digital stimulation!!!

Specialties Rehabilitation

Published

i need help figuring HIM out!!!

i have a pt ,incomplete quad who has been started on q other hs bowel program of suppository and dig stim...some nights bowel program was not effective, so t was changed to q hs; then to our surprise the pt demanded that supp be used as prn and said that dig stim worked better for him wthout the supp; per docs approval we did it; and now this pt wanted dig stim not only q hs but twce a day when he wants it...and to our greatest surprise :yeah:our nurse manager and primary physician approved it...even though hell have result w the dig stim he would want it again and agan during the day...sometimes he had like 3-4 dig stim done; he does not want to do it himself saying he is still weak on upper ext; family is visiting and he does not want them trained doing dig stim...

how frustrating can that be???...i dont know if im wrong but sometimes i would think that dig stim is giving him "another kind of satisfaction":angryfire..why else wound he want a finger up his orifice that frequent????:devil:

arrghhhh!!!!

:bowingpur

I took care of a quad also who was should I say "anal":down: about digital stimulation.He would throw a temper tantrum if we did not do it long enough, he was bleeding rectally and still wanted it done several times a day, and the family just said to continue doing it, really disgusting. Sorry if I am being crass, but I really do wonder, if there is not some sensation there and they enjoy it. I wonder if we had the same patient?

I dont know what his issue is. It may be his bowel program is not right. He may have a fear of constipation, it may cause him to go into AD I dunno. But a bowel program for a quad or para should not be done 3-4 times a day routinely. Otherwise you are defeating one of the purposes of bowel training in addition going to be causing trauma by doing it that often.

Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

Wow. I think I would really feel defiled if I was in that situation. Sounds like you need to have a care conference about this issue and set limits. It is not appropriate to be doing dig stim 3-4 times a day, prn. That is not a bowel program. A bowel program is supposed to be a scheduled type of thing anyway--that's what the suppository is for.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
i dont know if im wrong but sometimes i would think that dig stim is giving him "another kind of satisfaction"
I think you might be correct. :uhoh21:
Specializes in inpatient rehab (general, sci, tbi, cva).

Note:

Some patients with certain kinds of SCI can get stimulated, since they may only have the anal "wink" reflex intact. This is usually what gets them emptied on schedule.

If there's blood or cardiac issues, definitely tell them no, you will not do it. I have a para pt now whose routine was dig stim but twice daily and he did himself.

Sounds like this character is using dig stim as an out. If he did his own that often, he should be on the commode, etc. doing it. It also makes you wonder if he enjoys manipulating staff.

Lots and lots of control issues with SCI patients, but the doc should definitely know about this character.

Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.
Note:

Lots and lots of control issues with SCI patients, but the doc should definitely know about this character.

I agree. I hate to stereotype, but I have many times heard patient's referred to as having a "quad personality." Often these individuals seem to have the idea that the world revolves around them and their needs.

Just an observation.

Specializes in Orthosurgery, Rehab, Homecare.

OP: this is an old thread- how'd it turn out? What ended up happening?

~Jen

What's SCI?

Never Mind, I digured it out. Spinal cord inuury.

Specializes in acute rehab, ICU/CCU, peds, home health.

Sounds like an issue for your team meeting....

i need help figuring HIM out!!!

i have a pt ,incomplete quad who has been started on q other hs bowel program of suppository and dig stim...some nights bowel program was not effective, so t was changed to q hs; then to our surprise the pt demanded that supp be used as prn and said that dig stim worked better for him wthout the supp; per docs approval we did it; and now this pt wanted dig stim not only q hs but twce a day when he wants it...and to our greatest surprise :yeah:our nurse manager and primary physician approved it...even though hell have result w the dig stim he would want it again and agan during the day...sometimes he had like 3-4 dig stim done; he does not want to do it himself saying he is still weak on upper ext; family is visiting and he does not want them trained doing dig stim...

how frustrating can that be???...i dont know if im wrong but sometimes i would think that dig stim is giving him "another kind of satisfaction":angryfire..why else wound he want a finger up his orifice that frequent????:devil:

arrghhhh!!!!

:bowingpur

I agree. I hate to stereotype, but I have many times heard patient's referred to as having a "quad personality." Often these individuals seem to have the idea that the world revolves around them and their needs.

Just an observation.

As a student nurse I am embarrassed and shocked with many of the replies I have come across on this site. Many of you are not acting like professionals and that is really concerning. I honestly think many of you would do well to remember that you or any of those you care about could wind up with an SCI by sundown tonight. You could then find yourself as the unwilling recipient of dehumanising but necessary practices like dig stim. What happened to having a bit of humility towards, understanding and respect for people that have experienced such a life changing event? I'm completely confident that most loathe having to go through the stress of their daily routines and attitudes like many in this thread are not easing the trauma any. If you take such issue with caring for others, why choose nursing in the first place?

Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.
As a student nurse I am embarrassed and shocked with many of the replies I have come across on this site. Many of you are not acting like professionals and that is really concerning. I honestly think many of you would do well to remember that you or any of those you care about could wind up with an SCI by sundown tonight. You could then find yourself as the unwilling recipient of dehumanising but necessary practices like dig stim. What happened to having a bit of humility towards, understanding and respect for people that have experienced such a life changing event? I'm completely confident that most loathe having to go through the stress of their daily routines and attitudes like many in this thread are not easing the trauma any. If you take such issue with caring for others, why choose nursing in the first place?

Thank you for your observations. However, I would like to point out that I was simply making a statement based upon personal experience with quads. These are not facts I have read in books or studied in nursing school. I have personally observed very manipulative behavior by some quads. Because they have very little control over their own circumstances they seek to control others around them. That is actually quite natural. I'm sure if anyone of us were in a similar situation we would likely behave in the same way.

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