How does your facility handle swallowers?

[medpsychRN]

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]

Interested in knowing the negative/positive consequences you are using. Thanks

[Psychaprn]

When I was charge nurse on an adolescent unit 5 girls swallowed thumbtacks. All of them were "characterologically challenged". They were all x-rayed and it was determined it was safe to observe them and screen their feces for the tacks.. You should have seen their faces when I presented them with their OWN bedpans and tongue depressors to "search" for the tacks. They thought "the nurse " would do it! I kindly but firmly informed them they woukld be restricted to the unit until they "found" their thumbtacks and presented me with the evidence. It never happened again!

[midnitelpn]

one of may favorites is a chronic schiz/swallower!!!!! batteries, nail clippers, snaps from pjs, stones, sheet music from church & those little butter cups off the meal trays, checkers etc. (those are the only things we know he has swallowed!) this pt has had 2 resections 2o to this. we have not come up w/ a way to keep this from happening either! 1:1 and thats about it.....he is stealth!!!

[elizabells, BSN, RN]

one of may favorites is a chronic schiz/swallower!!!!! batteries, nail clippers, snaps from pjs, stones, sheet music from church & those little butter cups off the meal trays, checkers etc. (those are the only things we know he has swallowed!) this pt has had 2 resections 2o to this. we have not come up w/ a way to keep this from happening either! 1:1 and thats about it.....he is stealth!!!

I'm not a psych nurse, but I've read about this - some forms are related to an eating disorder called pica. People will eat anything, including clay, mud, and objects. One case involved a patient swallowing a pair of pantyhose, and another pt swallowed most of a bedsheet before anyone found him. There are articles on the net - I'd post the links, but many come from very controversial pro-anorexia websites that I don't feel would be appropriate to post here, but you can find the info by searching for "pica".

[marylyn_91604]

I knew exactly what you meant.I've been in psych nursing 24 years,

and have seen it a few times.I remember especially one lady who used to swallow spoons.I think they put her on Anafranil-for obssessive -compulsive behavior,you know. I agree the mitts would be helpful,and complete finger foods. I dont know how motivated this man is to stop,but my pt. had adhesions so much from all her surgery,she had pain and wanted to stop.Then you may be able to work w distraction,or with a contract and rewards for not swallowing anything. Thats all I can think of for now.

Any questions,or if you think I can help more-My email is;

[email protected]

Good luck and thanks for the caring work you do!

[pmchap]

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

And us males here have a hard enough time already keeping our minds on nursing.... :chuckle :chuckle

[medpsychRN]

One particular man is delusional. Hears voices telling him to swallow. Negative consequences (surgery, frequent scoping) have had little impact. Heavy medication slows him down but won't eliminate the delusions.