Clogged G-tube

Published

Ok, so I have been working for about 3 weeks at a LTC facility. 2 weeks on my own. Last night One of my residents G-tubes was leaking and apparently clogged. The aide never told me it was leaking, so from the time I got this patient at 11, until the time I went to give him meds at 4a, it could have been clogged the whole time. I had no idea.

So I tried to flush it, i tried pulling back. tried a bunch of things, several time. called the supervisor over, she tried. We tried for about 30 minutes. I kept asking her if we should send him out. We are both new, been at this place about the same amt of time as me. She states that we will just wait until Day shift comes in and ask them what the protocol is for this.

I was thinking he needed to be sent out. There was nothing we could do.

So day shift comes in. They aren't happy. I have never met the unit manager before today, and this is the scenario in which we have to meet.

I am not trying to pass the buck....to the on coming shift or the supervisor. But she told me it was her call.

Then I am trying to chart it, i'm tired because i hadn't slept in two days. and I started to chart terribly. Just not how I normally would. I couldn't even think straight. But I knew what I put, it wasn't correct.

So this manager says something about it...rightfully so, but I cry. Embarrassing! She tells me what to put. And then tries to attack the school i went to. She asked where I went. I wouldn't tell her, that is irrelevant to the situation at hand.

I just feel bad...needed to vent. and hear some comments...

Up Vote Up Vote ×
Specializes in Wound Care, LTC, Sub-Acute, Vents.

sorry about the bad experience. you are an rn, correct? aren't you allowed to change and insert a new gtube? can you look it up in you policy and procedures? i just change the gtube after failing to unclog it. only an rn can change gtube in my state.

sometimes flushing with carbonated soda works e.g. ginger ale, coke. sometimes milking it works as well (we are not supposed to but sometimes a little milking is all the tube needs to unclog).

it's tough being new so hang in there!

Up Vote Up Vote ×

Next time this happens, if you can't get it unclogged with a reasonable amount of effort, then change the GT, but first insure that there is a valid order allowing this, or a policy in place. Some people have to be sent out because there is no order for the nurses to do it at the facility. Check now on your residents with G tubes, so you have a good idea of where you stand. Look up the procedure in your policy manual or photo atlas of nursing procedures. There also should be instructions in the GT box. It is not difficult after you have done it the first time. Get your supervisor to be present when you do it the first time. It certainly can be stressful when you are trying to learn things on the fly. It does get better though.

Up Vote Up Vote ×

Sorry for the bad experience! It certainly does not help to have your superiors make unnecessary attacks on your credentials. We've all been in your shoes at some point or another, and I think it is important to separate genuine opportunities for improvement vs. overly negative criticisms (from yourself or from others). It's so easy to confuse the two.

What I suggest is to research the protocols for replacing every thing artificially hanging off your patients before they become an issue. Whether it be an IV, Foley, NG tube, g-tube, J-tube, tracheostomy tube, chest tube, Youtube... whatever. Chances are you'll have to pick it up off the floor and decide what to do with it at some point in your career. This is especially important if you work nights or weekends when there are less people to consult and you are less likely to get in touch with a MD/NP/PA for orders.

Get some rest and keep your chin up!

Up Vote Up Vote ×

You might also ask the facility to look into keeping g-tube uncloggers in stock. They are sort of like firm skinny drain snakes- and work like a charm :) They're sort of expensive- but they are reusable if cleaned (not going anywhere sterile), and saves a trip to the ED with that hassle :)

You did what you were supposed to do- you notified your supervisor. :up:

Up Vote Up Vote ×
Specializes in Med-Surg, ER.
sorry about the bad experience. you are an rn, correct? aren't you allowed to change and insert a new gtube? can you look it up in you policy and procedures? i just change the gtube after failing to unclog it. only an rn can change gtube in my state.

sometimes flushing with carbonated soda works e.g. ginger ale, coke. sometimes milking it works as well (we are not supposed to but sometimes a little milking is all the tube needs to unclog).

it's tough being new so hang in there!

i believe the op is talking about a g-tube, a la gastrostomy, not ng. therefore, she can't place or remove it.

Up Vote Up Vote ×

It was a G-tube. It wasn't pulled out, i could have tried to re-insert it. But there was no unclogging it, tried milking it, tried coke. And it was a kind of G-tube I have never seen before. I won't know what happened until tomorrow night when I go back, but I'm sure he was sent out.

Next time I'll call the Dr and or the unit manager. It is a learning experience. And he wasn't in distress. I just felt so badly about it.

Yes, I need to review the policies. And Yes, I will check on his G-tube earlier in the shift, as to catch any issues quicker.

Thanks for all the help and support!!!

Up Vote Up Vote ×
Specializes in Med-Surg, ER.
It was a G-tube. It wasn't pulled out, i could have tried to re-insert it.

Wow, may be a difference in policies, but I've never been anywhere where I was allowed to re-insert a G-tube. If it came out, came loose, or whatever, we're not allowed to touch it until a doctor has done it & placement verified by x-ray. But, that's just where I work.

Up Vote Up Vote ×

travkitty,

Mic-Key g-tubes can be changed and replaced by nurses and trained caregivers but they are usually for pediatric patients and not adults. They are these wee little things with balloons on the end. You lube them up, push through the stoma and inflate the balloon with water. Done.

Up Vote Up Vote ×
Wow, may be a difference in policies, but I've never been anywhere where I was allowed to re-insert a G-tube. If it came out, came loose, or whatever, we're not allowed to touch it until a doctor has done it & placement verified by x-ray. But, that's just where I work.

Also depends on the type of tubes used in an area. One place I worked, a tube got plugged- and had to be replaced. The jackwagon MD came in and simply YANKED it out of the woman's abdomen- there was no balloon. SO it was like yanking a Foley w/intact balloon out of her abdominal wall.

The poor thing was demented, but it was VERY obvious by the watery eyes that she was terrified, and it hurt. I felt SO bad for her- and had no warning; he walked in, pulled the sheet back, and yanked til it was out. And was sure to give general "lack of recommendations" about that doc to anyone who asked who was good in town- without going into details. I wanted to slug him. :mad:

She went in the next day for a new one (so NPO for 24 hours :uhoh3:). She did ok, but when I started her IV the next day, I had to keep reassuring her about what I was doing- she was traumatized because of "derogatory male genitalia"- head... :down:

Up Vote Up Vote ×
+ Add a Comment