Frequent Fliers...seeking ENEMAS!

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Specializes in Emergency Nursing.

Do you folks have your fair share of older folks c/o constipation? Sometimes coming in numerous times for enemas, laxatives, etc?

Don't get me wrong, I know from experience that this can be quite painful... but isn't there somewhere else for them to go? I'm guessing not, because it's not like you can get a GI MD appt overnight, I'm sure a PMD can't help too much, and a lot of these patients lack transportation for medical appointments. Plus some of them are on opiates and other medications which add to the problem.

Do you see the same type of patients at your facility?

It can just be frustrating as I deal with the 90 year old crotchety man who is demanding a "regimen" to relieve his constipation, even though this is my 3rd time personally dealing with him as a patient... and he has yet to follow up with his GI doctor. Just seems like going to the ETD several times a month is not appropriate.

With this being said, I'll take the older folk over the 23 year old female who hasn't had a BM in 3 days and usually has one daily... :facepalm:

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YES!

They don't need gi doctors. Just someone to shove something up their bum 3-4 times a month, as so as they walk in the doors cuz older folk have no time to delay....

I love old peeps!

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Specializes in Critical Care, Education.

I have an acquaintance - lovely RN originally from Jamaica - who opened up her own enema clinic in Florida. It is well within the scope of licensure, and her 'clients' are happy to pay cash for services rendered. She gets plenty of physician referrals. Strange but true.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

If only they would use the stimulants and softeners prescribed for them.

If only all providers would prescribe stimulants and softeners when they prescribe opiates.

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Specializes in Emergency Nursing.
If only they would use the stimulants and softeners prescribed for them.

If only all providers would prescribe stimulants and softeners when they prescribe opiates.

AMEN! I always try to tell people this on discharge!

Atleast to drink tons of water and eat fiber... and to try OTC stool softeners.

The worst is providers prescribing opiate pain killer for untractable belly pain....so they can get constipated and have more belly pain...

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Specializes in LTC, MDS, ER.

Ugh...not a frequent flier but I had an elderly patient demanding that I give her an enema before discharging her for her chief complaint of neck pain for last six months. Never mind that she had no problem having an extra large bowel movement while she was in the ED.

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Specializes in Emergency Department; Neonatal ICU.

A former educator of mine once claimed that she had only given one enema during her years as an ED staff RN. She said she always successfully argued that "constipation is not a medical emergency." The one enema she says she agreed to give was for a quad with autonomic dysreflexia ... Not sure whether I believed her although she was very firm in her manner and I could easily see her refusing to do them!

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Specializes in RN.

Ya...I see the elderly, and the idiots that could do this for themselves at home...sheesh. Can't imagine how desperate I would have to be to go through that humiliation by going to the ER....

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Specializes in Pediatric/Adolescent, Med-Surg.

I rarely administer enemas. Instead, I instruct pts on self administration and send them off to the bathroom.

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I have seen constipation so severe that it caused urethral compression and subsequent urinary retention. This is an urgent health problem, as it can lead to hydronephrosis and subsequent kidney damage/renal failure.

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Specializes in RN.
I have seen constipation so severe that it caused urethral compression and subsequent urinary retention. This is an urgent health problem as it can lead to hydronephrosis and subsequent kidney damage/renal failure.[/quote']

Good point

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Specializes in Emergency Nursing.
I have seen constipation so severe that it caused urethral compression and subsequent urinary retention. This is an urgent health problem, as it can lead to hydronephrosis and subsequent kidney damage/renal failure.

Definitely! I'm not saying the complaint is unwarranted. Without a doubt we often roll our eyes at a patient's complaint and they end up way sicker. You just never know, but hey, that's the fun of the ER.

Hence my young lady with a mild headache. Seemed like your typical migraine workup and she had 5/10 HA and no other real complaints. Okay, labs, reglan, and CT....then discharge home. NOPE! 36 years old and HUGE brain mass with shift! :eek:

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