Published
In recent years, most places I've worked no longer do manual disimpactions. Now your -plegia population may be different and it would be appropriate to have it as an order. Maybe it should be included into your protocol - just to be on the safe side (and care-planned also).
I've learned of another rational for avoiding that procedure because of complaints of abuse having been made (assaultive and kinky kinds). I'm not kidding - being honest!
PS - it's VAGAL. Vaso-vagal - you were close!
So I was informed recently that a doctor's order is needed to perform manual feces removal. Has anyone ever heard of such a thing? I always assumed this was purely a nursing intervention. I have a few para/quadriplegic residents residents who don't respond to our bowel care protocol (MOM, then suppository, then Fleets) and on the 4th day I automatically remove the stool manually if there haven't been results. Isn't this standard practice across the board?I was told this is an "acute intervention" and as such needs an order. Policy is policy, of course, but it seems extreme to me. I know there's vaso-vaugal (sp?) risk, and risk for trauma. But all nurses should know how to do this safely.
If they telling you it requires an order, then it does and that is pretty much the end of the story.
No, not all nurses know how to do it safely....that, I can tell you.
BrandonLPN, LPN
3,358 Posts
So I was informed recently that a doctor's order is needed to perform manual feces removal. Has anyone ever heard of such a thing? I always assumed this was purely a nursing intervention. I have a few para/quadriplegic residents residents who don't respond to our bowel care protocol (MOM, then suppository, then Fleets) and on the 4th day I automatically remove the stool manually if there haven't been results. Isn't this standard practice across the board?
I was told this is an "acute intervention" and as such needs an order. Policy is policy, of course, but it seems extreme to me. I know there's vaso-vaugal (sp?) risk, and risk for trauma. But all nurses should know how to do this safely.