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Will it hurt? Our student nurse editor investigates ...

  • Comments (10)

But when a member of staff needed a competency in this technique I volunteered. I had seen the procedure carried out on a number of patients. A nasogastric tube is a tube that is inserted through the nose to feed a patient who is unable to feed themselves.

As I sat in the treatment room with a small audience I certainly began to question why I had volunteered so eagerly. The trainee associate practitioner was preparing her equipment on a trolley beside me. There was the tube itself, lubricating gel, a 50ml syringe and a cardboard bowl. I had a glass of water to help the process along but not every patient always has this luxury.

The initial insertion the tube was a little strange but not uncomfortable. Once it reached the back of my throat it started to trigger my gag reflex. I think this is where the inexperience of the person conducting the procedure was evident. She continued to try and feed the tube but it was stuck. I was under the impression that it had travelled further than it actually had and it was only when we remove the tube to try the other nostril that all of the discomfort seemed to be in vain as the tube had only progressed around 2 inches.

I felt lucky that I was able to communicate in some detail what I was feeling and how I thought the procedure was going. Again this highlights to me how difficult it is when conducting these procedures on patients who are unable to communicate effectively.

The other nostril was more successful and after it had reached the back of my throat I was instructed to swallow with a little bit of water to help the process. In my opinion, getting past the back of the throat was the worst of it.

When the tube was fully in place a small amount of stomach contents was aspirated using the syringe, this will then be tested to ensure that the tube is in the right position. This would also be done in conjunction with an x-ray but as I wouldn’t be fed through the tube this wasn’t necessary.

I sat in the treatment room with the tube coming out of my nose and I had the almost uncontrollable desire to wipe my nose, it felt sore and irritated. It was now time to remove the tube and I wasn’t quite sure how to go about it. I was advised to go slowly and consistently when drawing the tube out of my nose. The constant friction of the tube coming out left a stinging sensation but afterwards I felt fine.

So what did I learn?

Despite the obvious that they are all uncomfortable, I learned that what I thought would be the least painful of the procedures actually turned out to be the most uncomfortable and now when a patient asks me if it will hurt or when I start carrying out these procedures myself, I will have the insight to know what the patient is feeling and how best to make sure that I conduct procedures in a way that causes the least amount of discomfort as possible.

There is clearly a limit to what I can volunteer to undergo and while I do have a dedication to understanding the patient experience I have to be realistic, but to the student nurses reading this I would encourage you to try and develop more of an insight.

This doesn’t necessarily mean you have to volunteer yourself for every procedure going but just be mindful of what these procedures may feel like.

What procedures have you undergone? Either as a volunteer or as a patient? How does your experience compare?

Do you think student nurses are effectively taught to think from the patient’s point of view?

Let me know what you think.

  • Comments (10)

Readers' comments (10)

  • Anonymous

    I think it would definitely help, but I'mnot sure I want to undergo any ... what else did you undergo?

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  • George Kuchanny

    Top guy for volunteeringg and sharing. This article will be helpful to fully qualified as well as trainees for sure.

    I volunteered for a cystoscopy, madness I know! This was not quite as bad as a nasogastric as it turns out. The anagesic goo squirt went without incident. I was in constant feedback with the wielder of the obscenely thick implement (microscopically small camera my ar*e!) as it was being inserted. "Past the prostate yet mate?" I bellow. "Yep, gone past now" he roars back. Meanwhile I am crushing volunteer nurses hand in an iron grip probably causing her more discomfort than I am in. Then implement wielder goes "Whoa! in the bladder already!" giving me a fright. FEAR written large in both my eyes I can tell you.

    The hubristic wielder clearly did not know that there was almost no more ureter between prostate and bladder, therefore speed was not of the essence at this time. He had shot through the last sphincter and nearly hit the opposite wall of the bladder. Narrow squeak or what? But all was well, torture implement withdrawn, no residual blood in pee after.

    Never again mate! is all I can say.

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  • George Kuchanny

    Ooops... sent it twice. Please delete on dear moderator :)

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  • Little One

    I had a lumbar puncture as a patient and can quite safely say that it was more painful than when I had an arthroscopy and all of the cartlidge from the inside of my knee removed.

    It was terrifying, I knew how big the needle was going into my spine and I knew that I might get feelings of electric shocks etc and was absolutely terrified. I was in pain, I could feel her prodding about in my back and I made myself sick because I was so worried. I can and do relate to patients who squeeze my hand so hard that I think my fingers are going to snap off when they have a lumbar puncture now and would never go through the process again, no matter what was wrong with me.

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  • Anonymous

    Thanks for this. I think its good that you have tried and tested these things, patients always ask what does it feellike? Will it hurt? Having watched NG tubes being inserted before, people always seem to gag, which is understandable. Atleast when patients ask you what it feels like? you will be able to tell them.

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  • Adam Roxby

    Hi everyone

    Thanks for your comments, I do read them all even if I don't get a chance to respond.

    George–I think you might have trumped me with your cystoscopy. Having seen them I can't think it's something I would volunteer for. Then again it's only my second year so I have plenty of time to put myself forward for more crazy things.

    Little one–I knew that lumbar punctures wouldn't be pleasant but I didn't know how bad it could be. I think sometimes in hospital you get used to the routine of doing these procedures and perhaps lose sight of what it is you're actually doing.

    Anyway, thanks once again for your comments. It is appreciated

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  • Anonymous

    I underwent an orchidectomy.... as a bet, co my friends said I wouldn't have the balls... guess what? I haven't got any balls now. Ha Ha!.

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  • Anonymous

    i think i've i had trained as a general nurse rather then a psych nurse i would have volunteered for different investiagtions but not Lumbar Puncture ( the thought of a needle gooing into my back no thanks)

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  • Anonymous

    Hi,
    I have been a patient many times and had various things done but the worst must have been my discogram without sedation. NEVER AGAIN!! I have I think quite a high pain thresh hold but this was the worst pain I have ever experienced. I have to say I am always honest with patients if they ask if something will hurt, for almost all patients I think honesty is the best policy however if you have never experienced any proceedures it is hard to say how much something will hurt. As a junior nurse I think I was fairly quick to tell a patient something is only a small scratch etc. I have often thought that being a patient should be part of a students training as your attitude does change when you have been on the receiving end!!

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  • the most uncomfortable procedure i have ever endured is intubation on a respirator/ventilator. it was after my open heart surgery in 1995 so i don't recall the insertion, but i will never forget regaining consciousness with the tube still in. this is legalized torture. just after undergoing such major surgery and with my hands restrained i still did a very good job of trying to get free. the nurse came running and gave me more sedation., and finally the tube was removed. i have had a living will executed and have given my sister medical power of attorney in case i ever become disabled. both the living will and my sister have been STRICT instructions that i am NEVER to be intubated again unless i will be completely unconscious the entire time the endotracheal tube will be in use. this may sound stupid and irrational, but i have been there and know i could never endure even a minute of this torture if i am conscious. finally, with such painful procedures such as nasogastric tube insertion and urinary catheterization, why aren't these patients sedated?

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