Digital Rectal Exam, procedure? Or nursing assessment

[Alex Egan, LPN, EMT-B]

I was dealing with a relative who was constipated and a thought struck me to which I had no clear answer. In assessing a patent for constipation/suspected impaction would it be permitted to proform a DRE or digital removal of stool without a physicians order. Also in thinking this it struck me that in long term care digital removal was common, however I now work in pediatrics, most of my clients are well managed but could the proformance of these procedures be condisered child abuse, even if nursing judgement is sound but a physicians order is absent? Thanks for your careful consideration and thoughtful answers.

[leslie :-D]

in peds, i wouldn't dare consider this w/o a dr's order...

and a parent present for the procedure, if possible.

even in ltc, you 'should' have a dr's order but it's one of those flexible policies that many don't enforce.

check out your p&p manual, to see if anything's written, first.

if nothing, then yes, get a dr's order...definitely.

leslie