Hospitals have protocols for what they will and not to do in the ER. One of my ERs will not perform manual disimpaction in the ER. Rather the hospital wants the patient to be temporarily placed on the observation floor for that procedure. For whatever reason, that is their decision.
In the past, we had a few doctors who actually traveled from out of state to pick up shifts in our ER. I thought that was strange, but the financial incentive must have been great for these doctors to fly into our area each week to work. This one doctor was a real gem. He liked to get into your personal space in order to make you uncomfortable, told off colored jokes, and basically was an asshole - Dr. A-hole. He did not like any of the policies in my hospital, so when I had a chronic constipated patient turn up in my room, I knew it was going to be an interesting day.
He said he was going to fix this patient's problem. I reminded him of the hospital's policy and he scoffed and said it was a fu&%ing stupid policy. Maybe so, but what can I do about it? Next he told me to go in there and disimpact the patient. Uh...no. For some reason, the hospital felt strongly about this procedure and nurses are not allowed to perform it and especially not in the ER. He was livid. He marched into the patient's room, told the patient that he better relax because he was going to, "Dig the shit right out of him." What the hell?!! He proceeded to do just that. The patient started screaming in pain as this doctor entered him. Dr. A-hole began talking about how stupid it was to not do this in the ER and began flinging feces into the garbage can. As he did that, fecal matter flew around the whole room - on the walls, the floor, the cabinets. Perhaps this is why the hospital didn't want it done down here? Ya think?
"You're not much of a basketball player, are you?" I said this deadpan.
I was trying to break the tension. With that, his face turned red and he flung more across the floor violently, not even trying to hit the garbage. I left the room, afraid he was going to start throwing it on me and went to find my charge nurse for back up.
Needless to say, this particular doctor did not last very long at my hospital - not for the poop party, but for his general attitude and treatment of others. The patient turned out to be okay, the room had to be closed for a few hours for a terminal clean after his 'monkey at the zoo' fecal flinging fiasco , and the whole ER smelled like crap for the rest of the day - literally.