How does your facility handle swallowers?

pattyjo, MSN, RN · Feb 10, 2005

We have had an increase in the number of patients we treat who ae swallowers. Two are so bad, the GI service refuses to see them as the patients have had so many gastric procedures to retrieve the objects swallowed.
These people are always on 1:1 but they have lightening reflexes and can grab something and have it down in seconds. One patient is a fairly large man and if he intends to swallow something there is really nothing I can do to stop him. Meds as you can imagine are not helpful.
Just wondering how other facilities address this problem. Thanks!

MedpsychRN: I remember a situation similar to this at the hospital where I worked a few years ago. This wasn't on my unit, but I do recall it being brought up in conference, and the decision was made to use mitts in addition to 1:1. Is that now considered to be a type of restraint?

As an aside, I am interested that you are seeing an increase in this; I haven't seen it at either of the hospitals where I work. Any explanation?

Patty

southern_rn_brat · Feb 10, 2005

I saw the name of this thread and thought it was about sex.

saskrn · Feb 10, 2005

I saw the name of this thread and thought it was about sex.

That's more than I wanted to know. :stone

saskrn · Feb 10, 2005

I don't work in psych, but it fascinates me. I can't imagine people swallowing objects!

CHATSDALE · Feb 10, 2005

i do work in psych but we don't have any swallowers..at least we havn't been missing any thing that i know of.....i sure hope that our people don't get any ideas....i would hate to have to wait for something to come out

southern_rn_brat · Feb 10, 2005

That's more than I wanted to know. :stone

:chuckle

Long Term Care Columnist / Guide · Feb 10, 2005

Wow......just when you think you've heard it all, something like this comes along. I never knew that people SWALLOWED foreign objects---stuck them up their bums, yes (which is equally weird, in my humble estimation), but I hadn't heard about this. I guess you learn something new every day in this business, no? :chuckle

z's playa · Feb 10, 2005

I saw the name of this thread and thought it was about sex.

:rotfl:

I'm sure you aren't the only one who did a double take!

medpsychRN · Feb 10, 2005

You know, I never thought about the sexual aspect of that sentence! Honestly, that's what we call them.

We have used mitts (which is considered a restraint) with some success. Of course the minute you take them off they're at it again. The biggest problem is at meal time with the plastic utencils. We do limit them to a fork or spoon. Also try for finger foods only.

I know it seems funny when you read about it but these people really do suffer! With some objects you can't wait for it to make it's way out which means at best they are scoped, at worst they open them up.

On a side note, I had a friend whose daughter accidentally swallowed her retainer (never did figure that one out!) and they did wait for it to pass. Unsure if it was worse on the way down or on the way out.

steelcityrn, RN · Feb 10, 2005

I did a double take myself on the heading here...lol...but very interesting topic for sure...Never had a pt or heard of one with this. We have psych nurses where I work, I am going to ask them about it. Guess it should come as no surprise since we have all seen ppl who have used the other openings...Mental health is very complex. I will never forget my first pt I had with full blown schizophrenia, really sad.

CharlieRN · Feb 10, 2005

Serious Answer

We treat it as a dangerous self distructive behavior, or as a suicidal one, depending on the psycho dynamic of the patient. The patient must be treated to render the behavior not life threatening, as a first priority. Then attention must be directed toward preventing a re-occurence. The focus of psych treatment is toward extinguishing the behavior. A behavioral mode of tx is usually indicated. The tx plan must be evaluated to eliminate secondary gain. There must be strong negative consequences for the behavior and stronger positive ones for not swallowing.