enema- is that oral or rectal?

  1. I have been an RN for about 3 months now. Where I work we have an RN and LPN on the floor plus 2 aides. I am so use to the LPN passing meds that the night I had to pass meds, I made the stupidest mistake ever!!!! The doctor had ordered a Neomiacyn(sp)? enema for a pt that was going to have a bowel resection the next morning. The enema was in the frig. in a bottle that looked like a big cough syrup bottle. At 2100, the ordered time. I read the order and it said give 100cc. I poured 100cc into a glass and gave it to the patient. The other nurse on that night about 0300 asked how that emema went. I told her fine and that the pt. commented on it not tasting very well. She looked at me in horror. I said what? It's like golytle isn't it? She of course said NO!!! My only comment was---so are you saying that I put it in the wrong end? Her comment--YES!!!
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  2. 15 Comments

  3. by   misti_z
    Learning the hard way, you'll never forget!!!
  4. by   nurs4kids
    LOL...you just wanted to be sure they were clean from top to bottom!!!
  5. by   debbyed
    Thats a mistake you won't make again. Life is all about learning and the best learning usually comes from mistakes. Not one of us is perfect
  6. by   RNPD
    Just remember, an enema always goes in the rectum. Golytely is not an enema, it is a cathartic, as are other oral agents used to clean out the bowel (eg castor oil, cascara).

    If that order actually read "Neomycin enema" and you gave it orally, I hope you notified the MD to make sure it wasn't harmful if taken orally, filled out an incident report and med error report, and notified your supervisor. Everyone here seems to think this is a funny incident; I see it as a major med error that had the potential to greatly harm a patient. I agree that we learn from our mistakes-but we also need to correct tham and admit to them, and you don't seem to have taken the responsibility you should have, but hopefully you did and just omitted that from your post.

    Did the patient ever get the med by the correct route prior to surgery? I hope so, because otherwise, you may have set them up for a major post op infection & peritonitis. Neomycin given orally would be broken down & systemically absorbed before it reached the intended target-the bowel-and would probably be useless to prevent peritonitis as intended. The purpose of the enama route is an attempt to actually clean the bacteria from the lower bowel, so it would be as sterile as possible when cut into by the surgeon.

    Didn't you learn basic medical vocabulary in nursing school?
  7. by   OntRPN
    I agree this is a mistake to be reported not saying we all have not made our mistakes But I find it hard to believe You don't know what an enema is this is basic nursing and not nursing term that people know. The doctors orders should have said the Route this med was to be administered. If I do not know or understand an order I alway ask or phone just to be sure to cover your butt.
  8. by   tonia
    I must need to add to my story for some people. This was not funny at first but after making sure everything was going to be OK , it is funny now. Yes, I informed all the right people and made sure there would be no ill effects. Some people need to be less ANAL!!!!!! Yes I made a IR, duh!!! Yes, I took vocab. Mistakes happen. I guess unlike some, I am not perfect. I hope most people can get a laugh out of this. The Drs. and nurses that I work with are still giving me crap about this. Everything turned out fine so what better to do but to laugh about it.
  9. by   mustangsally
    [QUOTE]Originally posted by tonia
    I must need to add to my story for some people. This was not funny at first but after making sure everything was going to be OK , it is funny now. Yes, I informed all the right people and made sure there would be no ill effects. Some people need to be less ANAL!!!!!! Yes I made a IR, duh!!! Yes, I took vocab. Mistakes happen. I guess unlike some, I am not perfect. I hope most people can get a laugh out of this. The Drs. and nurses that I work with are still giving me crap about this. Everything turned out fine so what better to do but to laugh about it. [/Q

    Would have been scared sh*%less, thank god everything turned out ok. Ahh the wonders of being a nurse
  10. by   RNPD
    Tonia-I am glad that the patient was safe-that of course is the most important thing. I am also glad you have a sense of humor-it will get you through many times when laughing is preferable to crying.

    I certainly am not perfect & have made my share of mistakes in almost 15 years of nursing. But sorry-I still can't imagine a RN not knowing where an enema goes, or the rationale behind an antibx enema prior to bowel surgery. (You obviously didn't understand the rationale or you would have known where the med goes & why). You need to think before you act, and understand WHY you are doing things. Otherwise, you are no better than UAPs who do tasks, but have no idea why. Use you nursing education and THINK about WHY you do something. Then your errors will be just that-mistakes-and not due to lack of knowledge or understanding.
  11. by   ClariceS
    I am glad your patient was okay. And that you can laugh now. I tell my nurses, "Kick yourself today, write the report, then realize that you will not make the same mistake again. You've learned and now can teach that."
    I've worked with some nurses that continue to live in fear that they will make the same mistake again. But if we are good nurses, we can learn and be better for it.
  12. by   KRVRN
    I thought it was funny.

    I guess I just assumed that in an attempt to avoid a big long posting she just left out the part about the incident report, calling the doctor, following up with whatever bowel prep still needed to be done, and explaining to the patient she just fed him/her an enema.
  13. by   Mellissa
    just a thought,

    why do they call it golytely- when ther is nothing going lightly about it.???
  14. by   debbyed
    I've often wondered that myself. It seems more like "Running torture"

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