Proper way to give suppositories

Nurses General Nursing

Published

hello allnurses!

i need your opinion on something.

i am an lpn in ltc. we have several floors or units in my building. one floor is being renovated so that floor is dispersing its patients to any floor that has available rooms. we received one female patient from that floor a couple of weeks ago and she is alert and oriented x 3 with physical deformities so she is unable to care for herself. she is not ambulatory but she can propel herself with one arm in the wheel chair.

anyway, she gets dulcolax suppository every three days and she likes to get it while she is sitting on the toilet chair. mind you, the toilet is low and she wants me to bend over (i'm 6 feet tall) and insert the ducolax without seeing the rectum. so the first day she was transferred to my floor, i did it her way because that's how she's been getting it from her old floor. it was very difficult for me because i had to feel for her rectum first because i could not see anything even with me bending and my face was so close to her crotch because the toilet is low and no extra room so i did it through her front. i told her afterwards that it was difficult for me and bending that low was not good for my back.

the next time i gave it to her i asked her to stand for me and hold on to the rails and i will insert the dulcolax that way. the c.n.a. was there supporting her back. i inserted it quickly and put her back in the toilet chair. she resisted at first but i've been doing it that way ever since.

i thought everything was fine but today the nurse manager on her old floor came up to my floor and spoke to my nurse manager and said the patient came to her and complained that we changed her routines. my nurse manager said to her that she agreed with me asking the pt to stand up. then the old nurse manager said she will go to the don and report this. my nurse manager said ok report.

so the old nurse manager came back and said to my nurse manager that our don said we have to follow what ever the pt wants. so when i came to work at 3pm, my nurse manager told me what the don said per the other nurse manager.

i told her i totally disagree with that and i am not going to break my back and plus suppository should be given when the pt is in bed. but no the pt wants it when she's on the toilet and exactly at 5pm. my nurse manager said she agrees with me and i should write a memo to the don.

then a couple of hours later i saw the old nurse manager and asked her what the don exactly said. she said if we have a problem go see the administration. so i explained to her i am tall and it was difficult for me to bend and i needed to see the orifice so i can insert the med properly. she said i did not have to look at the orifice and “just insert” it. she also said her staff did not have a problem when this pt was on her floor and why are we having problem following patient's routines.

so my questions to you guys, is it worth fighting this? should i just sacrifice my back to make the pt happy especially the don said we have to follow what the pt wants? is there a better way of giving suppository? i was taught in lpn school that i should be able to see the orifice before inserting suppository and proper body mechanics dictates that suppository should be given when the pt is in bed?

am i wrong?

thanks for your advice and for reading my long post!

angel

would she perhaps consider using a bedside commode on suppository days? by positioning the potty chair so you had adequate room to work in, you would eliminate (no pun intended...) the groping around from the front because you had enough room to work from the side of the chair.

kathy

shar pei mom:paw::paw:

kath, that's what i was wondering as well.

op, seriously, have a 1:1 with her.

listen to ea other's concerns/issues and see if you can negotiate something, i.e., using a commode.

if she refuses to budge, then you have the support of your nm.

let the 2 nm's duke it out betw themselves.

redhairednurse, all i'm saying is you can't go around saying something's against the npa, when it isn't.

in the meantime, i'll try to control being facetious.;)

leslie

Specializes in Wound Care, LTC, Sub-Acute, Vents.

i did speak to her yesterday. i was hesitant at first because i didn't want her to report me as confronting her. but i spoke to her professionally and she said she had no problem standing while inserting the suppository. her problem was i don't insert it at exactly 5pm. now this is the heavy med pass time to my 25 patients and she wants me to stop and give her the suppository. i was told during orientation that i am not supposed to stop my med pass even for treatments because that's infection control. isn't inserting suppositories like doing treatments or worst?

anyway, i explained to her i am usually done in 2 mins. she said "yeah i know." so i asked her how come her former unit manager said that she was complaining to her. she said she did not say anything to her. so i think she says something different to us and to her old floor staff.

i will try to use the bedside commode but i am not very hopeful because whatever she wanted, she got when she was on her former unit. and what the don said about "whatever the pt wants, we have to follow" makes me sick. so i don't think i can change the time either because she wants it at this time

Specializes in LTC, Memory loss, PDN.

Obviously the statement by the DON, "whatever the patient wants...", is not well thought through. However, I believe I would ask the unit manager from the other unit to have one of that unit's staff members show me how they do this. Then I'd try it this way. If I couldn't, because of space or physical reasons I'd discuss alternative options. BTW, why is giving a suppository or doing a treatment during med pass an infection control issue (just curious)?

I would not care to be a patient receiving my medication from the nurse after her hands have been in someone's perianal area. I don't care how many times s/he washed their hands or how many pairs of gloves were worn.

Specializes in Wound Care, LTC, Sub-Acute, Vents.

like what i said i spoke to the former unit manager yesterday. she said her nurses did not have any problem doing it for the pt. i asked her has she ever done it? and she said no. i told her that my unit manager tried it once and she agreed with me that it was difficult.

the former unit manager said she did not even think that she won't be able to do it. she then proceeded to demonstrate how she would do it. i did not pay attention to what she was showing me because she never done it and she does not know what she was talking about. i left because i did not want to argue with her. maybe i should have asked her if i can call her on suppository day and she do it and show me.

i don't know why doing treatments during med pass is an infection control issues. that's what i was told when i started and they said it's in the policy and procedures.

my unit manager asked me to write a memo to the don. they want everything in memo in my facility. i am just afraid that they would think of me as a trouble maker and cannot do a simple task such as inserting a suppository.

i am a pretty resourceful guy. i try to fix everything myself whenever i can. i mop and sweep floors when others are so quick to call house keeping. i go down in the lobby to buy sodas for my pt. i fix the cable in the tv. i lift tv and transfer to other rooms. i transfer beds myself. you see i am not so quick to call for whatever department it is. if i can do it, i will do it. i am saying these things because after work last night, i started browsing for job openings because of what the don said about "whatever the pt wants."

i think i am a pretty good nurse and my residents love me in my unit. i am able to give meds to very difficult pts when they refused others. they said i have that "charm." i am saddened that we are not getting the administration support when it is needed.

i should go ahead and finish my rn so i can have more optons. i am doing excelsior college so it is self-paced. i am very close to finishing.

thanks guys!

angel

i am saying these things because after work last night, i started browsing for job openings because of what the don said about "whatever the pt wants."

angel

angel honey, i hate to be the one who breaks this to you, but 99%+ of employers feel this way.

we are in a service industry and we nurses are their servants.

the only thing we haven't done yet, is sing the burger king song, "hold the pickles, hold the lettuce, special orders don't upset us, all we ask is that you let us serve you your way...

but we're approaching that point.:stone

the bottom line is admin doesn't give a fig about staffing, morale, or even pt safety/well-being.

the bottom line is $$$.

i don't know how new you are, but you may as well learn this as early as possible.

the only way it will ever change, is if we nurses start saying "no" and "no more".

but collectively speaking, this won't happen...for a million different reasons.

but definitely put your concerns on a memo.

notable issues are always put in writing.

you'll be fine...i'm sure.:)

let us know what happens.

leslie

Specializes in A myriad of specialties.
To be candid and bordering on crude: ... because rooting around blindly looking for a person's orifice borders on inappropriate.That is all I am going to say about that. >.>Tait

:eek::yeah:....hahahaha....dang it, Tait, I'm laughing so hard, there are tears streaming down my face!!!...guess it was the words "rooting around blindly"" that you used! I agree such probing behavior would be inappropriate.

Specializes in LTC, Memory loss, PDN.
I would not care to be a patient receiving my medication from the nurse after her hands have been in someone's perianal area. I don't care how many times s/he washed their hands or how many pairs of gloves were worn.

Since we do give suppositories, what is the proper amount of time for the perianal cloud to dissipate. :D

I'm just messin with ya. ;)

Specializes in ortho, hospice volunteer, psych,.

i'm beginning to think much of this thread should come with a beverage alert! :rotfl:

kathy

shar pei mom:paw::paw:

Specializes in LTC, Memory loss, PDN.
like what i said i spoke to the former unit manager yesterday. she said her nurses did not have any problem doing it for the pt. i asked her has she ever done it? and she said no. i told her that my unit manager tried it once and she agreed with me that it was difficult.

the former unit manager said she did not even think that she won't be able to do it. she then proceeded to demonstrate how she would do it. i did not pay attention to what she was showing me because she never done it and she does not know what she was talking about. i left because i did not want to argue with her. maybe i should have asked her if i can call her on suppository day and she do it and show me.

i don't know why doing treatments during med pass is an infection control issues. that's what i was told when i started and they said it's in the policy and procedures.

my unit manager asked me to write a memo to the don. they want everything in memo in my facility. i am just afraid that they would think of me as a trouble maker and cannot do a simple task such as inserting a suppository.

i am a pretty resourceful guy. i try to fix everything myself whenever i can. i mop and sweep floors when others are so quick to call house keeping. i go down in the lobby to buy sodas for my pt. i fix the cable in the tv. i lift tv and transfer to other rooms. i transfer beds myself. you see i am not so quick to call for whatever department it is. if i can do it, i will do it. i am saying these things because after work last night, i started browsing for job openings because of what the don said about "whatever the pt wants."

i think i am a pretty good nurse and my residents love me in my unit. i am able to give meds to very difficult pts when they refused others. they said i have that "charm." i am saddened that we are not getting the administration support when it is needed.

i should go ahead and finish my rn so i can have more optons. i am doing excelsior college so it is self-paced. i am very close to finishing.

thanks guys!

angel

chin up guy. write your memo as a request for help rather than a complaint. why would anybody think you're not able to insert a suppository? after all, the resident insists on not allowing staff to use the proper and usual technique. i don't know the details of your situation, but i wouldn't go job hunting because of a suppository crisis.

not getting support from admin is a sad, but common occurence. if indeed you end up labeled as a complainer, after all you do, then they're foolish and don't deserve you, but if you do look for another job, make sure there is a real benefit for you rather than a short lived " i showed them". best wishes!!!

Specializes in LTC, Memory loss, PDN.
i'm beginning to think much of this thread should come with a beverage alert! :rotfl:

kathy

shar pei mom:paw::paw:

the whole board should, for that matter. i've spewed and choked more than once while visiting an.

Specializes in ortho, hospice volunteer, psych,.
the whole board should, for that matter. i've spewed and choked more than once while visiting an.

i'm beginning to think much of this thread should come with a beverage alert! :rotfl:

kathy

shar pei mom:paw::paw:

it's official ... my husband thinks i've finally lost my mind. some humor does not cross over the non nurse boundary line. even the dog is looking at me strangely and two cats got down and stomped off.

back to the topic at hand...

write the memo and instead of being defensive, simply present the facts as they exist. you'll be fine. i do not forsee you ever having to explain why you quit a job you loved over a suppository.

kathy

shar pei mom:paw::paw:

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