Bowel Management Nurse Reflects on her Career

Our first guest blog is from Kath­leen Guardi­no, RN, MSN,  a renowned bow­el man­age­ment nurse, recip­i­ent of the Founders Award from the Pull- thru Net­work.  Ms GUARDINO worked for 20 years at Schnei­der Chil­dren’s Hos­pi­tal as the bow­el man­age­ment nurse for Dr Alber­to Pena, who was lat­er joined by Dr Marc Levitt.  Ms Guardi­no sub­se­quent­ly joined Dr Fredric Daum as his bow­el man­age­ment nurse at Winthrop Uni­ver­si­ty Hospital.

We are very pleased to present Kath­leen Guardi­na, RN, MSN  as our first guest to this blog, devot­ed to help­ing aware­ness and treat­ment of ENCOPRESIS and  STOOL WITHHOLDING.

My name is Kath­leen Guardi­no and I am a reg­is­tered nurse and nurse edu­ca­tor spe­cial­iz­ing in bow­el man­age­ment. In 1988, I found­ed the Pull-thru Net­work (PTN), an orga­ni­za­tion ded­i­cat­ed to the needs of chil­dren born with anorec­tal mal­for­ma­tions, colon dis­ease or asso­ci­at­ed diagnoses.

For 20 years (1985−2005), I was proud to work as part of the pedi­atric sur­gi­cal team cre­at­ed by Dr. Alber­to Pena at Schnei­der Children’s Hos­pi­tal in New York.  Dr. Marc Levitt joined the sur­gi­cal team in 2002.  Drs. Pena and Levitt are pedi­atric sur­geons who spe­cial­ize in surgery for con­gen­i­tal mal­for­ma­tions of the bow­el, specif­i­cal­ly imper­fo­rate anus and Hirschprung’s Dis­ease.  Dr. Pena and Dr. Levitt have made extra­or­di­nary con­tri­bu­tions to the sur­gi­cal approach to these prob­lems and improve­ment in their patients’ lives.  As their nurse, I had the joy of see­ing the sur­gi­cal mir­a­cles they per­formed.  My nurs­ing involve­ment with these chil­dren was post- sur­gi­cal as these patients often required bow­el man­age­ment to main­tain con­ti­nence.  In 2005, Dr. Pena and Dr. Levitt left New York to con­tin­ue their sur­gi­cal pro­gram at The Col­orec­tal Cen­ter at Cincin­nati Children’s Hospital

Soon after­ward, I joined the out­stand­ing bow­el man­age­ment team at Winthrop Uni­ver­si­ty Hos­pi­tal under the direc­tion and lead­er­ship of Dr. Fredric Daum, a pedi­atric gas­troen­terol­o­gist.  Dr. Daum has devel­oped a unique and high­ly suc­cess­ful pro­to­col for treat­ing chil­dren with stool with­hold­ing and enco­pre­sis.  Dr. Daum is a physi­cian of great integri­ty who works tire­less­ly, 7 days a week, to resolve the bow­el issues of his patients. Three years ago, Dr. Daum expand­ed his ser­vice by cre­at­ing doctordaum.com, a tele­phone con­sul­ta­tion pro­gram pro­vid­ing treat­ment for chil­dren nation­al­ly and inter­na­tion­al­ly who stool with­hold and have enco­pre­sis.  He has treat­ed patients through­out the US, Cana­da, Europe, Asia, Latin Amer­i­ca and the Mid­dle East and has a spe­cial inter­est in treat­ing autis­tic and devel­op­men­tal­ly delayed chil­dren. 

Sad­ly, there are chil­dren every­where with this ter­ri­ble prob­lem. The com­mu­ni­ty of patients with stool with­hold­ing and enco­pre­sis are for­tu­nate to have his ser­vices avail­able to them.  His com­mit­ment to help­ing these fam­i­lies is extraordinary.

I con­tin­ued to work with Dr. Daum until 2012 when I began my teach­ing career in nurs­ing.  In 2008 I proud­ly received the Founders award from the Pull-thru Net­work.­­­­­­­­­­­­­­ I con­tin­ue to con­sult and care for patients with imper­fo­rate anus.

Kath­leen Guardi­no, RN, MSN
Bow­el Man­age­ment Nurse
Nurse Educator
Founder, Pull-thru Network
Bow­el Man­age­ment Consultant