problems at work any help for way forward?

[malenursenortheast]

Hi all new to site looking for abit support, work in uk qualified in adult nursing 3 years ago. Been good and bad times but on the whole really enjoyed it.

ok so heres my drama last week gave a patient a fleet enima as protocol, easily inserted no probs noted. Done this 100's times before.

so few hours later patient started rectally bleeding (i had gone home by this point). next day to find situation where patient had been very unwell over night ? sepsis secondary to bowel perforation!!!

i have been ill on my days off wondering if i have caused this dont wana go back into work tonight, patient has had surgery and transfered ward, so not sure of outcome

so worried this is all guna come back to me!!

All help apreciated.

[SuesquatchRN, BSN, RN]

Well, go to work, first of all.

Second, he may have been impacted and the movement of very hard stool caused the perforation. It is unlikely that you did it with the enema nozzle. Possible, but not likely.

Third, the perforation may have been there prior to your administering the enema.

Fourth, stuff happens. Go in with your head high and find out what actually did occur.

[malenursenortheast]

Thanks so much i havnt had much sleep due to worry i think, im trying to tell myself it may have been there before hand, but seemed too much of coincidence it happened few hours after enima. Going to go in head held high (well thats the plan).

What sort of situation would i be in if the enima did cause this?

obviously my main concern is patient however i have a large morgage to pay!

[Been there,done that, ASN, RN]

There is no way a fleet's nozzle can perforate a bowel. Remember that anatomy?

More likely the docs screwed up...missed a bowel obstruction and ordered the WRONG treatment.

Stop doubting yourself, think the situation through and go from there.

[malenursenortheast]

Thanks any further comments??

Hi all new to site looking for abit support, work in uk qualified in adult nursing 3 years ago. Been good and bad times but on the whole really enjoyed it.

ok so heres my drama last week gave a patient a fleet enima as protocol, easily inserted no probs noted. Done this 100's times before.

so few hours later patient started rectally bleeding (i had gone home by this point). next day to find situation where patient had been very unwell over night ? sepsis secondary to bowel perforation!!!

i have been ill on my days off wondering if i have caused this dont wana go back into work tonight, patient has had surgery and transfered ward, so not sure of outcome

so worried this is all guna come back to me!!

All help apreciated.

[tokmom, BSN, RN]

I agree with the above. I would naturally worry as well, but think about the logic. If it was that easy to perforate the bowel with the enema, how bad was the bowel in the first place? Where in the bowel did the perforation occur? It could be much higher than you think!

I too think there had to have been something else going on that caused it. Not a simple fleets.