT had been witnessed by family?

HoustonRN · Apr 24, 2003

The dead bowel story reminds me of when I was a baby nurse-- I had a little old lady from a nursing home who had come in for abd. pain. I assessed her and asked when the last time was she had a BM. She stated, 2 weeks. Well, I thought she was exaagerating. Later that evening I was feeding her clear liquids, and she kept "spitting" and the jello etc was hitting the wall at the foot of the bed. After asking her to stop spitting several times, I became angry and quit feeding her. While I was changing her gown I thought I saw her stomach move, but didn't think anything of it.

WELL, it turns out she had a twisted gut! She was completely obstructed and what I had seen was visible peristalsis!! Now when they tell me they haven't had a BM for two weeks I believe them.

gwenith, BSN, RN · Apr 24, 2003

I work with a consultant who regularly orders prune juice 40-100mls bd down the nasogastric to prevent constipation in long term ICU patients. We are also trially "Yokult" a liguid yoghurt acidophillus preparation for diahrrea

Retired Nurse · May 3, 2003

You can get used to most everything. It is the smells that tops it off. If you can turn and get a fresh breath!!!!! Once when I was holding the basin for a resident vomiting fecal matter, I ask the aide to bring another pan, but then didn't need it. It was worth it when the resident was so thankfull that I hadn't left her. (The least you can do for anyone near death)

Streamlined · May 3, 2003

This thread went from disimpaction to glass eyes so fast, I couldn't keep up. I'm pretty darn good at disimpacting. I always remember a nursing instructor telling us to think of it as getting tomato paste out of a can. This is not accurate, of course, but I smile imwardly and think of her saying this as I'm doing the deed. Use lots and lots of lube. Wear three or four gloves on your "working" hand to begin the job. You could, say, wear one size small, two size mediums and then a size large or whatever works best for your particular hand. Goes without saying, that you would warn your patient first for what you're about to do to them, along with the promise that they'll feel a helluva lot better. Introduce that digit slowly, aiming for the walls of the rectum as high as your well-protected finger will let you. SLOWLY "around the world" several times, then retract your finger and peel off the first layer of glove. Lube up again, keep repeating the slow spin around , attempting to make contact with the lumen of the rectum. No need to "dig out"--Jeez, I hate that expression--unless there's a very obvious and grabbable chunkette. Let the dig-stim and the lubricant do the work. Be patient. Keep the person warm and covered. Once you've explored the landscape in there, you might come to find out that there's room to tuck a suppository up against the intestinal musosa and then, well-Bob's your uncle! Try not to be grossed out. This is a skill to be proud of because you can offer so much relief in a well-educated and holistic way, thus utilizing all your best gifts. So, to summarize: lube, slow, multiple gloves and the Golden Rule.

gizzy76 · May 3, 2003

Wonderfully put...thanks Streamlined!

TiddlDwink · May 5, 2003

:imbar

I've known 'em all... those who couldnt stand phlegm, mucous, feces, vomitus, even blood! I think each of us has something... for me, it's the odor of an infected wound! Truly makes me want to puke!

sb22 · May 5, 2003

I had a patient vomitting stool once. I almost threw up on the patient. The doctor wouldn't even go to the patient's room. He called to have the patient sent out to an acute care hospital (I work in a physical rehab facility) and filled out the transfer form. All I had to do was stay with the patient and not vomit on him. Believe ot or not the patient lived. He had a bowel obstruction.

Yech!!

dosamigos76, RN · May 5, 2003

Vomiting stool? Oh geesh-I didn't know that was possible. Guess I'll be learning alot once I get in the Nursing Program.

Ewww.

Cheryl

Jenni · May 5, 2003

Originally posted by PerkyCardiacRN
I can suction...no problem. Worked 4 years with vented/trached pts.

Just keep the eyeballs away from me...especially the prostetic (sp?) ones.

Ewww, that has to be the worst. Not much bugs me..but taking out someone's prosthetic eyeball and dropping it in a denture cup for the night just gets me. :eek: