Check for Bowel Sounds?

[All4Seasons]

During phone report to the receiving nurse on an ortho floor to whom I was discharging my pt,the nurse tried to lecture me about giving water in PACU without listening for bowel sounds first -I was already a bit irritated with him anyway -he is one of those nurses who interrupts YOUR report,because he has his own agenda -rather then waiting until the end to ask anything you haven't covered. He also said "and you've done all of the postop blood work?"....ah,no....we don't do that here... (I felt like adding "this is where pts recover from their ANESTHETIC,we are not a postop nursing unit"**) but because I try to be professional,I don't say it.

** of course,if we have an ICU case, blood is sent off for a full panel of testing immediately postop, and anyone who is ordered blood work for PACU is done...but not routine b/w for the floor (that's not done until the next am anyway)

Anyway,we don't give a lot of water to drink here -we're pretty conservative -but we DO give po Tylenol 975mg with water very frequently - this is well after the gag and swallowing reflexes have returned.I did a little survey here yesterday,and no one seems to check for bowel sounds (I am talking about non-abdominal surgery/fairly short procedures ~ 2 hours). Anything abdominal is NPO in here -except for mouthcare with iced water spongettes. And I'm fairly certain that nurses in the Post Recovery Lounge don't check for bowel sounds before giving a snack to those pts going home...

What is the practise in your PACU?

Thx,

jen

[Babs0512]

I wouldn't check for bowel sounds either, sounds ridiculous to me.

If they had bowel surgery, they would most likely be NPO anyway, and immediately after surgery, they wouldn't have bowel sounds anyway.

Sound like the nurse you were giving report too was a bit to big for his britches. Probably insecure with himself, and thought it made him sound more knowledgeable. I've dealt with many like him - we all have.

No worries, just do your job and eventually someone will put him in his place.

I've actually said to nurses, "May I please finish my report and then I will be happy to answer any questions you may have." Most are pretty good about it. Constant questions gets me off track, and I tend to lose my train of thought.

[koalarn]

My guess is that listening to bowel sounds is part of HIS adm. assessment & he's hoping you've done it for him. There's one in every crowd! And no, we don't routinely do bowel sounds in PACU- as you said, if they're a bowel case they're NPO anyway.

[PACU'er]

It drives me crazy when my report is interrupted with questions. I'll say something like "if you will allow me to continue, I will probably answer your questions".

It also drives me crazy when the staff nurse asks if the patient has bowel sounds--uh, no! The patient (including their body) was put to sleep. Yes, we give the patient ice or something to drink, especially phase 2 because they are required to be able to hold fluid before discharge. We only give ice chips sparingly to abdominal surgeries, if ordered. We assess the readiness of the patient before giving ice or fluid. the only problem they may have will be with nausea, not a bowel obstruction.

Other questions that drive me crazy (since I get to vent) include "did you ambulate the patient?" or "they haven't voided yet, why not?". I kindly tell them that we worry about bigger issues like breathing.

[pacunurse12]

well next time ask him what his rationale is for asking that type question..lol

[firemantoddswife]

Exactly! Part of the discharge criteria is taking PO, but part of the discharge instructions are "We put your stomach to sleep too, so please do not go home and eat tamales!"

[GHGoonette, BSN, RN]

A patient who was NPM for how many hours preop? How far into the GIT does he think it's going to get before being absorbed?

[wannabecnl]

I tell them (particularly parents of pedi patients) not to serve anything you wouldn't want to see come back up...