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"butter bullets"--narcotics mixed with butter for rectal administration



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No. 10
from Whispera
Old May 11, 2009, 01:40 PM

Default Re: "butter bullets"--narcotics mixed with butter for rectal administration
microbes--don't want an uncomfortable infection....water--don't want more diarrhea than is there already...
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No. 11
from pammyf
Old May 11, 2009, 04:37 PM

Default Re: "butter bullets"--narcotics mixed with butter for rectal administration
Hi Nameste (BTW-I have spent YEARS in India!) I totally relate to you about "hello they are dying....",

And as for the glycerine suppositories. Now, that it a GREAT idea!

Our hospice is connected to a massive hospital-based center with over 10000 employees. As such, the "Jayco"
warriors, as well as the FDA, tend to target every little thing. We try to be very careful to adhere to the fear-based principles of modern medicine and conform to all the appropriate standards of care. As we know, in hospice, when there are times creativity, love, and good old fashioned nursing far outweigh "standards" (not). Butter bullets fall into the category "creativity, love and make it work in the home setting when our patient needs quick symptom management without the frills". Patients come first. Thanks for your support and the glycerin idea!
PS Have you seen any articles supporting your glycerin action? I am on a literature quest for my hospice. I am NOT a student (although I am considering an MSN)..
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No. 12
from Lorie P.
Old May 12, 2009, 05:50 PM

Default Re: "butter bullets"--narcotics mixed with butter for rectal administration
I just ocmpleted my first orientation day for a local hospice. I asked about the "butter" being used and was told yes! It works and they don't have a problem with it. The Rn that did ( doing) orientation says" what can be used for the good of the pt" use any and everything!!

Was also told that the Pharmacist told them that almost any pill you give PO can be given PR, except the enteric coated and a few others.

I learn something new everyday!!
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No. 13
from RNnamaste
Old May 13, 2009, 06:42 AM

Default Re: "butter bullets"--narcotics mixed with butter for rectal administration
OK, now be careful with that advice of the nurse telling you that "whatever is takes for the patient". She is wrong. You WILL lose your license if you are a rouge creator of different methods. Please understand that I was that way once and then learned to comply within the system. I did VNA homecare hospice for many years and you have to detach your emotion at times so you can think clearly when the family is dire for assistance. With true compassion it means to meet them at their experience, but you were brought in for clarity and service. Yes, maalox on wounds, pineapple juice in peg tubes and olive oil on pills is fine, but the efficacy of meds is very different in the pr route. You must speak to Hospice Pharmacia first. This is gentle advice and my hope is that your service is graced with the beauty I have seen for many years.
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No. 14
from RNnamaste
Old May 13, 2009, 06:48 AM

Default Re: "butter bullets"--narcotics mixed with butter for rectal administration
Long conversations with Hospice Pharmacia, enabled us to do with with a couple of meds, not many. Plus, most families will not choose to adminster meds via rectum. I rarely advise this, esp if you stimulate the vagus and then they are nauseous. It rarely is effective.
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No. 15
from Lorie P.
Old May 13, 2009, 07:44 AM

Default Re: "butter bullets"--narcotics mixed with butter for rectal administration
I didn't say that I was going to give po meds pr, jut mentioning what was told. I know better than to just take some one's word for anything , I always research and go by the Policy manual.

Thanks so much!
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No. 16
from RNnamaste
Old May 13, 2009, 07:53 AM

Default Re: "butter bullets"--narcotics mixed with butter for rectal administration
Perfect! I know I got a bit preachy! Have a wonderful day!
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No. 17
from shrinky
Old May 15, 2009, 03:58 PM

Default Re: "butter bullets"--narcotics mixed with butter for rectal administration
We have used them when patients are in pain and unable to swallow, we can't wait on SL meds when we are standing there watching a patient in pain. I don't know of any literature but will look around to see if anything is available. It does work well but not too many of the newer nurses use this method because of the availability of SL drugs which are not as readily available right now. We even have that in our 485 orders that we can give oral meds rectally if patient is unable to swallow.
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