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Peter sat in his living room looking up the road for the arrival of the nurse in her car. He had had surgery the previous year which had removed most of his colon, leaving just a short rectal stump and Peter with a permanent ileostomy. He had had problems with his rectal stump. It continued to produce mucus and the build-up of mucus had proved uncomfortable and, at times, very painful. Initially his colo-rectal consultant had prescribed Fleet phosphate enemas every fortnight to clear out the mucus build-up. The community nurses had come every two weeks to do this but the phosphate enema had caused rectal irritation and bleeding: the consultant called it distal proctitis. He'd then been told to try self-administered glycerine suppositories, but these too had caused irritation and bleeding. The consultant had decided to try rectal washouts with just warm water and he was going with one of the community nurses for her to learn the procedure at the local hospital.
As he was reflecting on this, the nurse's car drew up and he went to meet her, locking the front door behind him. He sat beside Carol in the car and they exchanged the usual pleasantries as she drove him to the hospital. As usual, they had to drive around the car parks before they could actually park. The community nurse put her parking permit in the window of her car and she and Peter made their way into the hospital.
Once inside, Carol and Peter made their way to the main lifts and Carol pressed the button for the top floor. Peter had been told that they would be going to one of the wards used for general surgery where the sister would run through the procedure with Carol and provide her with a protocol for it. Leaving the lift, they went down a short corridor to the ward where they were met by Julia, the ward sister. Julia called two student nurses over to her desk. "This is Susan and Mary who'd like to watch the procedure, if you don't mind, Peter?" Peter said that he was happy to help them with their training and so Julia turned to the nurses and said, "Take Peter to side room three and help him to get ready while I show the protocol to Carol."
The two student nurse led peter to room three and explained to him that they'd prepared the room for him and had hoped that he'd let them watch and assist if possible. The side room had a wash basin, a wardrobe, the usual armchair and plastic chair, a standard hospital bed made up with a bottom sheet, pillows and an incontinence pad strategically placed where Peter's bottom would be. Beside the bed there was a drip stand on the left and a trolley covered with a paper sheet and a hospital gown on top of that. The two student nurses went over to the window ledge and put on pale green see-through disposable plastic aprons and two pairs of rubber gloves. Mary turned to Peter, "We've been asked to help you undress as part of our training. Would you mind?"
Peter blushed with embarrassment at the thought of these two young nurses undressing him, but, thinking that they had to practice on someone, agreed.
Susan went up to Peter and said, "Let me help you out of your jacket." She did this and placed it on the hard chair. Mary said to Peter that she would remove his tie and shoes, and did so. Susan explained that, as part of their training, they had to explain to the patient exactly what they were doing and it was a great help that Peter was willing to let them practice on him. Susan undid the front of his trousers and he felt himself 'stand to attention' at the attention which he was receiving! She slid the braces off Peter's shoulders (to prevent squashing his stoma, he wore braces rather than a belt to hold his trousers up), unfastened the buckle and slide down the zip. Peter was blushing furiously as she slid his trousers down and off with Peter assisting by lifting each leg when prompted. Mary then unbuttoned his shirt and removed it, folding it carefully and placing it on the growing pile on the chair. Peter was now in just his briefs and socks. Susan picked up the hospital gown and held it out for Peter to put his arms in. As usual, the gown hardly covered his bottom and Susan just did up the single tape at the back at the top, explaining to Peter that, because of the procedure, there was no point in doing up more tapes down the back. Standing behind him, Susan requested permission to remove his briefs. Peter agreed and she opened the back of the gown and hooked her thumbs either side of the waistband, sliding them down to his feet. Mary asked Peter's co-operation to remove the briefs from around his feet and then his socks. Peter was then asked to lie on the bed.
With almost perfect timing, there was a knock on the door as Carol and Julia came in. Julia removed the paper cover from the trolley and addressed Peter. "I'm going to explain what we'll do and show you the equipment. On the trolley, we've got a bucket, thermometer, rectal catheter, funnel, jug for warm water and tubing to connect the funnel to the rectal catheter. There's a disposable enema giving set, lubricating jelly as well as a urinal, slipper bed pan and a vector bed pan and cover. There are two methods of doing this and I'll show Carol both. We suggest that you try one method for a month, then the other method and, between you, decide which is most effective for you. We'll start with the bucket and funnel method. Would you lie on your left side with your knees drawn up?" Peter knew this position well from the internal examinations which his surgeon and the junior doctors had done.
Julia turned to Carol, "Fill the jug with about a litre and a half of water at just above body temperature, say 40 degrees Celsius. It'll cool down as you prepare your equipment to around body temperature." Carol went to do this as Julia instructed Mary to lubricate the tip of her middle finger with the lubrication jelly and to thoroughly lubricate Peter's anus. Mary pulled Peter's gown off his bottom and asked him to arrange it so that he wasn't lying on it. She then squeezed a large blob of the aqueous jelly onto the tip of her middle finger on her right hand and, spreading the cheeks of Peter's buttocks with her left hand, lubricated his anus and then thrust her finger deep inside, working the jelly around the anal orifice. Julia was consulting the protocol and said, "I've forgotten something! Peter is supposed to be allowed to empty his bladder before we start this." With that, she handed Peter a urinal, lifting his gown so that he could place it over his penis. "At home, Carol, you'll ask him to use the toilet first rather than bothering with a urinal." Peter, still lying on his side, tried to empty his bladder, but his monster erection and the inhibition brought on by the presence of the four nurses meant that he struggled in vain. Julia, seeing his difficulty, said, "We'll try plan B!" She removed the urinal and then fetched a packet from the trolley. She opened it and showed it to Peter. It was coloured pale green and looked like a shower cap with a wide elastic fastened to it and the moth of the cap was gathered tightly with elastic. "This fits over your penis and genitals, Peter, and the band goes round your waist to hold it in place. It'll cover your modesty for you and, as it's got an absorbent lining, if you pass any urine, the lining will soak it up."
She then got Peter's help to slip the band around his waist and then, holding the mouth of the bag open in her gloved hands, slipped it over his penis and testes. The elastic held it snugly in place and Peter could feel the soft lining of the pouch. It looked like a green codpiece and Peter found its presence even more embarrassing than nakedness.
Julia placed the bucket at the side of the bed and took the rectal catheter, connected it to the tubing and attached the funnel. She held out the tip of the rectal catheter and asked Mary to coat it with more lubricating jelly. She then inserted the rectal catheter into Peter's back passage and held up the funnel. Carol passed her the jug of warm water and Julia poured some into the funnel. As the water entered Peter, the level in the funnel dropped and Julia topped it up until the water level stopped falling. She asked Peter if he was all right and he replied that he just felt a little full inside. She then lowered the funnel until the mouth of the funnel was over the bucket and below the level of Peter. The water, and some of the mucus was drained out of him into the bucket. Julia handed the funnel to Carol and asked her to do it. Carol filled Peter's rectum up with the warm water twice and emptied the water out through the funnel once. On the second occasion, Julia prompted Carol to remove the rectal catheter by pulling gently and asking Peter to 'hold' the fluid still inside him. Susan was asked to pass the Vector bedpan and Peter was directed to sit on it. "If you'd sit up straight and then try to push as much of the water out of you as possible," asked Julia. Peter sat on the bedpan and decided that they really were a strange form of torture as he tried to balance on the pan. Mary took a sheet off the trolley and covered Peter from around his waist down to his feet to give him some semblance of privacy. "You'll probably pass urine at the same time, Peter, but don't worry! That's what your pad is for."
Peter felt really embarrassed to be using a bedpan with the four nurses still in the room, but he squeezed hard and the fluid was expelled from his rectum. As he did this, he felt the need to urinate and so let that go. A warm flood came from his penis and washed over his scrotum until it was absorbed by the padding. Julia asked if he had finished and he confirmed that he had. Susan removed the bedpan and Peter was asked to roll onto his back. "I suggest that you ask him to evacuate the last washout into a bedpan, Carol. It's easier for you to check that all the mucus is cleared than to try to look into the toilet bowl. Now let's show you the second method."
Julia went to the trolley and picked up a disposable enema set. She went round to the right side of the bed so that Peter, as well as the other nurses, could see it. She showed them the triangular p.v.c. bag with hole to hang it from a drip stand and with a screw cap to fill the bag with warm water, the tubing and clip, and the enema nozzle. This was made from a white rigid plastic with a tip which was wider than the rest of the nozzle. There were two holes, one either side, in sides of the tip of the nozzle. Carol was asked to refill the jug with more warm water and was shown how the clip on the tubing worked to stop or release the flow of water from the bag. Carol clipped the tubing closed and removed the stopper from the bag. She filled the bag, at Julia's direction, with warm water and replaced the stopper. The bag was hung up on the drip stand. Mary was asked to remove the covering sheet and then to position Peter on the slipper pan with his bottom partly in the opening, his feet tucked up to the pan and spread on either side and his knees up. This position meant that Peter's anal cleft was spread wide to allow the nurses access to his anus and rectum. Julia told Carol to open the clip a little and to run water into the slipper pan until all the air was gone from the tubing. Carol then, on Julia's guidance, lubricated the nozzle with jelly and, after warning Peter of what she was going to do, pushed it into his back passage. Julia told Carol to make sure that the nozzle was well past the anal sphincter, the muscle which closes off the anus. Peter was asked to lower his legs, but still keeping them apart. Julia taped the tubing firmly to Peter's right leg with several pieces of tape from near his buttocks to half way down his thigh. "This will hold the nozzle in place in his rectum," said Julia. Peter was then asked to bring his legs together and Susan covered him with the sheet.
Carol opened the clip and Peter could feel the warm water filling his rectum. "Stop now, please," he said as he'd been told to say when he felt full. Carol clipped off the tubing and asked Peter push out he water into the slipper pan. As he did this, he could feel the water running down his buttocks into the slipper pan and more urine trickled out into his 'codpiece'. "Done," he said, again as per his instructions, so Carol reopened the clip to allow more water to flow into him. Again, when he was full, the clip was closed and he voided into the slipper pan. On the third fill-up, he was told to relax his anal sphincter and to let the fluid flow out of him. "Because we've placed the nozzle virtually at the end of his rectal stump, the water flowing through will wash out the stump effectively. Peter could feel that the slipper pan was beginning to fill as his buttocks were in contact with the water. Carol asked Peter to hold his muscles clenched to retain the water this time. When Peter said that he was full, the clip was closed off and the tape removed. The nozzle was carefully withdrawn and then Peter was asked to sit up to expel the water. He pushed the water out of him into the now quite full slipper pan and he found that he was sitting in a pool of the enema water. More urine passed from his bladder and soaked the absorbent 'codpiece' which was by now both warm and damp against his privates. Susan was directed to remove the slipper pan and Mary the bedpan to empty them and bring them back. Peter was still very wet, but he was lying on the incontinence pad on the bed which soaked up some of the water.
Julia turned to Carol, "We'll go and get your equipment pack sorted and I'll arrange for Home Loans to delivery a drip stand to Peter's house for you tomorrow along with a bed pan and slipper pan. I'll also arrange for a plastic sheet for the bed and some inco pads until you can get a supply for Peter. The bucket will have a lid and Peter should rinse the funnel set through and then leave it in a sterilising solution overnight with the lid on the bucket. As it's only used for him, the equipment doesn't need to be single use. Oh yes, and would you like some of the 'modesty' pads?" Carol said that she would. With that, Carol turned to Peter and said, "See you at home tomorrow!" Julia said to Peter that another nurse would come in a short while to sort him out. She and Julia left.
A few minutes later, another nurse, Helen, came into the room with Susan and Mary. Susan was pushing a trolley with what appeared to be a bowl, towels, cotton wipes and the bedpan and slipper pan on it. Helen said to Peter, "Julia has asked me to supervise the students giving you a bed bath to clean you up, if that's acceptable. I'll be assessing them while they do it as part of their training." Peter felt that, as they'd seen so much of him, a little more wouldn't hurt, so he agreed. Helen blushed and said, "Thank you for that. It's better for them to wash a person who's not sick as they can't do any harm if they get it wrong! But I've got another request, please. Susan and Mary would like to try out the skills which Julia showed to your district nurse. Could they try giving you a rectal washout, or would that leave you sore?" Peter though about it and decided that he was game for it! Helen thanked Peter and said that he could probably do with a drink. Mary was dispatched to get him a coffee and some biscuits which he consumed whilst the nurses were getting the equipment ready.
This time, Susan did the honours with the lubricated finger and, at Helen's prompting, carried out a thorough rectal examination. Pressure on Peter's prostate produced some pre-cum, but, with Helen advising, Susan 'milked' the gland until Peter ejaculated into the absorbent padding. "That's how we can get a semen sample from a patient without actually handling his penis," Helen told the students. Mary was waiting with the funnel and rectal catheter and inserted the catheter when Susan had withdrawn her finger. The two students took it in turn to fill Peter's rectum with warm water and to empty it into the bucket. Peter by now was finding the whole process sexually arousing with the pressure of the warm water on his already sensitised prostate.
After each nurse had done it twice with the funnel, Susan inserted the tip of the disposable enema giving set whilst Mary taped it in place on Peter's leg. The students, under Helen's prompting, place Peter on the slipper pan and proceeded to wash him out. Helen picked up a purple plastic covered folded item off the trolley which Peter hadn't noticed before. "OK,, we'll wrap it up now," Helen said to the students. Both of them laughed as Mary gently removed the tape and Susan held the enema nozzle inside Peter. "Would you lift your bottom off the slipper pan for us, Peter?" asked Mary.
Peter did as he was asked whilst Susan still held the nozzle in him. "Keep your bottom off the bed, please," requested Mary as she slid the disposable all-in-one diaper under Peter's bottom. "We'd like to fill you up again, but get you to retain it for as long as possible. We'll put a disposable diaper on you and you can use that when you need to go. We'll take half an hour for lunch and arrange for some food to be brought to you and, after lunch, we'll give you a bed bath. OK?"
Peter agreed that it was. Mary removed the 'codpiece' which was, by now saturated and Susan opened the clip on the enema tubing. Helen raised the bag a little higher and Peter was asked to say when he was full. "Enough," Peter cried.
Susan closed the clip and removed the nozzle. Mary expertly pulled the diaper tight around Peter's waist and thighs and fastened the tapes. She checked with a gloved finger to ensure that the diaper's plastic cover fitted snuggly and wouldn't leak. She then covered Peter with the sheet and said, "We'll bne back in half an hour. Try to hold it as long as possible. We''ll send an HCA in with some lunch for you."
A few minutes later, one of the Health Care Assistants came in to offer him his choice off the lunch trolley. She brought the food on a tray in to the room and placed it on the overbed table, inviting Peter to sit up. He did so and she left the room. As Peter started to eat, the action of eating caused him to need to empty his rectum. He did so, releasing the warm water into his diaper, along with a stream of hot urine. By the time Helen, Susan and Mary returned, he'd eaten his lunch and well used his diaper which was now very soggy. The nurses put on aprons and rubber gloves and started to make preparations to give him the promised bed bath.
This was a day to remember!
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