Since when do nursing assistants give enemas?

[Bonny619]

I am doing questions for the NCLEX on Jan. 22nd and this was a question in the Saunders review book.

Sounded kinda crazy to me, I have certainly never seen that nor can I imagine that happening.

Any insight?

[KimblyRN]

prehaps you can clarify the question that you are unsure about, becuase it is not clear to me what the question is.

[Bonny619]

It was a delegation question....let me go get the book.

[Bonny619]

Question:

The registered nurse employed in a long term care facility is planning assignments for the clients and has an LPN and 3 nursing assistants. Which of the following clients would the nurse assign to the LPN?

1) the client who requires a bed bath

2) an older client requiring frequent ambulation

3) a client who requires a Fleet enema

4) a client with an abdominal wound requiring wound irrigations and dressing changes every 3 hours.

Ok, here is the rational. The answer is 4.

When delegating nursing assignments, the nurse needs to consider the skills and educational level of the nursing staff. Collecting a 24 hour urine sample, giving a bed bath and assisting with frequent ambulation, and administering enemas can be provided most appropriately by a nursing assistant.....

[Bonny619]

Anyone have any insights into this?

[Silverdragon102, BSN]

Not sure what problem you are having?

If they are trained and covered by licensing board and you have seen them give one and are competent then they should be covered. Overall though responsibility would be with RN

[CT Pixie, BSN, RN]

CT CNA's can give enemas. Years back (1993?), I started working in a different facility than the one I had been at for years. I was dumbfounded when the floor nurse told me that Mrs X needed her enema by 8am and handed ME the enema! Where I worked previously we NEVER did enemas..ever. This facility allowed it. When I explained that I had never given an enema and had never been trained to do so (I became a CNA about 2-3 yrs before you had to be State tested. We were trained by the facility we were to work for). She laughed and said i must have been taught "old school" and she show me how. its been a while since I've done CNA work, but all my fellow students who are currently working CNA's also give enemas in a variety of different facilities.

[bethin]

I routinely give enemas on my floor (med surg and ICU). Granted, if the pt is having heart problems we don't for fear of the vagal nerve. But that's rare.

I was trained in my CNA classes to give them. It may vary state to state.

Good luck on your boards!

[Achoo!, LPN]

I think the question may be messed up. The rationale is talking about a 24 hour urine. Where is that in the question?

[Bonny619]

I know, that made me think twice too.

Thanks for the replies everyone, I had NO idea giving enemas was in the scope of practice for a nursing assistant. I've never seen that.

[riverrose]

Well, Bonnie how did you do on your nclex? Great I hope

[suanna]

Non medicated enemas are within the scope of the NA practice as far as I know. Medication administered by enema is of course forbidden.