Question about gj tube mickeys

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Hi, stupid issue here. I work in hh and with a new company. A case I just started on has a pt with a gj mickey. My first week I noticed it was loose and checked the water in the balloon like I have a million other times with other pts. It was low so I filled it to the required amount and let the pcg know.

I'm here a week later and the am sn tells me we (lvns) aren't allowed to check the balloon on a gj mickey. (So, what then? ER trip each f**.. week?!)

The case manager still hasn't gotten back to us on this and I'm working nocs so calling the doctor (to request the stupidest order ever) would be stepping on the am sn's toes.

Suggestions?

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It depends on your state. In Michigan we change the entire Mickey.

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Where I have been, LVN/LPNs changed mickey's, and checked per the MD orders. Get with your supervisor to get appropriate orders. If it said anything on the 485 to check the amount in the balloon, then you are ok. If that action is not on the 485, then get it on the 485. Or otherwise, if your supervisor says you are not allowed this level of intervention.

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In CA mic key changes and care are within scope. What do you mean by loose because even with low profile short mic keys there can be some space between port and stoma. If it's coming out all the way then the balloon isn't patent and it needs to be changed. Get order if there isn't one to change Prn. We change ours Q3mos or PRN.

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Specializes in Complex pedi to LTC/SA & now a manager.

GJ is very different. Even twisting can adjust the position. It's NOT the same as a G button/GT. GJ can ONLY be replaced by interventional radiology. This is the difference

GT is within scope but may not be agency policy.

Only nurses assisting in IR can replace GJ. If you had dislodged or adjusted the GJ position when checking the balloon a hospital visit would have been necessitated.

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Whoops:whistling: I misread gj tube my apologies.

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Specializes in Complex pedi to LTC/SA & now a manager.
Hi, stupid issue here. I work in hh and with a new company. A case I just started on has a pt with a gj mickey. My first week I noticed it was loose and checked the water in the balloon like I have a million other times with other pts. It was low so I filled it to the required amount and let the pcg know.

I'm here a week later and the am sn tells me we (lvns) aren't allowed to check the balloon on a gj mickey. (So, what then? ER trip each week?!)

The case manager still hasn't gotten back to us on this and I'm working nocs so calling the doctor (to request the stupidest order ever) would be stepping on the am sn's toes.

Suggestions?

It's not standard practice to check balloons of GJ buttons. If you slipped and adjusted the position even a little it could become an emergency visit to IR. Therefore most agencies don't permit nurses to check the balloons. A loose GJ button has specific parameters to assess and intervene

You should not even twist/rotate a GJ button as it can alter the J position or worse cause the JT to kink. This is per both major manufacturers AMT & MIC-KEY.

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Specializes in NICU, ICU, PICU, Academia.

Yeah......GJ is an entirely different animal. Necessary for some kiddos- but not a fan personally.

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