How to Perform Fleet Enema (rectal)

Ria, a 3rd year nursing student is assigned in the Intensive Care Unit. Today, she is assigned to the patient at cubicle 3. Scanning the chart for new orders, she finds out that the patient is due for fleet enema. What is fleet enema? And how do you perform it? Both confused and curious, she approaches her Clinical Instructor to know more about the procedure.

How it is done

  • Wash your hands before and after using this product.
  • Remove the protective shield from the enema.
  • Let the patient lie on the left side with knee bent. Or if the patient finds it more comfortable, he/she may kneel, with the head lowered and chest forward until the left side of the face is resting on a flat surface with the left arm folded comfortably.
  • With steady pressure, gently insert enema tip into the rectum with a slight side-to-side movement, pointing the tip toward the navel
  • Do not force the enema tip into the rectum because you could hurt the patient.
  • Squeeze the bottle until the recommended amount of the drug is inside the rectum. You do not need to empty the bottle completely because it has more liquid than needed.
  • Remove the bottle tip from the rectum. Let the patient stay in position for 1 to 5 minutes until he/she feels a strong urge to have a bowel movement.
  • The use of this product is ordered by the doctor(either before surgery or a bowel procedure), he or she should tell you how long before the surgery/procedure you should use this product.
  • Follow your doctor’s directions closely. After using the medication, the patient may be asked to drink plenty of clear liquids as directed by the doctor. Doing so will help prevent serious side effects (such as kidney problems, dehydration).
  • The dosage is based on the patient’s age, medical condition, and response to treatment. This medication is not to be used more than directed, use this medication more often than once in 24 hours, or use this medication for more than 3 days unless directed by the doctor.
  • Also, other laxative products shouldn’t be used while using this product unless directed by the doctor since doing so may increase the risk for serious side effects.
  • This medication may cause a condition known as laxative dependence, especially if used regularly for a long time. In such cases, the bowel may stop working normally and the patient may have ongoing constipation. For most people with occasional constipation, a bulk-forming laxative (such as psyllium) or a stool softener (such as docusate) is a better and safer product.
  • Tell the patient to inform you or the doctor right away if the enema tip causes rectal bleeding/pain, if he/she does not have a bowel movement within 30 minutes of using the product, or if the patient has symptoms of dehydration, or if the patients thinks he/she may have a serious medical problem.



Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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