Is it Safe for UAP's to manage G-Tubes?

ChristineN, BSN, RN · Mar 3, 2013

Hello, im a third semester Nursing student and I am also employed on a very very PT basis at a human services residental group home for the developmentaly disabled. We recently got a new consumer to the site who requires a G-Tube.
This is something I have not covered in Nursing School so far, but I do know it's not anything simple either. Being in RN school, I find it very interesting to learn this skill.
But, my Question that I was wondering is.....is it safe for Unliscened Assistive Personel (UAP's) to be able to perform such tasks with such little training given all the things that could go wrong, and all the things a person would need to keep an eye out for?
Especially considering many of these staff members/ UAP's have 0 experience in anything related to healthcare.

If you are allowed to work with G-tubes or not is a question for your employer. Since you work in a group home I am assuming you pass medications, and are concerned about any risks of giving G-tube meds.

If it is an established G-tube (been in for at least 3 months), you do not need to worry as much about the hole the tube goes in closing up if the tube does happen to come out. Many facilities have protocols for what to do if the tube falls out, typically stick a foley catheter in the hole to help keep it open and then send pt to ER to get the tube fixed

The other big issue that could come up is if the tube gets clogged. Normally if meds are allowed long enough to dissolve with at least 20ml of a water flush after the meds you will have much less risk of clogging. Some places will have you use ginger ale, coke, or even pancreatic enzymes to try to unclog the tube. If none of those were to work the pt would need to be sent out to get a new tube placed

netglow, ASN, RN · Mar 3, 2013

Remember regular people at home these days do just about all of care themselves. So no it's not strange. However, as soon as you get your license, you must do things as an RN would. The acceptance of "non-perfect" (word?!) care that lay people are allowed, will not be allowed of you. I guess, in other words the "work-arounds" others do to get by are generally things that cannot apply to the way you practice.

SwansonRN · Mar 3, 2013

Yes I think it's safe. Once established g-tubes are actually pretty straight forward. I'm sure your group home has a nurse that oversees the house if anyone has questions/needs training and you can always go to the ER if something happens.

KelRN215, BSN, RN · Mar 3, 2013

In these kinds of facilities, it is very common for UAPs to do work that would be done by nurses in a hospital. G-tubes are pretty straight foward- we teach parents to manage them at home- so UAPs can certainly be taught to administer meds via that route. The important thing is to get the proper training. I once heard of a child who lived at a residential school for blind children. In that facility, the staff gave meds. The child's MIC-Key balloon ruptured because the staff were administering his Prilosec into the balloon rather than into the med port.

flyingchange · Mar 4, 2013

I did home healthcare for the developmentally disabled as a PSW before I decided to enter nursing school. One of my clients had a g-tube. I did the best I could at the time with the knowledge I had, but I still cringe to think of all the stuff I missed. Poor guy had a raging infection in his stoma for MONTHS (red, bled easily, purulent discharge) and we never thought to seek medical attention for it. One worker's conventional wisdom was that we should just smear zinc oxide cream and cover it with gauze, so that's what we did.

My reservations with UAPs is that (IME) they don't get enough education or ongoing support from regulated professionals. I never saw an RN in my entire 5 year history with the agency. I was never trained about s/sx of infection, among other basic health complications. I dispensed medications according to the label but had NO IDEA what I was dispensing, and I didn't have the critical thinking ability to question why we were still putting wart remover on a client's wart 6 months after the initial OTC recommendation was made by the GP (poor thing just about had a hole in her foot).

I do think UAPs in home health are critical to the system, but I think they are delegated way more than is safe.

schooldistrictnurse · Mar 5, 2013

UAP's do many tasks in a school setting. As far as supervision, though, I observe every delegated task in my schools on a quarterly basis as a minimum, and conduct refresher training annually.

FurBabyMom, MSN, RN · Mar 5, 2013

If it is something the facility allows to be delegated, and you are taught how to do it, with some assessment of competency - then it is something you can do.