Need an honest answer here r/g clinicals...

  1. ...and please no one flame me for asking this question

    I start my clinical rotations in 2 weeks at a hospital. I found out today that we have the option of doing all of our clinical rotations at a hospital vs a couple of nursing homes that are in the area.

    We watched videos on colostomy bags, enemas, etc. I have to be honest in saying, I just about couldn't look at the video.

    I was wondering, REALISTICALLY, how much of this do you deal these in the hospitals during your training? I know it's an extremely common thing in nursing homes (one of the reasons I picked the hospital).

    I know that some of you are thinking, "Lord, then why did she sign up for nursing school?"...it's b/c I want to work with neonates, but I know I have to get through this part and not only do I have to get through it, but to make sure the client is comfortable, that his/her needs are being fully met.

    I am mature enough to just "get in there and do it", but I was just wondering how much you have to deal with it.

    I have no issues with urine...it's the poop thing that is going to "get me".
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  2. 24 Comments

  3. by   Achoo!
    Well, my patient this week was found to have an intestinal tumor and had a colon resection with temporary colostomy bag. She then developed an ileus and had to have an NG tube placed. Yes, it is fairly common. If you are in a hospital, don't forget about C-diff!! There will be poop, no way around it
  4. by   TheCommuter
    Fecal matter is virtually inescapable in nursing.

    RNs who work in the ICU often don't have aides, so they must give their own baths, change diapers, and turn and reposition Q2H. RNs who work in L&D see their fair share of poop, because fecal matter frequently squirts out of the laboring mom's anal sphincter as that 7-pound neonate is progressing through the birth canal (right on top of the woman's rectum) to the outside world. RNs who work in the NICU often change poopy baby diapers. RNs who work in med-surg often empty their own urine bags if they want to visualize the color and clarity of the patient's urine for themselves. Nurses who work in oncology sometimes deal with freshly poopy colostomies due to colon CA, and must instruct the patient on ostomy care.

    All nurses must participate in the so-called "dirty work." The "dirty work" seems unimportant to misguided people, until they end up in the hospital and need someone to take them to the bathroom!
    Last edit by TheCommuter on Oct 1, '07
  5. by   SuesquatchRN
    A lot of nursing is simply wiping butt. And that's okay.

    We do a lot of belly surgeries so we have lots of ostomies, Crohn's, colitis, etc. And ALL post-op is concerned with when flatus is passed and then feces.
  6. by   BoonersmomRN
    Well in all my clinicals so far ( I grad in DEC) I have never had a pt. with an ostomy. I have cleaned up poo ( in long term care, Ortho, and ICU) but it's been few and far between. Somehow I have managed to get through most clinicals days without my pt. having a BM. I'm also going to the NICU when I graduate.

    It all depends on the type of floor you are on, the day, and the pt.
  7. by   justme1972
    <sigh> Ok...looks like I'm going to have to tough it out.

    See with babies, it doesn't bother me in the least. I guess it comes from being a mother, I just see it as different than an adult.

    My instructor, whom I talked about this with a little today, said that she has seen students go from not even be able to stay in the same room to being the first to jump in to cleaning up a big mess. I am hoping the "nursing fairy" comes and sprinkles some pixie dust on me to help me get over it.

    I know it's a necessary evil, and I by no means think I'm above it...I would never, ever in my wildest dreams pass something off to a co-worker that would be my job to take care of...that's just unprofessional and rude...it's just this "mind" thing that I just want to badly to get past.
  8. by   MikeyJ
    I would much rather do all of my rotations in a hospital oposed to nursing homes. Nothing against the elderly but it is just a personal preference. HOWEVER, I see colostomies and every other type of ostomy quite often. Although, the hospital I do my clinical rotations at as a nursing team for everything. Thus, the ostomy team does all of the ostomy care. Staff RN's need to do ostomy care once in a great while, but the nursing students never have to unless they follow the ostomy nurse. I must be lucky though because I have never cleaned up any poo or vomit yet!
  9. by   Jolie
    I'm not trying to burst anyone's bubble, but you asked for honest information, so here goes:

    Some of the most difficult cases of ostomy care I've experienced involved neonates. Babies are sometimes born with meconium ileus, or gastro-intestinal defects requiring bowel surgery, that result in temporary ostomies. Other babies get nec, have bowel resections and end up needing ostomies. It's not an uncommon thing in the NICU, and caring for them can be difficult due to the baby's small size.
  10. by   WDWpixieRN
    Quote from Jolie
    Some of the most difficult cases of ostomy care I've experienced involved neonates.
    But I think if I'm empathizing correctly, baby poop is different (at least in some of our minds)....

    To answer the OP's inquiry, we only do clinicals in a hospital and I've had 2 or 3 pts with ostomies of some sort, but they were all able to do self-care, so didn't have to do it myself....

    That being said, I've had plenty of other pts who've had bowel difficulties, so I don't know if you can plan to get away from it either way.

    I, too, don't consider myself a person who will ever work LTC...it's been interesting to see/hear everyone's different interest...some can't stand the thought of working with babies, so thank heavens we're all different!!
  11. by   Daytonite
    I've been working in the acute hospital and nursing homes throughout my career as a medical nurse. I didn't have that many patients in the nursing homes with colostomies and even less in the hospital. I think you're worrying over nothing.
  12. by   RN BSN 2009
    I was on a med surg floor and saw a few colostomy patients, however I never saw any at the LTC.
  13. by   nurseontheway
    I have already come to terms with this aspect of nursing. I am starting school in December. I currently work at a daycare and get paid eight dollars to deal with poop pretty much on a daily basis. As a nurse you have to deal with bodily fluids but we are well compensated for it! Plus, when you are dealing with someone who is sick you can have empathy for them. I don't deal very well with seeing blood so I will have to get over this. Good luck!
  14. by   Jules Anne
    I think almost everyone has some aspect of nursing that grosses them out. For me, it's mucus. But it's something that you will learn to deal with. A summer internship in ICU with vent dependent patients helped me get over the mucus thing. It still grosses me out but I can get through it without gagging now. It helps me to remember that the patient would most likely not need to be suctioned, have their poop cleaned up, etc. Keeping this in mind makes me want to act as nonchalantly about it as possible to help them not to feel embarassed.

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