One PM Shift

Those of who are into enemas and rectal treatments as an erotic experience sometimes believe that working as a nurse would be the ideal sort of job. That, for the most part, is not true. The hospital remains one of the most strenuously anti-erotic subcultures in our society. Nevertheless, opportunities do sometimes occur; here's one of them:

I rotated up to the Med-Surg floor because the census in the unit where I normally worked had gotten low. Rather than be sent home I agreed to spend an evening in the trenches. Med-Surg, as the name implies, is where the majority of patients are admitted, and remain, during their stay. It is there that surgical preps are done, routine surgicals are recovered, and patients with intermediate illnesses are treated. In short, it is the heart of any general hospital.

That evening I didn't have too many patients on my list, and only a couple of admits and one post- op. Not bad. I began the paperwork for the admits. One was a young woman in to have a bunion reduction scheduled for the next morning. Another patient had been brought in via the ER, had accidentally OD'd on antidepressants, but was well along in her recovery. The only difficulty I anticipated was with another woman who was one day post-op from an abdominal hysterectomy. Even milomfortable, particularly hysterectomy.

As I walked down the hall, preparing to inventory my bunion lady's valuables, the charge nurse handed me a post-it noting that the very patient I was going to see had been ordered to have a soap suds enema that evening.

"For bunion surgery?" I asked incredulously

The charge nurse shrugged; she didn't why either, but she heard right. The attending MD wanted her to have an enema. Putting the slip in my pocket, I went into the room. The patient was about twenty, slightly plump, and very pleasant. She showed me the deformed part of her foot. I wasn't sure how to bring up the part about the enema with her. Did she know the doctor had ordered it?

Did she know why? I figured that she would probably want one of the female nurses to actually perform it, so after she was settled in, I said, "Oh, by way, your doctor ordered an enema for you tonight." I cringed, awaiting an explosion.

She smiled. "I'm glad he remembered," she said. "I asked mom to remind him."

"Well," I said, "It's not standard in foot surgery."

She laughed. "It's not for that; it's just that I take one every day. Sometimes mom gives it to me, or I take it myself. Otherwise.... I'm pretty hopeless...."

"I understand. If you'd like to have now, I can give it you, but if you'd prefer one of female nurses, that's okay--but it might have to wait for the next shift," I explained, feeling much better.

"I don't mind," she said, "If you don't."

"I'll be right back," I said.

I returned a few moments later with the necessary apparatus. As I pulled the screen closed she turned onto her left, expertly flexing her right leg forward. I folded one side of blanket down and she used both hands to slide her pajama bottoms down to her knees. Her buttocks, though not small, were shapely, the color of porcelain; and fine, downy hair ran along her upper thighs. I took my time preparing, never more grateful for the unit lab-coat I wore over my scrubs, the bottoms of which were beginning to deform. I lubricated the rectal tip carefully, using Vaseline because I knew it would slide in more comfortably than K-Y, but might also prevent the warm, sudsy water from flowing into her bowels.

"Okay, ready?" I asked, reaching to spread her upper cheek.

"Are you using soapsuds?" she asked.

"Yes, Castile--it comes in the kits."

"Mom's got me using Dr Bronner's at home," she said.

"I've heard of that."

"It's very mild."

"It's rare, you know," I started, a bit awkwardly. "I mean, I've heard of people taking daily enemas, but usually they're much older than you."

She laughed again, but without sounding self-conscious. I had her buttocks spread wide now, and placed the glistening tube lightly against her crinkled anus. I was glad for the talk, otherwise she might have heard my breath catch. I pressed the tip past her sphincter; it slid easily.

"I started when I was fifteen," she said. "I had pneumonia really bad. I had to stay in bed all the time, and I got really constipated. So my mom started giving me enemas and laxatives all the time."

The tube had gone in about three inches by then. I decided to try for five because her expression didn't change once while the enema tube entered her body.

"I didn't take one every day until last year," she continued.

"What made you start?" I asked. Four inches. I could see a glistening ring of Vaseline build and move back along the tube as it passed her sphincter. Although it was cool in the room, I felt damp perspiration on my forehead and neck.

"I had a roommate my first year at UCSD, and she was really into them, and colonics. She thought enemas were a cure-all, so she got me to take one a couple times a week, then three times- It got to where I couldn't go at all without taking an enema."

The tube was all the way in her now, the blue plastic finger-guard pressed lightly against her anus. Earlier I had set the bucket on her over-bed table; now all I had to do was raise the table a few inches and the warm water would begin to flow very slowly into her rectum.

"Are you ready?" I asked, fingering the clamp.

She nodded. I released the clamp, but nothing happened. Then I raised the bucket a few inches more, and fluid began to shoot through the tube.

"Is it going in?" she asked.

I nodded, not trusting my speech, then realized she couldn't see my face. "Yes- Yes, it's going in slow."

Doubtless we made quite a tableau at that moment: My right hand still held the enema tube near to where it disappeared between her buttocks, while my left hung uselessly by the slowly draining bucket; she lay with her back to me, legs and fanny exposed, mouth slightly open. I couldn't tell from her expression whether she liked having this enema, but I had to assume she didn't hate it. I was glad.

"So, have you tried colonics as well?" I asked, fearing the silence would grow awkward. She nodded briefly, as if distracted. About a third of the enema had passed into her.

"A few times," she said. "They're expensive." I commiserated with her, having priced colonic treatments myself once or twice and finding them to be real budget busters. "I like how they don't just fill you up, like an enema," she said. We were about two thirds done. Soon only a layer of soap bubble would remain in the bucket. She shifted her hips slightly against the mattress (which in my haste I had forgotten to protect with a pad - fortunately she was not a novice to receiving enemas); the water stopped flowing. Rather than raise the bucket again, I carefully slid the tube back about an inch. Once again the water started to flow.

"Are you okay?" I asked. "Can you take the rest?"

"I'm fine. You do that much better than my mom. It sometimes feels like she's pumping a gallon in."

"The secret is to give it as slowly as possible, but I guess that's not as easy with the bags and opaque tube where you can't see when it starts."

I clamped off the tube just before the last of the water siphoned through. Then I carefully set the bucket onto her nightstand where it would be out of the way. Frankly, although this was a medical procedure, I did not want it to end. The sight of that plastic rectal tube running into this young woman's pale, shapely buttocks was, simply put, gorgeous. And, to have not only her acquiescence, but her desire for this procedure...!

Again I placed my left hand on her buttock, this time pressing it gently closed, and, with reluctance, slowly pulled the tube from her rectum. It came out, inch by inch, dulled with Vaseline, but otherwise clean. A few drops fell upon the sheet as I dropped the business end into the bucket.

"Will you be able to make it okay?" I asked.

"Sure, no problem," she said, flipping onto her back and covering up.

I gathered up my equipment. "Thanks," she said.

"No, thank you!" I replied, inwardly. "That's okay," I said out loud, leaving the room. My next stop was the utility room where I discarded the used enema kit, then paused long enough so that I could walk normally again.

My post-op hysterectomy was still asleep, her breathing regular. I decided not to bother her right then, and look in on Pris. She'd been on the floor about four days and would probably go home tomorrow. Her roommate had offered to lend her some water pills, told Pris where to find them, but forgot to add that she also took antidepressants. Taking down the first bottle she found in the medicine cabinet, Pris swallowed three or four water pills--way too many--only they weren't water pills; they were a fairly toxic form of tricyclic antidepressant. Hours later poor Pris wound up in the ER, hallucinations altering with bouts of vomiting. Though her life wasn't in danger, the medication had caused severe disorientation, vertigo, and might have precipitated seizures. She had to be watched as it worked its way out of her system.

"Hi, Pris," I said, rolling a portable BP cuff as I entered. I had seen Pris a day or so before, when she still had an IV. I'd said hello and we chatted for a moment. This was the first time I had cared for her.

She lowered the copy of Elle she was reading. Only nineteen years old and very slender, Pris now had deep circles under her eyes that made her look older. The hospital lights accentuated her normal pallor, but her long black hair shined like it had been freshly washed. She smiled.

"Hi, uh, uh...?"

"Andy."

"That's right. How are you?" she asked. We chatted inconsequentially for a moment. She confirmed that she was indeed going home tomorrow. Then, pointing to my BP cuff I told her it was time for vital signs. She sighed, an comical expression on her young/old face. As I came around the bed to her nightstand, she nodded at the curtain, now drawn back, that separated her side of the room from the other patient's (who'd been engrossed in a TV show since the start of shift). It surprised me that after four days in the hospital she'd be shy about having her blood pressure and pulse taken, but I drew the curtain. I didn't see the usual thermometer kit lying on her nightstand, so I opened the drawer. To my surprise the plastic box within was red. Red boxes held rectal thermometer kits, their plastic sani-shields already lubricated for easy insertion. I looked quickly down at the vital sign flow chart--sure enough, all of Pris's notations had a small letter R alongside, to signify rectal readings.

She must have watching my face. "That's right," she said with a rueful grin. "They've been sticking that in my ass since I got here."

"Oh," I said intelligently. "Do you want me to have of the nurses...?"

"That's okay," Pris said, casting off her blanket to reveal a long blue nightgown that looked like silk but probably wasn't. She turned on her side, flexing both hips slightly while I inserted the blunt bulbed thermometer into a sheath that was lightly covered with K-Y. I'd had one of these put into my behind once and knew that they could do with some additional lubrication. Had I known in advance I would have brought Vaseline, but I didn't. I looked in the drawer again and gratefully spotted some packets of K-Y. As I applied the extra K-Y, Pris reached down and pulled the hem of her nightie up to her hips, revealing pale slim legs, and tight buttocks contoured like young boy's. She flexed her hips a little more, and they parted slightly.

"Don't hurt me, now," she said with a nervous laugh.

"Don't worry, I've done this before," I said, leaning over her. When right hand touched her hip, the warmth I felt made me wonder if Pris had developed a fever on her last night in the hospital. Then I remembered that she'd been in bed for hours, buried under two or three blankets which prevented the natural warmth of her body from escaping. Using my thumb, I spread her upper cheek; it moved easily revealing her anus. It too was pale, almost like the rest of her bottom. Her hips jumped slightly when the dripping plastic coated rod touched her hole.

"Easy, easy," I said.

"It tickles," she said, laughing embarrassedly.

"Well..." I didn't really know what to say to that. So intent was I in getting this thermometer into Pris's rectum without hurting her, that I forgot to be turned on. What she had just said reminded me a little.

"I'm okay, now," she said. "Go ahead."

This time the lubricated tip passed easily through her anus and into her rectum for about two inches, meeting no resistance.

"Ohh, that's cold," she said, but didn't move.

"The idea is for you to warm it up," I said, wondering where I'd come up with that. She laughed, then coughed once. The cough jiggled the thermometer, forcing it out half an inch or so. I pressed lightly with my forefinger, sliding it back into her. Although the bulb was planted a good two inches past her anus, Pris's bottom was so slim that the remaining three inches, topped by the red paper tab, jutted well out from her buttocks--a little like a flag. I thought at that moment I knew how Perry, Admunsen and Sir Edmund Hillary had felt.

"You know," Pris said, "I think that thing is making me constipated."

"What thing?"

"The thermometer in my tush. I think that's the reason I can't go," she said.

"Usually it's the other way around," I said, grateful as always, that pretty young women receiving rectal treatments from me usually could not look directly at me during the procedure. "Having something in you behind, even a thermometer, stimulates it--makes it more likely that you would have to go."

"I don't know...," she sounded skeptical.

"Maybe you need an enema," I suggested, ever helpful.

"Maybe," she agreed.

Five minutes arrived quickly. I pulled out the thermometer as slowly as I had put it in. I spread her cheeks again so her bottom wouldn't feel to sticky from the K-Y. I read her temperature, normal, while she pulled her nightie down and replaced the blankets. I finished her vital signs, then left, promising to see what I could do about the constipation.

Unfortunately there was no standing order for an enema or laxative in her orders. Maybe I was the first one she had told. Two new patients had arrived, so when I told the charge nurse about Pris's problem, I didn't expect she would have time to call the doctor for orders until the next shift.

Sandy, my post-op hysterectomy was awake now, and not altogether happy. In addition to the normal discomfort she felt from having her belly slit open then stitched up--and which could be controlled with morphine, Sandy had severe bloating and gas pains, made worse by the morphine she took for surgical pain, because it had the side effect of reducing her intestinal motility to a crawl.

We spent the next few hours walking up and down the hall in an effort to try and get things moving, so to speak.

"They'll give you a good Harris Flush enema tomorrow, Sandy," said her roommate, also post-op hysterectomy, but one day longer. "After the nurse did one to me this morning I felt sooo much better."

"I don't know if I can wait till morning," Sandy groaned, gripping her mobile IV pole as if it were all that held her up. "Couldn't I have one tonight?" she asked me. I knew ob/gyns didn't like their patients to have enemas on the first post-op day, so I thought her request unlikely, still, after settling her into a chair, I promised to see what I could do. Her chart listed all of the usual orders: She could have a little more morphine, but would only make things worse later. I described Sandy's situation to charge nurse, explaining that Sandy hurt more than was to be expected. She agreed to try and get a hold of the doctor. That was all we could do right then.

I walked with Sandy some more, then checked on my other patients. Pris seemed to have dozed off, while my foot surgery lady was back in bed, watching TV.

"Did it work okay?" I asked.

"Oh, yes," she said. "Thanks. You give a first rate enema." Another satisfied customer, I thought as I left. I met the charge nurse in the hall. She'd spoken with Sandy's doctor, and while she didn't want Sandy to have an enema yet, she did order a rectal tube be inserted for the discomfort.

Surprised, but glad to be able to do something for Sandy, I stopped by the utility room to check supplies. Rectal tubes have become less common in recent years, mostly because the Harris Flush enema is considered to be more effective in relieving flatulence. We still had a couple of different kinds and sizes on hand, however. I choose the thickest one because I figured Sandy wanted action asap, and a thicker tube provides greater stimulation to the anus and rectum. This tube was thicker than most enema hoses, but had a small bag on the far end that could be filled with water which then bubbled discreetly as gas exited from the other end.

I also grabbed several packets of my beloved Vaseline.

"Good news," I told Sandy as I unloaded the equipment onto to her over-bed table.

"Dr Kray said I could have that Harris..., that enema?" She looked at me hopefully.

"Better than that--she ordered a rectal tube for tonight--enema first thing in the morning."

"Oh-" She looked a little doubtful as I connected the thick, twenty inch plastic hose to the now water filled bag. Then, breaking open a packet of Vaseline, I carefully spread the opaque jelly along the first three inches, avoiding the small holes that ringed the tip.

"Will that do any good?" she asked, grimacing as another cramp hit. I knew she wasn't doubtful about me this time. She would have been happy to receive an enema from Charlie Manson at that point if he'd been around to make the offer.

"Look at this way," I said, holding the lubricated tube in one hand while I bent to hang the bag on the bed-frame below the mattress. "Even if you could have an enema tonight, you could only have one--it'd be too stressful to have more; but this--" I indicated the glistening tube "--You can have this inserted as often as you need, and for as long as you need. It goes about six or seven inches in your behind, but no further, so nothing else is disturbed."

"What have you got to lose, Sandy," her roommate, who I had thought finally asleep, called from behind the curtain.

With that Sandy turned carefully to one side, pulling her sore body with one hand on the far bed-rail. I moved back the sheet; her hospital gown had already fallen forward, so her buttocks were exposed. They were very full, but surprisingly muscular. Tramping up and down the hall like an aged rag women wearing hospital gowns front and back, Sandy hadn't seemed particularly athletic.

I spread her as far apart as I could. I didn't want the thick tube to hurt going in, although I knew from her chart that she had already had numerous enemas pre-operatively. I placed the glistening tip against her anus, angled my wrist so that it aimed more at her navel (from behind, of course), and said, "Take a deep breath, Sandy."

As she inhaled, I pressed the rectal tube into her; her sphincter pressed back for a moment, then the tube glided past. I eased about two inches into her, then paused. "Are you okay?" She nodded. "That feels thick," she said.

"It is - it'll work faster the thicker the tube is." I continued passing the plastic hose into Sandy's rectum. I listened for the sound of bubbles passing through the water below, but heard nothing. The tiny ring of Vaseline disappeared after about four inches. I stopped again, this time to smear a little more Vaseline onto the tube. I knew I didn't dare go much further, but I wanted to hear the bubbles that would indicate the tube was high enough. Otherwise Sandy would get her butt stuffed for nothing.

I had already marked the first seven inches past the tip with tape. Now the white tape passed between Sandy's still spread buttocks and pressed against her anus. It could go into her no farther. The water remained silent. I took another piece of tape, wrapped the center around the tube near to where it entered her crack, and placed either end on her right buttock to secure the tube.

"How far in is it?" she asked.

"About six or seven inches."

"It's not helping - I don't think it is," she said. "Can't you put it up a little higher?"

"That's as high as it can go," I said. At that point she gave another grimace; her body quivered.

"Stay like that," I said, putting the sheet back over her. "I'll be right back." I hurried to the nurse's station, knowing she hadn't had any pain medication for several hours.

I hoped that blast of morphine, this time instead of exacerbating things, would relax her enough to pass some of the painful gas.

When I returned she hadn't moved. Her bare behind was a perfect target for my needle. I zapped her right away. "There, that ought to help, too, Sandy," I said, pressing a swab against the pinprick. I looked down, still no bubbles.

"What...?" she said, in so much pain that she didn't realize I'd just given her a shot.

"The morphine. I just gave you a shot," I said.

"Oh - " A cough interrupted her. She coughed again, and at the same time the little bag at the foot of the bed shook with air bubbles forced through the tube in her rectum. "Oh," she said again. "That's so much-" More bubbles passed, the bag fairly shook with them.

"That feels so good," Sandy said. She pulled her body further over, pressing the mattress slightly against her abdomen, the tube between her buttocks jittering against the tape. The little bag of water continued to bubble. "Oh, oh. I feel so much better." The water bubbled on. She wasn't a large woman, and I had this sudden, absurd image of her slowly deflating, crinkling and folding like a Macy's Christmas Parade balloon that has sprung a leak. She just sighed and nodded. "Better," she said, "Much, much better." I could see that as the gas diminished, the morphine had begun to take hold.

"Mazel tov!" Sandy's roommate called, having heard everything.

"Oh, I can't tell you how much better I feel," she called back, her voice taking on that dreamy, opiate quality. "All I needed was to have a tail up my ass!" We laughed.

"Can you stand that a while longer?" I asked. The bubbling had diminished, but by no means stopped.

"Yes." She sounded suddenly anxious. "Can't you leave it in a while? I mean, I've had everything else done to me--this is nothing."

"No problem," I said, taking one more--professional, I assure you--look at the thick hose anchored between her handsome buttocks. I helped move more onto her back, keeping her hips twisted slightly so as not to kink the rectal tube and prevent further passage of air.

I left to check on my other patients. Tonight, for the first time in years, the shift had gone by with dazzeling speed. Pris was still asleep and now too was the foot lady. I wondered if Pris would have time for an enema in the morning before going home, and hoped that, if she did, it would be done by someone who cared enough to take the time and make the effort to do it right.

I got my charts caught up. Last stop was Sandy's room. She dozed lightly; the water bag quiet now. When I touched her shoulder she smiled, a familiar sort of expression people have when recently delivered from intractable discomfort.

"I think you'd better let me take that tube out now, otherwise you're going to have a permanent tail, like an orangutan," I said gently. She actually giggled.

"Orangutans don't have tails," she said.

"Darn straight, they don't. Now turn over." Buoyed by morphine and free of gas, she moved with much more grace, pulling her knee forward as she came onto her side so her fanny would be easier to see. The tape did a good job of holding the tube in. I was glad to see, however, that peristalsis had forced a little bit out. Sandy's GI tract was coming back into play.

Gently, I pulled ends of the tape loose, then pressed the rectal tube slightly forward before starting to pull it out. The anal sphincter tightens around anything placed within it for more than a few minutes. Sandy's tube had been inside her for about half an hour, and I didn't want to hurt her removing it. "Let me know if this is uncomfortable," I said, beginning to slowly slide the tube out.

"No," she said. "Noooo--ooohh--it feels strange though."

"It's been in you a while, that's why." I had about two inches out, five more to go. The soft plastic slid easily, aided by Sandy's rectum contracting to expel a foreign object.

"Can I have this put in again if I need it?" she asked as I removed another couple inches. The tube slid out covered only with Vaseline; they'd done a good job prepping her for surgery.

"Sure," I said. "Just wait an hour or so. Then you can have the night nurse reinsert it for another half hour."

"I never felt such relief before." The last of the tube popped free from Sany's anus. I hoped she would always have pleasant associations when rectal tubes came up in the conversation, but then I wondered what kind of conversations they'd have to be in the first place. I bagged the last of the equipment.

"Goodnight, Sandy."

"Goodnight. Thanks."

If I had had more nights like that--and, indeed, if the culture of the hospital had been more conducive to them--I might have stayed in nursing. Nevertheless I am grateful for to have had one shift like that, along with a few other experiences over the years.

I'm always anxious to hear what people think. And would particularly gratified to hear of anyone else's hospital experiences, whichever side of the bed they happened to occur on.

Andy