Trainee nurses getting enemas

I have heard stories of nurses giving each other enemas. I have seen adds for rubber ass dummies, for training people how to give enemas. (They have ones for shots and catheters also.) I guess it has a realistic asshole with a container behind it to catch the enema water. I think those were some of the features listed in the add. (I wonder if anybody has copyrighted or trademarked the names Realistic Rectum or Realistic Rubber Rectum?) I have seen stories, of back in the good old days before the invention of Realistic Rubber Rectum, where nurse trainees gave each other enemas to get some hands on experience. I do not know if it was necessary for the receiving nurse to get the whole enema. It was more the experience of getting ever thing prepared, doing the nozzle insertion and starting and controlling the enema. The receiving nurse also got to experience how it felt to be on the other end of the nozzle. That experience help her understand what the patient was feeling and what she was trying to control during the enema. I saw a hospital show (fictional) where the head nurse took all the trainee nurses into an empty ward and told them to pick a partner, get the enema equipment ready, pick a bed and give each other an enema, to the horror of the trainees. (I wonder if they were going to be graded?)

Anybody know if this was how it was generally done or if this is somebody's fantasy? Also what percentage of nurses are into enemas?

Privacy is very important for both patients and nurses so they dont give each othe for sure.

When I was going through college for my RN we always used dummies to practice rectal tube insertions, rectal temperature taking, suppositories, or any other procedure involving the rectal area. Later in the curriculum you have to actually spend time in the hospital performing enemas under the supervision of an acting RN. This is where some aspiring nurses decide they really don't want to be a nurse after all. It's tough that first time you tell some stranger you're going to give him an enema, but you have to do it if you want to pass. After you get the hang of it and learn to actually deal with patients one on one it's not so bad. Nowadays, I think no more about giving some guy an enema than I would taking a walk. It's become SO routine. As for the shots, we actually practiced giving them to each other , because this is something you actually have to experience first hand to get it right. Wasn't uncommon to go back to the dorm with a sore,bruised shoulder or butt from being stuck so much.

Nikki the bum nurse: What would be in the syringe for shot practice? What gauge needle? Is a little bit of air in the syringe as bad as they say?

Do you know about when they started using the dummies? When giving enemas who decides the quantity, number and volume? How far will you go to get "until return is clear"? What do you think was the average number of enemas for "until return is clear"? How long would you wait between enemas? Who is it easier to give an enema to, men or women? What changed, over time, that it got routine to give an enema? Was there something about giving enemas or was it fecal management in general that would make the aspiring nurses decide that nursing was not for them. Sorry for so many questions but "inquiring mind want to know".

P.S. I was in the hospital once and got a hospital grade bacterial infection (big deep boils). They gave me strong antibiotics (my feces were like a wet white powder). Killing off the bacteria, in my body lead to fungal problems that were even harder to cure. That experience left me with the feeling that there is some pretty nasty stuff is living in our hospitals (the stuff we can't easily cure). How dangerous do you think it is being a nurse and spending 5 days a week in a hospital?

Hey Fred, syringes we used to practice with is the same you normally get vaccinated with (3cc) and we filled them with 0.5cc of sterile water just for that purpose. You can never really get ALL of the air out of the syringe. Some of it is suspended minutely in the injectable solution. It's the sizeable bubbles that you have to worry about, very dangerous.

As for the dummies I don't know when they started using them. I know the ones we had looked well used,so I'm guessing a good while. The attending physician is the one who decides if an enema is to be administered, and what solution is to be used, and how much. We can't do an enema without a Dr's approval. If a physician orders "until return is clear", which rarely occurs, you can expect around 2qts of saline given up to 2 or 3 times. If you open the clamp only halfway, and slowly fill the patient's colon completely, you can get the greatest majority of fecal matter out in the first fill. Then you might be able to get it all out with only half of the second bag or at least avoid using a third bag. This prevents us from having to put a patient through so much, because enemas can be very tiring. Usually its better not to wait between enemas. It's preferrable to go ahead and get the patient through the ordeal all in one go and when perstalsis has been induced by the first enema.

Nothing has really changed as to enema routines. What I was referring to earlier is that it is routine for us nurses because we see many patients over given length of time. Some do get enemas, but most do not. Still just dealing with the ones that do get enemas is enough to keep you well familiar with it. As for giving enemas to males or females, I have had rough times and easy times with both sexes. It really more depends on the patient. Some males preferred me over the orderlies because they did'nt want another man touching their backside. Others were too embarrassed to let a female view or let alone penetrate their bottom. Female patients almost always prefer a female nurse. If a male nurse administers an enema to a female patient in our hospital, another female nurse has to be present in the room for the duration. This does not apply though when I or any of the other female nurses give men enemas. And as for my classmates back in nursing school, there were those of us that could deal with the embarrassment of confronting a patient and telling him you're going to give him an enema, and there were those of us who could not. I did it, and it was probably one of the hardest things I have ever had to do in becoming a nurse. But you get over it like everything else. Those other people that dropped out of school thought it was going to be a gravy train I guess.

I really hate you had such a rough time with boils during your hospital stay. Yes, antibiotics are our friends and sometimes our worst enemy. The same toxins the sporins use to kill infections also unfortunately kill off helpful bacteria that protect our bodies. And yes, the hospital is one of the dirtiest places you can possibly go. We don't get our reputation by taking in people of picture perfect health, so when you enter a hospital you may share what any number of ailments our patients might have. It surprises me that I don't get sick no more often than I do, but we take preventive steps to keep germs down. It's just one of those risks that I signed up for, but somebody has to do it! Well I hope this answers most of what you asked. I answered them to the best of my professional knowledge. Need to know something else just ask.

Thank you for answering "the post of 1001 question" so quickly and methodically. Your answers, as in most scientific research, generated more questions. What makes a dummy look well used, the paint is wearing off its anus or is the anus actually starting to get ripped (anal fissures)? Are doctors good at estimating the quantity of fluid need for an enema, for a particular patient. If you encountered some of the people here 2 quarts might only be a half fill. Have you figured a way to determine the fullness of a patient? Would you know that 2 quarts had only half filled somebody? Would you be able to clean out the high capacity person only using 2 quarts at a time? I assume the percentage of the colon cleaned, is related to the percentage of the colon filled. When trying to clean one of the high capacity people, is it that in half filling the colon, the solution infiltrates approximately half of the colon's length, as apposed to filling all of the colon's length but to only half of its volumetric capacity? (There was probably an easier way to ask that question.) Restricting the inflow of the enema with the clamp is better than lowering the height of the bag because if the solution reaches an obstruction the pressure will slowly build and overcome the obstruction, as apposed to the obstruction acting a dam and just totally stopping the flow? Why do you think the slow fill does a better cleaning job? Is the nurse expected to be present during the whole time of the injection of the enema. (My ex told me the story of the delivery her first baby. She was given an enema, the tube was inserted and the solution injection was started and the nurse went away. She thought it was very busy that day in the ward. The enema bag emptied and the nurse didn't come back. She was left laying in the bed with the tube still inserted. She said when she had contractions or the strong urge to evacuate, the used enema solution would sometimes push back up the tube and into the bag. When the pressure subsided she got to take that part of the enema again. She press the call button but nobody came. The woman in the next cubical was in the same state. After about 10 minutes she had to pee really bad. The woman in the next cubical had had previous babies and said it was not like this for her previous births. My ex and the woman in the next cubical decided to rebel, they removed their own tubes and went to the john). Why is "return until clear" not uses much anymore, the "Start at the beginning and works your way through" chemical solution works better? Which method is harder on the patient if only the lower G.I. needs to be cleaned. I guess the chemical method is more convenient, as the patient can do it them self. The only skill the patient has to have is to understand "drink this" (even if it is a gallon, probably something they have not done before but the learning curve is fairly short and steep.) What is "rough times" when giving an enema? What are the rules for orderlies and children (same as the orderly - female stuff)? (If male nurses are orderlies, are female nurses disorderlies?)

Don't worry we are getting close to the 10,000 question limit per post. Please do not forget to answer the questions on the back of this page.

After having those boils, (they were not all that painful but it was scary watching your flesh rot away) I can see why, back in the old days, cursing somebody with a pox and boils was so bad, being that they probably had no good way to cure them. I wonder if back then, a major illness could be as financially ruiness as it can be these days?. I do not think they had socialized medicine back then. That brings up one more question, being that your site name is Nikki the BUM nurse as apposed to Nikki the ASS nurse does that mean you are practicing in Britain? (Or did bum sound classier than ass?)

Thank you for being one of those people that risk their own health to help other. Also thank you for answer my 10,000 questions.

Nikki; I was a patient in a childrens hospital with TB for twelve years near Boston from 1937 to 1949.When the new nurse recriuts were being trained for enemas,I was on the receiving end many times over.They wheeled me into the boys bathroom and place me on a long table then they stripped me naked in front of five recruits.The head nurse would give instructions and demostations on me.A funnel and colon tube were the equipment used in those days.

Each nurse would pracice given me an enema as the supervising nurse looked on .I was enjoying the whole thing and felt like a super star with all the attention.When it was all over,I was given three or four enemas until I expelled clear.My last year at the hosptal at age fourteen I was getting a little stiff down there as the nurses gave me enemas .Some of the recruits were not much older than I was because they just out of high school.I got enemas before several surgeries and when I did not have a BM for three days.On several ocassions I would cheat on the chart hanging on the back of the bathroom door indicating that I had not had a BM on a giving day.When the night nurse came in,she would check the chart to see what kid did not have a BM,if she saw three zeros in a row on the chart,well,that kid would get an enema that night.I pulled that stunt a few times and was proud as a pickle knowing I was going to get an enema.It was fun while it lasted and it made me who I am today,a true blue enema lover and still going strong at age 73.

You are right about one thing,a sickness can spread like wildfire in a hospital,when one kid got diarrhea,so did everyone else.Colds and flue also spread very quickly around the wards.The nurses were almost in panic when so many kids were throwing up at once.They did not give us any medications either.

Let the good times FLOW to the max,thrre quarts will do.w/m73yrs/Western Ma

Hey twobagger: What did they do to cure your TB? Also was that a continuous 12 years in the hospital?

Fred;Yes, it was twelve continuoues years from age two until age fourteen.I had TB of the bone which required several operations on the left knee.The knee cannot bend because they fused it.Each operation meant many enemas on the night before to clean me out.That's OK,I was in enema heaven.

Let the good times FLOW.w/m73yrs/Western Ma

Fred, I guess what made the dummies look so well used was in the way they were stored perhaps or if they were transported from time to time to different locations, or maybe dropped at some time. Just general longterm use I guess.

As for doctors judging the amount of fluid in an enema for a particular patient, they usually don't. Usually the order will entail what type of fluid is to be used if the enema is large volume. Otherwise they will specify a small volume fleet enema. The large volume kits we use are actually one size for the adults, which is a clear vinyl 3qt bag with a narrow rectal tube. Like I mentioned earlier, if I am working with a larger patient, I'll probably prepare the full 3qt volume just in case I need it. This doesn't mean they'll necessarily be able to take the whole bag, but it's there if I need it. And the best way to judge if the colon is full or not is by listening to the patient themselves. I constantly monitor the patient as the enema progresses to see how they're feeling or if they need me to stop for a while. If they start complaining of cramps I'll stop and wait a bit. It helps if the patient takes deep breaths through their mouth. If or when the cramps subside, I'll start letting more solution in slowly until all of it goes in or the the patient complains of cramps again. There a signs you look for in knowing whether or not if a patient has had enough. If you hear them say "STOP!STOP!" or

"THAT'S ENOUGH!QUIT!" or if you start seeing fecal matter rush back up into the enema bag, then you'd should really clamp it off and help them to the toilet ASAP. I've had accidents where we would not make to the toilet in time, but if you pay close attention you usually dont have much of a problem. The height of the bag and overcoming a fecal obstruction you were refering to? I never hold the bag or hang it more than 18"-24" above the patients anus. To much water pressure can really hurt and cause unecessary cramping. Again, the key to any good enema is to go SLOW. If you go slow, it allows the pressure inside the colon to equalize slowly and delay perstalsis. It also gives the saline or castile solution time to work its way further up into the colon and soften harder fecal matter that may be obstructing normal bowel movements.

Under no circumstances should a patient be left alone during an enema. From the time the tube or nozzle is inserted to the time you walk them to the toilet and remove the tube you should always give the patient your undivided attention. I try to maintain verbal contact with the patient and make sure they're OK throughout the procedure. You gotta be real gentle and reassuring to a patient because they're usually freaked out and wanting to get it over with.

The "return until clear" is not used much anymore because the primary reason enemas are given in the first place nowdays is for relief of constipation. And if the enema is given as a surgical prep measure (ex.open heart surgery, some orthopedic surgeries, or extensive abdominal surgeries), what you're really trying to do is relieve the patient of the burden of having a bowel movement during anesthesia or right after surgery. A "return until clear" regimen could be prescribed however if the patient has to undergo an emergency intestinal procedure, and hasn't had the time to drink the "Go Litely" bowel prep solution. Go Litely is probably better also for evacuation in lower GI because in addition to the drinkable solution, an enema is usually included that you take at home just before your procedure.

You were asking about the "rough" times during an enema? I was referring to the patients that put up a fuss over an enema or just flat refuse to let you give them one. Either way "NO" means "NO", and you definately can't force a patient into taking one. Also, the rough times are when like I was mentioning earlier when a patient has a premature expulsion "accident". All this comes with the territory. And as for orderlies administering enemas to children, we prefer to have a parent or guardian present to help comfort a child when they are getting an enema. I guess I dread giving enemas to children more than any other patient. They're scared, they don't understand why you have to do them this way, and it's just flat out uncomfortable if you're a child. This is why we female nurses are almost always preferred, because an orderly can be intimidating to a child.

The username you mentioned earlier was a spare the moment thing that just came to the top of my head,hahahahah LOL.Sounds silly I know! I'm thinking about changing it to RN Nikki or Nikkinurse, so if you see the change you'll know it's still me. No I'm not living in England, "bum" just sounded more polite. I'm trying not to be vulgar here.

Hey N. Nikki or anybody else that has used one: How or why are those "Realistic Rubber Rectum", rubber ass training dummies good for enema training. We all know about getting the angle of the nozzle right, for a not unpleasant insertion. If you get it wrong, is it like the children's game Operation, it buzzes or something? Does it have any kind of other feedback, similar to what you would get from a real person? Does it have simulated cramps, and get full and start complaining to stop I can't take anymore?

Would it be of training value to have the trainee nurse give herself an enema, in private, to feel what it is like to receive an enema. What percentage of trainee enter nursing school never having received enema? what percentage of practicing nurses have never had an enema?

Asking more questions than one person should ask --- Fred

Back in the 50's and 60's , many a nursing school would have the students pair off and give each othe enemas, injections etc. Then came Enema Annie, the enema practice dummy. In medical schools we would divide up for proceedures as well, only not for enemas.

Years ago when I was in college, I dated s student nurse for several years. Early on she asked me if she could "practice" giving an enema to me. I was totally surprised by that but I had gotten a lot of enemas growing up, would sneak them after mom stopped giving them to me, and really enjoyed them so I said go ahead. Well, she "practiced" on me quite a bit, 2-3 enemas a week for the duration of our relationship. No doubt she liked the fact that I got a hardon nearly every enema I got. I gave her some too and she seemed to enjoy them too.

A social group i was in in the early '60s included a nursing student. She announced with a giggle that it had been "Enema Day "at school. That cauised the other girls to giggle while most of us guys blushed a little. No one asked for details, unfortunately.