The role of nurse in digital rectal examination and manual evacuation

 Ali Wileman 21 Jul 2017

Bowel care is a fundamental area of patient care that is frequently overlooked, yet it is of paramount importance for the quality of life of our patients.

At RCN Congress 2017, the RCN Continence Forum hosted a fringe event where we discussed the role of the nurse in digital rectal examination (DRE) and manual evacuation. Over 50 members from primary care, secondary care and the private sector attended the event.

From the discussions, we discovered that:

  • 8 of the attendees had carried out a digital examination.
  • 10 had provided digital removal of faeces.
  • 15 of the attendees were students who had no experience of DRE or manual evacuation.
  • 100% of the attendees agreed that DRE and manual evacuation were nursing roles.
  • 7 attendees stated that they had procedures/ protocols at their places of work regarding DRE and manual evacuation.

DRE and manual evacuation is still withdrawn in some areas where managers have highlighted it as a form of abuse. The attendees discussed this and offered support for those facing this challenge.

The attendees also discussed the inconsistent approach with regards to supporting the needs of patients who require DRE and manual evacuation. A community nurse present was asked to attend hospital to manage a patient from her caseload, while another nurse was not allowed to attend hospital to support her patient’s needs, which were subsequently not met by the hospital. The attendees agreed that they would welcome the implementation of a standardised bowel management programme.

Since the publication of the original RCN bowel care guidance in 2000, the RCN Continence Forum have taken steps to support members working in this area:

If this is an issue you feel strongly about, we’d love to hear from you. You can follow us on Twitter (@RCNContinence) and join our Facebook group.  

Ali Wileman

Ali Wileman

Chair Elect, RCN Continence Forum

Ali qualified as an adult nurse over 20 years ago. She currently works as a Project Nurse at Southern Health Continence Service. Ali has a particular interest in bowel care and promoting good continence care. Ali will become chair of the RCN Continence Forum in 2018. 

Page last updated - 05/09/2018