I think that nursing today is often forgetting the basics. I had a patient this weekend who I transfered from a stepdown bed to med/surg. I followed the patient and floated to Med/Surg. By the end of the shift I became aware that the patient really needed a BM, and in report I suggested that the patient needs some MOM, ect.
This didn't get addressed and the patient went into A-fib with RVR in the night and ended up an ICU patient on a cardiziem drip. I took care of him the next day, he was distended and no appetite, and was more SOB (his underlying dx was pneumonia)
I told the hospitalist I was going to get his bowels moving when I reported some things to him in the AM, which I did with MOM and a suppository, much to the patient's relief. He had been having runs of wide-complex beats, most likely V-tach, and once he got into bed after his BM (med, hard) he settled down, his nausea went away (doctor had started troponin protocol based on nausea sx), and his heart gradually slowed down, allowing me to wean him off the drip. He converted to NSR at around 1500. The hospitalist put the patient on metamucil, and suggested that cardiziem (patient was on PO cardiziem at home) is a poor choice for a patient with tendency to be constipated.
My point in telling this story is that, I notice patients are being allowed to go too long without BMs. It seems that the basics of nursing care are being lost in a sea of regulatory overdrive demands and high tech wizardry.
unfortunatly for your patients, its OJT, I learned when I was a CNA and we had a patient who was a parapalegic and we had to do it every morning, Its pretty disgusting but it still doesn't bother me as much as suctioning a trach!
constipation can also be a symptom of something greater too. i've had "problems" for about 5 years now and the pain has been excrutiating. i was transported to the er by ambulance once (on easter sunday) and was told i was "constipated" and to go home and take some metamucil. (i felt very embarrassed and was treated as if i was totally overreacting to the pain)
i also had a horrific episode when i was newly pregnant with my son and i thought i was having a miscarriage the pain was so bad. this happened to me about 5 times over the course of 5 years. and because of the er incident on easter, i was too embarrassed to go back in and seek treatment for it as i felt i should have been able to get through it on my own (which is what i was told).
it turns out i had gallstones. i had to have my gallbladder removed in december because it was infected and dying. the wall of my gb was 15mm and the normal width is 3mm. the surgeon said this has been going on for about 5 years and it just happened that this time the duct got blocked by one of the stones and thats what led me into the hospital. the er doc said that constipation is a symptom of cholecystitis (or i guess cholelithiasis in my case over a period of time).
but when i was in the er.... the nurse just "poopoo'd" on my complaints. i wish i could go back and let her know what happened to me after she was done with me. it was awful and i wouldn't wish that pain on my worst enemy!!!
When I was in for my hysterectomy I thought I had a UTI after the catheter was d/ced. The nurse wouldn't come back to take my temp ( i had just had some ice water and those were the days of the old thermometers by mouth). So when my doc came in to see me that afternoon I told him...he got a thermometer, took it himself, and showed it to the nurse at the nurses' station. I know coz I walked out with him to the ns, as I was 2 doors away. So with my UTI symptoms, I got a u/a done and voila, I got what I needed.
unfortunatly for your patients, its OJT, I learned when I was a CNA and we had a patient who was a parapalegic and we had to do it every morning, Its pretty disgusting but it still doesn't bother me as much as suctioning a trach!
Constipation can also be a symptom of something greater too. I've had "problems" for about 5 years now and the pain has been excrutiating. I was transported to the ER by ambulance once (on Easter Sunday) and was told I was "constipated" and to go home and take some Metamucil. (I felt very embarrassed and was treated as if I was totally overreacting to the pain)
Thank you for reminding me of that fact! Constipation can be a sign of something else happening in the body. That reminds me of how many women with ovarian cancer don't get diagnosed quickly because they have GI symptoms that look like lots of other medical problems.
smilin_RN
12 Posts
unfortunatly for your patients, its OJT, I learned when I was a CNA and we had a patient who was a parapalegic and we had to do it every morning, Its pretty disgusting but it still doesn't bother me as much as suctioning a trach!