Most people would consider having a tube inserted into your nose and fed down to your stomach as something to generally avoid 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.
- Originally published 11th April, 2012
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 many procedures are uncomfortable, I learnt that what I thought would be the least painful of the procedures i’ve tried (a cannula) 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?
