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by GoLytely

This is long and I apologize for the drama but I woke up thinking about this and wanted to share.

My father-in-law is in assisted living but has recently needed a foley catheter. As we were walking him out the door home health came (no one knew HH was coming) and said they were going to take his catheter out. I apologized but told them we would be late for his doctor's appointment if we went to take out the catheter now. I know what it is like to go to a patient's house to find them heading out the door or gone, it is an inconvenience but it is a fact of life.

Anyway, the doctor made some med changes and said go ahead and dc the catheter. I asked him if he could do this at the office but he said he didn't have the equipment to take it out. I had some odds and ends supplies from my stint at home health. I asked the doctor if I could go ahead and take it out so the HH nurse wouldn't have to come back that day. He said it was fine with him, all that mattered was that it came out. So, we went by the house before taking him to the ALF and I took out the catheter. At first he freaked out and asked are you sure you know what you're doing??? (of course, Gramps, I've only done this about 500 times...) Anyway, he didn't even notice when I deflated the balloon and pulled the catheter out.

He ended up having to go to the ER that night because he couldn't void and the HH nurse said nothing came out when she put the catheter in. Then, the ER people acted like we were crazy when they put a catheter in and a few minutes later urine started flowing.

Then, my husband didn't make things any better by calling the HH agency the next day and unloading on the nurse because we were with him in the ER until 2AM. My husband blamed her for it because the guy in the ER said all the HH nurse would have had to do was wait a few minutes for urine return.

This all happened about a week ago. I want to add also that when the ER put the catheter in the first time there was some bleeding and he screamed in pain when they did this.

But this is what irks me. We went to see him yesterday and the couple who own the facility (the husband is a pharmacist) asked me if I was an RN then asked if I deflated the balloon all the way when I took his catheter out because he was bleeding a lot and his urine looked like molasses. I told them of course I deflated the balloon all the way. We informed them there had been bleeding when the catheter had been inserted before, and he has a history of kidney failure.

Anyway, we're going to take my FIL to a urologist, but it just steels my wool to have been asked such a thing, especially when I am always so conscientious about nursing procedures. In spite of other mistakes I might make, nursing procedures I take very seriously and I remember drawing the water out of that until I couldn't get any more.

I guess there were more people than just me who are victims of dumping. Now that I read this post it looks like the HH nurse who had trouble putting in the catheter got dumped on, too. I feel for her and can't be responsible for my husband. It doesn't make it any easier to take, though. Why does it seem to be nature for some people to have to dump blame on others?

[TazziRN]

Re: When the blame gets turned on you.

Because it's easier to do that than to look to oneself for the mistakes and problems, or to admit that "It's something that just happened, it's no one's fault."

[RazorbackRN]

Re: When the blame gets turned on you.

"I asked him if he could do this at the office but he said he didn't have the equipment to take it out."

I guess I'm curious as to what equipment he thought would be necessary to d/c a foley??
An office without a luer lock syringe???

[GoLytely]

Re: When the blame gets turned on you.

Originally Posted by RazorbackRN

"I asked him if he could do this at the office but he said he didn't have the equipment to take it out."

I guess I'm curious as to what equipment he thought would be necessary to d/c a foley??
An office without a luer lock syringe???

When he said this I looked across the hall and saw some blood drawing equipment (it is one of these hole-in-the-wall clinics where the secretary doubles as a nurse) but yea, I was suspicious of this, too.
More like, he didn't want to be bothered.

[hollyberry678]

Re: When the blame gets turned on you.

I think that when you assume caregiving/ doing a skilled procedure that another entity is 'responsible' for, and there is a problem in that area (i.e. blood, inabilty to void) then the responsible entity would have a right to question you so as to get to the bottom of what is going on with your father in law.

[DutchgirlRN]

Re: When the blame gets turned on you.

I'm just curious....what was the hurry in getting the cath out? If the doctors office couldn't take it out why not wait and let HH, who put it in, take it out? I'm not being judgemental. I'm sure you did it correctly. Just curious?

[GoLytely]

Re: When the blame gets turned on you.

Originally Posted by DutchgirlRN

I'm just curious....what was the hurry in getting the cath out? If the doctors office couldn't take it out why not wait and let HH, who put it in, take it out? I'm not being judgemental. I'm sure you did it correctly. Just curious?

I tought I was being courteous so the home health nurse wouldn't have to make another trip out that day.

As for the hurry, if you knew my husband you'd understand. He'd wear the hair off a donkey's behind.

[DutchgirlRN]

Re: When the blame gets turned on you.

Originally Posted by motorcycle mama

I tought I was being courteous so the home health nurse wouldn't have to make another trip out that day.

Yes, that I definately understand, in the same circumstances I would likely have done the same thing.

Originally Posted by motorcycle mama

As for the hurry, if you knew my husband you'd understand. He'd wear the hair off a donkey's behind.

As the wife of a nurse...does he not know better? I'd be wearing the hair off of his behind!

[chase4myheart]

Re: When the blame gets turned on you.

I'm just curious about something. It's the policy at my facility before removing a catheter, that we do bladder retraining for 24 hours prior to the catheter removal. This is done by clamping and unclamping the catheter for a certain period of time over 24 hours. This works well for us because we haven't had any problems with patients voiding when catheters are removed. Didn't anyone suggest this to you? Perhaps this could have helped your FIL or you can use this info if a catheter needs to be removed again.

[MoopleRN]

Re: When the blame gets turned on you.

We don't routinely do bladder retraining before removing a foley but I have seen it done with mixed results.

If there was some difficulty/blood inserting the catheter, that could cause some inflammation making it more difficult to void after removal (how long did he have the foley in?). And maybe Gramps is one of those guys who tug on it (un)intentionally, causing more inflammation. I hope he'll be ok.

BTW, I've seen nurses deflate a balloon without anything more than a pair of scissors!