Practicing NG Tube on each other?

Debra ACRN · Apr 26, 2012

Oh me, my class had to. It was in 1982 so it was ages ago. It was horrifying! I remember it was Bev, one of my good friends who did me. She inserted the tube about an inch per painful, grueling, minute. When she finally got to the stomach and the instructor was satisfied I pushed her back and yanked it out. I do have to admit I am really sympathetic to anyone with such a device. We did bed baths, IM, SQ, and IVs on each other too. I am glad we have moved forward and left the past behind. :)

applewhitern, BSN, RN · Apr 26, 2012

We inserted IV's on each other, plus gave each other injections. Never an NG tube tho; I would have to draw the line at that!

AgentBeast, MSN, RN · Apr 26, 2012

I'd let someone practice brain surgery on me before I let someone practice inserting an NG tube on me.

sandyfeet · Apr 26, 2012

The only time I ever heard of students inserting NG tubes on each other was from an LVN, recently. You can always refuse anything, though, just like a patient.

nurseprnRN, BSN, RN · Apr 26, 2012

i beg to differ on #10's description of placing ng tubes. there are some considerations besides measure, lube it up, and shove.

1) get the ok to use lidocaine jelly instead of ky. numb that sucker up. soften the tube in warm water to make it a little more flexible.

2) explain, explain, explain. "i'm going to put this tube through your nose and down your throat to your stomach... i'll use some sterile jelly to help it slip through ... you will be able to breathe... i'll have you swallow a little water to help us move it along easily. ready?"

3) remember how you hyperextend the neck to open the airway? you flex the neck to get something down the esophagus (same as you do to feed someone with a weak airway protection reflex). sit the patient up as high as possible, if you can. chin down decreases the chances of your going down his trachea. sitting upright also puts your face even with his, a less dominant and threatening position when you're doing something necessary but nasty.

4) the swallow reflex is your friend, and can also help distract the patient from the vision of your hand approaching his nose to advance the tube some more. say, "swallow," preferably with a straw to take sip of water with it, and advance as you see the swallow occurring in the neck. repeat, repeat, repeat. i know he's npo, but you're gonna get it right back as soon as you hook him up to suction.

5) if your patient is unconscious and cannot help you with any of this, it's sometimes helpful to put your first two fingers over the tongue and into the pharynx (be sure he's unconscious!) to help guide it straight down posteriorly (behind the epiglottis, avoiding trachea which is anterior). hold the fingers together and feel the tube slide parallel along and past them, along the dorsum from knuckle to fingernails. guide that puppy posteriorly with straight fingers until you are sure you're past the epiglottis.

avoid pushing hard at all times. one of my favorite x-rays of all times is a levine tube curled up in two graceful loops in the frontal lobes, having been pushed right through the pituitary fossa. adequate lube should get you going in the right direction, but if it gets stuck and you just can't advance it anymore, get help.

Dixielee, BSN, RN · Apr 26, 2012

Grn Tea, great description of the proper way to do it! The lube and shove method is the fastest way to getting things slapped out of your hands, nosebleeds and an agitated patient that is not likely to let you complete the task! It is also so much easier if you have two people. One can be on one side of the bed offering sips of water and offering comfort and explanation, while the other prepares the equipment. The second person can verify placement while you hold the tube in place as well. It is much faster and less chaotic.

I also found the best way to secure it is to take a plain bandaid (cloth ones work best), cut one end of it in half, leaving two strips. Remove the telfa part. Once you have the tube in the proper place, put the uncut end of the bandaid over the tip of the nose, and then wrap the two cut ends around the tube going in opposite directions. It is so much faster and neater than cutting a bunch of little strips of tape and stays in place better.

MattNurse, MSN, RN · Apr 26, 2012

I am in the process of applying to a local LPN program as soon as I get all my ducks in a row. I have been doing a lot of searching as to what all tasks a LPN can and cannot perform in my state and what is required for LPN's the learn in school. I have a general idea. My only fear at this point when it comes to school is if they will ask me to allow other students to practice inserting a NG tube on me. I am fine with shots and IV's and even bed baths as long as I can keep some undies on. I just have a very big fear of things in my nose/mouth/throat and gagging. I know it seems silly but I just...I can't help it. So I was wondering if anyone knows if this is done in Arkansas. Thank you!

You don't have to do anything you don't want to do when it comes to your body, including injections, IV's. This is the reason you have clinical time and if anything makes you uncomfortable talk with the instructor.

I frequently offer my arm to nursing students and new grads for IV starts, but it doesn't bother me.

Creamsoda, ASN, RN · Apr 27, 2012

I am in the process of applying to a local LPN program as soon as I get all my ducks in a row. I have been doing a lot of searching as to what all tasks a LPN can and cannot perform in my state and what is required for LPN's the learn in school. I have a general idea. My only fear at this point when it comes to school is if they will ask me to allow other students to practice inserting a NG tube on me. I am fine with shots and IV's and even bed baths as long as I can keep some undies on. I just have a very big fear of things in my nose/mouth/throat and gagging. I know it seems silly but I just...I can't help it. So I was wondering if anyone knows if this is done in Arkansas. Thank you!

I am fairly certain that wont be a problem. You just say no. I would never, ever, ever let anyone put one in me unless I was sedated. Ive put too many of them in to see how horrible they are and I hate them. NG's are my number one hated thing to have to do to patients.

lifelearningrn, BSN, RN · Apr 27, 2012

No way on earth I'd have done the NG tube on my partner or allowed it to be done to me. We have mannequins for ALL of the invasive procedures. (NG, Foley, injections, IV)... we did practice assessments and bed baths and stuff like that.