Her pager was going off and it jarred L. from a sound sleep. She had been watching Dateline on TV and apparently had fallen asleep. It took her a minute to realize she was on call for the agency and when she glanced at the number she realized it was the answering service. L. had been busy all day with her home care clients, and the last thing she needed was to have to go out in the stormy weather at this time of the night. It was 8:25 PM. L. called the service and was told Mr. Evan had called and could she please return the call to him. L. jotted down the number and remembered seeing her client earlier in the week.

He was a man in his forties who had crashed his motorcycle a month earlier. She had admitted him to the agency on Monday to help him with his wound care. He lived with a lady friend who was willing to help with his care but she also worked and was really quite squeamish when it came to his various wounds. Mr. Evan, known to her as Tom, per his request, had spent a week in the hospital and then about 3 weeks in the rehab unit before being released to home care. His injuries to his lower extremities had been quite extensive. He had some healing wounds to his arms and trunk. Thank God he had been wearing a helmet.

L picked up her phone, blocked this call and dialed up his number. Katie, his friend answered the phone and told L. that Tom was having a major problem, and could Nurse L. please talk to him about it? When Tom got on the line he told L. rather timidly, that he was really miserable. He hadn't gone to the bathroom for several days, and he was feeling rather sick at his stomach. Did L. have any suggestions or could she possibly come out to see him? L. explained to Tom that his inactivity, and the use of pain medicine had probably caused his problem. L. suggested a Fleets enema, but Tom reported to her that he had already tried one and was unable to obtain any results. He told L. again how miserable he was and begged her to please help him.

L. picked up her bag and umbrella and headed out the door. She had checked the book and realized Tom lived clear South of town on one of the back roads. In this rain she was glad she had a 4-wheel drive SUV. Her vehicle was stocked with most of the items necessary when making late night calls, but she wasn't sure if she had an enema can packed in with all her stuff. Well, she could always use a red rubber catheter and a large syringe if she needed to give Tom an enema. It was the motto of the home care nurse to always be prepared or learn to make do.

She found his house without too much difficulty and with her bag in hand, she dashed for the front door. One thing about her job, her clients usually welcomed her with open arms. The door opened as she was reaching for the bell and Katie stood there in front of her with a worried look on her face. "Thank you so much Nurse L. for coming out. Poor Tommie is so terrible miserable and I just don't know how to help him." Katie said softly. L thought she was about to cry. She led L. down the hall to the French doors that opened into the large bedroom. Tom was there in the middle of the big four poster, holding his belly and moaning in pain. He had a metal fixation device on his left leg and a blue fiberglass cast on the right leg clear to his thigh. He appeared to be in a great deal of distress. L. took her stethoscope out of her bag and placed it on his abdomen and listened for several minutes moving the piece around to listen to the different areas of his bowel for sounds of activity. His bowel sounds were present, albeit greatly diminished, and L. knew she was going to have to help him gain some relief. Katie stood in the corner of the room watching worriedly. "I may need some help from you Katie if you don't mind." L said as she turned to pull her thermometer out of her bag. "Do you think you can hold his legs up for me so I can take his temperature?" "Did they send a bedpan home with him from the rehab unit?" L. shook the thermometer down with a couple of quick snaps of the wrist and just as efficiently slipped a rubber glove onto her right hand. She squeezed a little of the lubricant onto her gloved finger and then wiped a small amount onto the thermometer. Nurse L. placed her index finger at Tom's tightly puckered hole and then gently applied pressure to the rosebud until her finger slipped into him. She immediately realized that Tommie was very impacted. The stool was firm, not really hard, but certainly more than he could expel on his own. She worked her finger around inside him a little until she felt she had moved enough of the impaction to get an accurate temperature. The thermometer slid into him and Nurse L., who was now kneeling on the bed, turned it a little so she could read the temperature as it registered. "Tommie, my dear," Nurse L said to him as she extracted the thermometer, "You are running a low grade fever and I do believe we need to get you cleaned out so you feel better." Tommie nodded and then muttered, "I'm kinda scared, I haven't had an enema since I was just a little boy. I was sick and my Momma had to do that to me." Nurse L. smiled a little smile and then reassured Tommie she would be very gentle and not cause him any pain. "You will be just fine my dear. I'm sure I can make you feel so much better."

Nurse L. had a red rubber sheet which she carried with her and she proceeded to extract it from her bag, unfold it and tuck it carefully under Tommie's hips. Katie had let his legs down and was leaning over him kissing him passionately. It was almost embarrassing to L. except she had seen everything in her *lifetime* as a home care nurse.

Searching in Tommie's bathroom proved to be quite an experience. Nurse L. looked into the bottom drawer and found a basin he had obviously brought home from the rehab unit. Nurse L. filled the basin with hot water and squeezed 3-4 packets of castile soap into it swishing it around to make it suds just a little She took a number 22 FR. Foley catheter from her bag and attached the 60cc piston syringe to the end of it. She attached a smaller 30cc syringe to the other port of the catheter and checked the balloon to make sure it would inflate. She carried the basin of soapy water and the tools of the trade to his beside and placed them on the nightstand. Nurse L. snapped another pair of gloves on and then asked Katie to help her turn Tommie onto his side so she could give him his enema. Tommie groaned a little as they turned him over and he groaned loudly when Nurse L. placed her gloved hand at his anus with a large glob of Lubefax. L. worked her finger in and out of his "rosie hole" for several minutes and Tommie couldn't believe the effect if was having on him. He had not had an erection since before the accident and here this nurse was making his little pee pee stand up hard as a rock. My God!!! What was he to do now. L. slid the catheter into him and filled the balloon with hot water. Tommie could feel the pressure and heat against his little hard gland and it only made his erection more intense. He wanted to reach down and feel himself but he was afraid to draw her attention to what was happening. As if Nurse L. was unaware of the effect she was having on her "sweet patient."

Nurse L. filled the 60cc syringe with hot soapy water and attached it to the catheter and slowly pushed it into her waiting patient. She worked the catheter back and forth a little each time she refilled the syringe to make sure it was sealed against his tightly clenched butt hole. Slowly she injected the hot water, one syringeful at a time until she was satisfied he had gotton at least 2 quarts worth. Tommie was moaning and writhing from the full feeling of the balloon against his anus and generous amount of water Nurse L. had instilled into him.

It suddenly dawned on Tommie how helpless he was. He was unable to get up and walk to the bathroom. How was he suppose to get rid of all this water. Sure he had a rubber sheet under him, but he was so full and it would get all over the bed. "Gee, Nurse L. What am I suppose to do now? I can't hold anymore! I ccaannn't hold anymore! I ccccaaaaann't!!! It's all going to come out." Nurse L. couldn't help but notice the large erection her patient was sporting and she ignored his pleas for help and reached between his legs for his now fully erect member. She held it in her hand while he spurted all over the rubber sheet. Nurse L. left the catheter in place while she got up off the bed and went to the bathroom to retrieve the bedpan she had found under the sink. She came back to Tommie's bed and slipped the pan under him as she deflated the balloon and removed the catheter from his bottom. Tommie expelled into the bedpan with a splash.

Katie and Nurse L. stood watching as Nurse L. explained to her that she would have to check Tommie afterwards to make sure he was okay. Maybe I could teach you to give him an enema?

To be continued

Auntiel auntiel_99@yahoo.com