- 0The other day the doctor ordered a pt.'s Foley changed out. I didn't feel good about it going in, because the last time the Foley was placed the urologist had to do it. Also, the pt. had been confused and had pulled it out three times before. It was a struggle to get it in and when I finally did, there was A LOT of blood (this is a heme unit). I just can't stop feeling horrible about injuring this patient and I can't get the picture out of mind of the blood coming out of his urethra.
- 4Feb 19, '10 by roser13I would not even have attempted to place the foley under those circumstances. If a urologist had previously been required, then a urologist certainly should have been required this time around, after even more possible trauma has taken place.
- 0I don't know. I guess my rationale was that a month had passed since the last Foley was placed and the previous problems were probably due to trauma/inflammation from pulling the Foley out. Do you think I should have refused? I feel like you're blaming me. Doesn't the MD who ordered this have any responsibility? This is the first time I had this patient.
- 0Feb 19, '10 by RunnerNurse09I dont think anyone is blaming you. You should not have been asked to put it in if the urologist had to put it in before. You learned from your experience, and will know better. You have the right to ask that someone else do a procedure if you dont feel comfortable for some reason.
- 4Feb 19, '10 by JRD2002I would probably have gone ahead and replaced the Foley without talking with the urologist. Just because they had to consult one for Foley placement the last time does not mean that the patient will need a urologist every time it needs to be changed. Also if you did call the urologist they would probably want to know if you had attempted to place it and what problems you encountered. If you told them that you had not even tried I think they would probably be a little upset.
I understand feeling bad about causing some hematuria. It occasionally happens and I usually feel bad about it myself. Hopefully though with a little irrigation and some time the bleeding won't be too severe. Don't beat yourself up over it.
- 0I feel terrible about this. I know this doesn't excuse anything, but I probably would have discussed this if it had been another doctor, but this particular doctor is always such as a jerk. He really treats all the nurses like their idiots if they questions anything he orders. Frankly, I don't even know what the rationale for changing the Foley was, except it had been in a while and was leaking a little.
- 2Feb 19, '10 by JRD2002It is most facilities P&P to change a Foley every 30 days. You gotta get over that fear about talking to jerky doctors especially when it is a safety issue with a patient.
Chances are that if a urologist did come and place the Foley he would still be having hematuria. Sometimes there is just nothing you can do to avoid it.
I just now realized you are a student which really helps explain why you are beating yourself up so much. When we start out in nursing we are focused on helping people so much that whenever you have to cause pain to a patient it makes you feel like a scumbag. You changing the Foley caused the patient to have some temporary discomfort and some bloody urine. If you had not changed it the patient could have developed an urinary tract or bladder infection or even worse his next Foley change would have to be done in the OR when they surgically remove it.
You are also going to have to learn to leave work issues at work. You can't make it in nursing when you go home and obsess over what happened during your last shift.Last edit by JRD2002 on Feb 19, '10