In which Nurse Collins recruits Peter for a demonstration of patient care procedures. Editor's Note: Every practicing nurse is well aware of the involuntary sexual arousal experienced by many male patients receiving enemas. The symbolically submissive posture of the enema recipient, the forced exposure of private parts of his body, the sense of personal invasion, and (most importantly) the intimate pressure of the warm enema fluid on his sensitive prostate gland often produce a sexual response in the male. Although the response is harmless and entirely involuntary, and usually goes away as soon as enema delivery is completed, many men become highly embarrassed over their reactions.
Generally a nurse should ignore penile erections or other signs of mild arousal during administration of the enema to avoid embarrassing her patient further. (Of course she should take care to adjust the position of the patient's penis as necessary to avoid discomfort.) She may wish to discretely reassure her patient that such reactions are entirely normal and he need not be embarrassed by them. But men with lowered sexual activation thresholds, especially habitual masturbators, are more susceptible to the sexual stimulation of the enema and it is necessary to make some explicit accommodation of the effect. Awareness and proper management of his sexual arousal is necessary for successful enema delivery as well as maintaining patient comfort.
We advise the nurse to be sympathetic to his situation, since the patient can not help his responses to the enema. In this chapter Peter's nurse exhibits a laudable example of sensitive, patient-centered care.
--Dr. Margaret Wilson, Registered Genital Therapist
Peter awoke groggily from his afternoon nap and looked slowly around the hospital room. He had been there for several days now, while some routine tests were being performed. The inactivity and lack of diversion would have been onerous for most people to bear, but to a young man of Peter's inclination, the hiatus was welcome, offering unlimited opportunity to indulge his private pleasures. Lying there in bed, he slid his hands down beneath the sheets until he found his penis snuggled between his legs and, sighing deeply, began to stroke it in a familiar caress. Thus he passed the days, alternating sessions of prolonged, languid masturbation with pleasant, restful naps.
After the embarrassing incident yesterday, he was being especially careful today to hide his actions under the covers. He had been lying with the sheets pulled down to his ankles and hospital gown up above his waist, stroking his naked penis with complete abandon. As he crossed the point of no return and felt the flood of climax approach, the door flew open and a nurse walked in, just in time to witness his eruption. Although she seemed to ignore his actions completely, he was mortified with embarrassment. Afterwards, he could tell that the word of the incident was circulating among the nursing staff, by the half-hidden smiles and sidelong looks of the nurses attending him.
He was grateful for his precautions today, when again the door flew open. In walked the chief floor nurse, Mrs. Collins, followed by two pretty student nurses. Peter instantly ceased his hidden manipulations, but blushed as he realized that the location of his hands was clearly visible beneath the covers.
Nurse Collins said, "Hello Peter. I'm showing Alice and Lisa some basic patient care procedures today, and we need a demonstration subject." She glanced at the bulge of his hands under the covers. "You weren't busy, were you?" Her meaning was unmistakable.
"N...No, Ma'am," he stammered.
"Good. Bring in the equipment, girls." He watched as Alice wheeled a small cart into the room. On it were a coiled rubber hose, an assortment of straight plastic tubes, and a rubber bag about the size of a hot water bottle. He did not recognize the function of the articles at first.
"Wh...what are you going to do?"
Nurse Collins smiled. "Don't be nervous, Peter. I'm merely going to demonstrate to Alice and Lisa how to administer an enema."
"What? No! I don't want one, I don't need one!"
"That is beside the point, Peter. This is a teaching hospital, and our patients must cooperate in the training of our staff. Don't be embarrassed, we are all nurses, and we are accustomed to seeing a man naked. Now stop making such a fuss and roll over on your stomach." She grasped the covers and quickly jerked them down, leaving Peter exposed to view. The front of his gown was still raised from his interrupted activities, and his partly tumescent penis, glistening with the dew of its arousal, was revealed to their view. The two student nurses giggled at the sight, and he quickly rolled over to hide the incriminating evidence.
"That's better. Prepare him, girls." He suffered with embarrassed patience as he felt the rear of hospital gown raised and secured above his waist. Alice placed her hands firmly on either side of his hips and forcefully lifted them, as Lisa gently urged his knees forward underneath him. He was doubled up and kneeling, his head on the pillow hiding his face, and his bare buttocks thrust indecently in the air. The cool air he felt on his naked backside contrasted with the hot blush of shame on his cheeks.
Nurse Collins said, "Now girls, you've already learned the basic techniques of administering enemas, but as you know the enema can cause surprising side effects in males. Certain special patients will require additional care, and from what we know of Peter's personal habits, I expect that he may provide a demonstration of the full range of enema response."
Peter cringed at her obvious reference to his practice of masturbation, but could not guess at what connection it had to the unpleasant process about to begin.
"You'll notice how Peter keeps his thighs pressed tightly together? A young man with his habits is usually shy about exposing his male organs, especially when there are several nurses in attendance. But we must have his thighs separated for proper insertion, so please spread him, Lisa." The student nurse took his thighs in her hands and gently but firmly pried them apart. Peter now felt utterly naked, with not only his bare backside but his very maleness fully displayed in this most undignified posture.
Nurse Collins began instructing, "Now we must choose the proper enema nozzle. For a healthy young man like Peter, I recommend this large, long model to provide the maximum degree of penetration." Alice connected the nozzle to the bag and lubricated its length with KY jelly. Lisa completed preparations by gooping KY on the tip of her rubber-gloved forefinger and carefully applying it to the vestibule of his rear gateway. His bottom wriggled as she spread it in delicate, tickling circles around the rim of his anus.
Nurse Collins said, "Very good, girls. Peter, we're ready to give you your enema, now. You may feel some discomfort at first, as the instrument is inserted. Try not to fight it. Try to relax and accept the instrument within you. It will be easier for you if you do. Nurses, you may proceed."
Lisa placed her thumbs alongside the cleavage of his buttocks, and gently spread them apart. Alice guided the tip of the nozzle to his anus and pressed it against the opening. At first Peter could not help resisting, his rear gate straining to shut out the invader. But Alice inexorably increased the pressure of her assault, and at last broke through. Peter gasped as several inches of the hard plastic probe slid up his bowels.
"There, there, Peter. You're doing fine," Nurse Collins said. "Start the water now, girls, at medium flow." Alice twisted open a small valve, and Peter felt an indescribable sensation. The warm water flooded into his body, stretching him painfully at first. But as the liquid invasion penetrated more deeply, surging hotly within his bowels, he began to feel a second sensation: a fullness, a completeness he had never known. The water filled and swelled his very core, and he let out a long, loud, involuntary moan.
Nurse Collins patted his head tenderly, and said, "That's it, Peter, yield to it. Accept it deep within you. There's nothing you can do to stop the water now, so don't try to resist. Just let it flow into you. Can you feel the water, Peter?"
"Yes ... Uhhnnnn ... " he groaned loudly.
Lisa was genuinely concerned at his reaction. "We're not hurting him, are we, Nurse Collins?"
"No, Lisa, don't worry. The sensations of an enema are powerful, and sometimes uncomfortable, but not painful if the patient learns to relax and open himself. As I've told you, some males even experience physical gratification during the process."
"I'll say!" Alice cried. "Look-- he's gotten all stiff!" She pointed, and Peter became suddenly aware of the rigid erection springing between his thighs. He squatted lower on the bed, pressing his groin against the sheets and trying to hide his penis beneath him.
"Is that OK, Nurse Collins, for him to get stiff like that?" Alice asked doubtfully. "I mean, it seems kind of weird or something."
The older woman smiled, "Oh yes, it is quite common for male patients to develop an erection during enema delivery. You will see it often, so you must learn how to deal with it."
Alice volunteered, "Should I slap his testicles? The Nurse's Handbook says that always makes patients lose their erections."
"Well, that is certainly one way to deal with it," Nurse Collins said. "Some nurses do believe in strictly suppressing a patient's sexual arousal during enema delivery."
Peter cried out, "Please, Nurse Collins, I didn't mean to get an erection. I'm sorry, I couldn't help it. Please don't let her..."
Nurse Collins soothed, "There, there, of course you couldn't. Don't worry, Peter, no one will hurt you. No, Alice, in patient-centered care, we must be sensitive to a patient's feelings. His erection is an involuntary reaction, and we shouldn't punish him for it."
Lisa asked, "Is it because he jerks off so much, that he gets like that?"
"No, Lisa. A frequent masturbator does present special concerns, as we shall see, but even normal young men without Peter's private habit may erect during an enema. They can't help it, really, the poor dears. There's something about having his bottom stuck up naked in front of a nurse, and feeling the nice warm water pressing on his insides that makes a man become sexually aroused.
"Usually you can just ignore his erection, and it will go down by itself after the enema is over. Most men find it quite embarrassing to erect for a nurse during an enema and prefer that you don't draw attention to it. But you have to be careful that the penis doesn't get cramped beneath him, or that he doesn't start unconsciously rubbing it against the bedclothes and chafe it. Here's what I usually like to do to protect it."
She took the tube of KY Jelly and spread it generously on her right hand. Then sitting on the bed beside him, she reached between his legs up under his belly and gently enclosed his penis with her lubricated hand, cupping it safely beneath him. Peter jumped at the unexpected but delicious contact. "Just relax, Peter, we're going to hold your member for the remainder of the enema, to keep it safe. Doesn't it feel nice in my hand?"
"...y...yes, Nurse Collins" he said in confused delight.
Continuing the demonstration, she informed her students, "More excitable patients may exhibit expressions of sexual arousal other than erections during an enema. This is especially common for habitual masturbators, so you may see it today."
At the older nurse's nod, Alice checked the valve on the enema bag, and opened it another turn. As the warm water swelled and surged within him more insistently, Peter's groans became louder and more frequent, until he was emitting an almost constant stream of moans. Lisa and Alice listened to him, giggling to each other at his inarticulate groans. He was deeply humiliated to offer such ludicrous amusement to the nurses, but the sensuality of the experience overwhelmed him.
Lisa giggled, "He's really doing some moaning and groaning now! He sounds just like a woman when she's getting a real good 'you-know-what'."
Nurse Collins agreed, "Yes, that's quite right, Lisa. Receiving an enema is the closest a man can come to the sensations a woman experiences during sexual intercourse. Some men turn into real 'moaners' when you turn the water on. They may be deeply embarrassed by their response, even though they can't help it, so it's a good idea to reassure them."
Lisa leaned forward and brushed his cheek tenderly. "You sure are a 'moaner', aren't you, Peter. Do you like this? Do you like a nurse to pump your bottom full of nice warm water? Go on, Peter, tell us how it feels." He could only smile up weakly at her, and moan softly in response.
Nurse Collins explained, "And actually, girls, a nurse can use the patient's sexual arousal to therapeutic advantage. It is beneficial during the enema if the patient moves his hips slowly up and down. It helps to distribute the water within the bowels and promote thorough irrigation. A patient in Peter's state can be easily persuaded to execute these movements."
She put her free hand on Peter's hips and urged his buttocks slightly higher. Her other hand drew his turgid member back between his legs, until it pointed straight down at the bed.
"Now Peter, I want you to raise and lower your hips for me, to help spread the water around inside. I'll just hold your penis, to be sure that it doesn't chafe against the bed. Begin moving now, up and down, up and down, that's it."
Peter obeyed her instructions, and found to his surprise that her hand on his penis did not follow the movements of his hips, but remained stationary on the bed beneath him. Her curled fist made a snug tunnel, and with each thrust of his hips his stiff member slid in and out of her slippery fingers. Her knowing grip was neither too tight or too loose, and Peter soon forgot the original therapeutic purpose of his movements as sweet sensations overwhelmed him. He even forgot the amusing spectacle he presented to the nurses, wagging his naked bottom up and down as he pumped his rigid penis between Nurse Collin's fingers.
As Peter's mounting sexual abandon became more obvious, Alice said, "Nurse Collins, look what he's doing in your hand! He really looks funny, doesn't he? Is that all right, if he does that?"
She explained, "Yes, Alice, Peter can't help it. I think that this is the best way to deal with persistent erection problems during enemas. His sexual arousal does no real harm, and as you can see, it encourages him to move his hips very effectively."
Lisa asked, "What if a patient wants to, you know, finish off? Is it OK to let him?"
Nurse Collins advised, "It is entirely up to the nurse. Ejaculation serves no therapeutic purpose, so there is no need to permit it. Some nurses feel that allowing a patient to express his semen during an enema is unprofessional and undermines the nurse-patient relationship. But I usually take the patient's comfort into account. A male develops strong prostate tension during an enema and appreciates the opportunity to release it. I believe that ejaculations have a place in patient-centered care."
She leaned down close to his ear. "Peter, can you hear me?" He mumbled something through the haze of his ecstasy. "We're going to introduce the remainder of the water now. You may feel some unusual sensations when this occurs. There will be a strong pressure on your prostate gland, and you may not be able to retain your semen. Try to hold your semen in as long as you can, but if you have to release it, just let it go in my hand. It will be all right."
Alice turned the valve fully open, and suddenly Peter felt the pressure within his bowels double, and the tension in his genitals threatened to explode. He began thrusting faster and faster in Nurse Collins' hand, and cried out, "Oh, Nurse! Oh Nurse! I can't help it... I'm... I'm going to..."
"Yes, Peter, I know. Let it out now, let go in my hand, that's right."
Lisa stroked his face and reassured him, "Go on, Peter. It's all right. We all know you have to. Just let it go."
Peter smiled gratefully at Lisa and yielded at last to the pressure in his organs. Still thrusting, he flooded Nurse Collins hand with his semen, feeling her lubricated fingers grow yet more slippery with his own spending. Lisa patted his naked bottom and encouraged him, "There, there, Peter, don't hold back, let it all come out."
But as soon as the pressure of his ejaculation eased, the sense of the other pressure in his bowels reasserted itself with intensity until he cried out in agony, "Please, no more, no more water!"
"Remove the nozzle, now, girls. Peter will need to have his movement." All at once he was free of the enema tube. He sprang from the bed and ran to the toilet, not taking time even to close the door. The women laughed as they watched him evacuate noisily.