Rectal Tube Insertion: Scope of Practice for Support Workers vs. Nurses

Support workers / healthcare assistants are generally NOT authorized to insert rectal tubes.

Scope of Practice

• Registered Nurses (RNs) / Licensed Practical Nurses (LPNs): Yes – with competency validation, order, and policy adherence.
• Support Workers: No – invasive procedure requiring sterile technique, anatomical knowledge, complication recognition (perforation, bleeding, vagal response).

Procedure Requirements

• Provider order.
• Informed consent.
• Sterile technique (tube, lubricant, field).
• Patient positioning (left lateral, Sims').
• Insertion depth (10–15 cm adults).
• Monitoring: Vitals, discomfort, output character.
• Documentation.

Delegation Rules

Only tasks within the delegatee's legal scope, training, and competency may be assigned. Rectal tube insertion exceeds support worker scope in virtually all jurisdictions.

If flatulence relief needed: Support workers can assist with positioning, ambulation, abdominal massage, simethicone administration (per MAR), and reporting.