I think nowadays the most training nurses get is a lab session with a maniquin. My last two hospital visits kind of bear this out. I learned at the pre-surgical conference that if you want a trditional enema you have to start lobbying for it immediately, which I did.
My surgery was to repair my shoulder after a sever ski injury. I wound up in the hospital for 4+ days, on heavy pain meds.
The nursing staff started to push stool softeners and other oral meds immediately, all of which I rejected and said if I need something I'd lke an enema. My previous surgery (5 years prior), was day surgery and the constipation caused an anal fissure which needed treating, and I wasn't going to let that happen again.
So, day 3 My day nurse tried to get me to accept a dulcolax suppository, which I rejected. I told her they cause a lot of spasims and don't really work. The next morning she showed up with a fleet enema, I also rejected it. She said "If you want a regular enema I will have get the charge nurse to do it." Later in the day the charge nurse came in with a bucket enema kit and said "is this what you want?" I said yes, and then she asked, "do you think you can take the whole bucket?". I said, "Il'l try". She then told an attendent who was taking my IV out to come back later, as she was about to give an enema.
She then proceeded to get the enema ready and ask me if I wanted a bedside commode. I told her I thought I could make it to the bathroom. As she was preparing and positioning me she asked "is this what you would do if you were home?" I said yes, except it would be impossible after the surgery.
The next thing is her inserting the tip, then she asked "can you feel the water?" I told no, then the rectal tip popped out and I got flood of water. I told her I don't think it was in far enough. The she re-inserted the enema nozzle, really high and we were off to the races. I had to ask her to stop once for a cramp.
All in all she was very experienced and gave a good enema. I think my day nurse had never done one, that's why she got her boss to do it.
On my last surgery, 5 years ago. My nurse told me she had only given one other water enema, and didn't even know that soap should be added. She also offerred to let me give it to myself, which I declined. I had to explain the whole process to her, but, she was kind and followed all my instructions. It was still a very good enema.