G-tube pulled out by patient

Specialties Rehabilitation

Published

Im a new nurse who got hired 3 weeks ago at a rehab/acute care. I had one patient who pulled out his G-tube. It happened so fast. At 9pm, I have just given her her PRN pain med and she was fine. At 1030pm, the CNA just check on her and she was still fine. When I checked on him at 11pm, it was all out. I immediately called the other nurse whom I am working with. I am so worried that they will kick me out of the rehab because of what happened. =(

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I've done rehab nursing for years. Multiple patients have pulled their feeding tubes out. You cannot always stop them from pulling their tubes out. Unless you work at an extremely austere place, I wouldn't worry about being fired.

Perhaps the patient needs an abdominal binder to prevent him/her from being able to access the tube. In other cases, hand mittens work very well. Good luck!

She actually got a binder before. But she was out for a day or two to have surgery and when she went back, the binder's no longer there. The family was so hands on in the care of the patient, and that is what I am afraid of esp. that they know that I am a new nurse, they might blame me. I am handling 20 patients by the way.

Oh let me tell you, it will happen! I've had pts rip out their foleys, IVs, G-tube, nephrostomies, and just about every other line you can think of. Anything can happen in a minute. If you've been making rounds and the pt is confused, no binder, or restrained, it's almost unavoidable.

Peds patients in home care like to do this too. Once they discover that their hands can reach the tube, they find it to be a great toy, especially by pulling on it until it comes out. You just learn to reinsert, or put in the replacement, and keep on trucking until the next time they manage to play with it. If nurses got canned every time this happened, there would be a lot more nurse-swapping on home care cases!

Specializes in Pediatrics, Emergency, Trauma.

Breathe, OP...it happens.

Just follow your facility's policy and procedure; some facilities that I worked in allow nurses to place foleys to prevent closure to the site.

Specializes in Hospice.

This was very unnerving for me the first time one of my patient's pulled out his g-tube. He was twirling it around and smiling at me when I walked in the room.

Does your facility allow nurses to replace g-tubes and do you have current and/ or standing orders for this? With a little practice, most are easily replaced.

On a side note, this is why it's so important to verify placement frequently. I also cared for a patient who partially dc'd his g-tube unbeknownst to the staff caring for him - it was in the peritoneal cavity instead of the stomach. Those were some funky auscultated sounds when I went to trouble shoot why it was not flowing well at all.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
some facilities that I worked in allow nurses to place foleys to prevent closure to the site.
I totally agree. If a patient has pulled a tube out, you'll want to temporarily stick something into that G-tube stoma to prevent it from closing. Once it closes, the patient might need a trip to the operating room to reopen the stoma, so we want to prevent that by any means necessary.
I totally agree. If a patient has pulled a tube out, you'll want to temporarily stick something into that G-tube stoma to prevent it from closing. Once it closes, the patient might need a trip to the operating room to reopen the stoma, so we want to prevent that by any means necessary.

Red rubber!

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Red rubber!
At my place of employment, the little 14-French in-and-out catheters are called Red Robins. I concur that they'd be perfect to get this type of job accomplished. :)
Specializes in Hospice.

Where I worked w/ g-tubes, we used the corresponding size foley as the temporary solution.

Just curious, what is the best way to secure an in and out foley used as a temporary g-tube stoma-opener?

Specializes in Pediatrics, Emergency, Trauma.
Where I worked w/ g-tubes, we used the corresponding size foley as the temporary solution.

Just curious, what is the best way to secure an in and out foley used as a temporary g-tube stoma-opener?

Depending in the facility, there are devices made by Hollister that I use that are helpful, especially if access is needed and the GT placement is anticipated later rather than sooner:

Hollister #9781 Horizontal Drain / Tube Attachment Device (HTAD) EACH

+ Add a Comment