Ummm..not sure how to ask this but who has experience "digging out" a patient?

[LucyLu]

I'm a relatively new nurse and I this situation came up yesterday. The patient was having difficulty with a BM. The aide came out and said "she wants the nurse to dig her out!" I've never done this. It certainly wasn't taught in nursing school. I looked it up in my "skills" book and it's not there.

So is anyone willing to share their expertise in this area? Also, is it solely a nursing responsibility? Do you need a Dr.'s order. She was a telemetry patient, post lap. choley. HELP!!!!

[LucyLu]

It makes sense to me that you would need an order for this. I guess I'll be bringing it up at our next staff meeting. I could get no clear direction from my peers yesterday--just lots of snickering and "you mean you've never done that before?" Thanks for the replies.

[meownsmile, BSN, RN]

I think id call for a bottle of citrate of mag or a few doses of MOM. Removing stool manually not only is unplesant from both sides but really isnt necissary with whats available. A suppository and a bottle of mag would work fine. There is fleets phospha soda and enemas, all much safer than manual extraction.

[old rural nurse, RN]

One thing to try before actually digging is to really lube up the area while they are on the commode (gravity helps), and then pushing up gently around the orifice while telling them to bear down. Sometimes once you get it started for them then they can go on their own. Prevention is best, but some elderly are so laxative dependant or have literally no rectal muscle left from repeatedly full rectums that they need assistance to prevent an actual impaction.

[Ginger35]

I don't think you want them to bear down if they are a cardiac patient. In the ER we get a few of these now and then. They are quite memorable experiences. Normally, we need a docs order to implement - however, I would rather go the less invasive way.

[all4schwa]

Usually, once youre being called to dig for it, it's "right there," just needs a budge. If you had to go any further than that, you would of course try the aforementioned ideas. Also, if youre at one of the small nursing homes like I'm used to, you cant always get ahold of some mag citrate (or other pharmaceuticals) in a timely manner.