Scope of practice - page 2

Hi there.. I have a few questions in regards to foleys. First, is it true that it will no longer be in the scope of practice for RN's to insert a male foley due to the high risk of rupturing the... Read More

  1. by   cardiacRN2006
    Quote from wdwpixie
    Ditto here in Missouri....and an aide was putting one in yesterday on a male pt in the hospital where we were located...
    Of the bazillion foleys I've put in, 99.9% of them were placed while I was a tech.
  2. by   CityKat
    Quote from SMK1
    Well this begs the question...Who is going to be inserting those foleys then? A doctor who hasn't done one since med school (if then) or a nurse who has done them routinely through nursing school and on the job for years? Out of those two people who do you think has the highest probability of causing trauma to the patient?
    Lol Unfortunately, we have NOT done male foley insertion routinely through our program and I am graduating in May. Today, I just talked to two of my friends in nursing school, but attend different universities. Neither of them have been allowed to insert male foleys either. I think I'm going to the director of our program and figure this out. Something doesn't sound right.
  3. by   smk1
    Quote from StudentNurseBean
    Lol Unfortunately, we have NOT done male foley insertion routinely through our program and I am graduating in May. Today, I just talked to two of my friends in nursing school, but attend different universities. Neither of them have been allowed to insert male foleys either. I think I'm going to the director of our program and figure this out. Something doesn't sound right.
    They aren't "super" common for us either as they usually have already been put in by the time we are assigned to them. However, We have done a few and the nurses have an opportunity to do more. My point is that if the issue is causing trauma, you would want the person with the most experience to do it. That would never include an MD. Unless you are going to put a scope on the end of a catheter in order to visually guide it in past the prostate, I don't see how having an MD put in a foley is going to lower any risks. As a student I freely admit that I am a newbie and don't know it all though, so to all you experienced nurses out there, what am I missing? :uhoh21:
  4. by   smk1
    Quote from txspadequeen921
    and then here is another fine point. It can take hours to get a doc to even call back when we page them. How long do you think it would take to get them in to insert a foley
    This is a good point as well, how long are we going to let a person sit in unbearable comfort waiting for a doc to show up? I just don't understand the benefit....
  5. by   CityKat
    Quote from SMK1
    They aren't "super" common for us either as they usually have already been put in by the time we are assigned to them. However, We have done a few and the nurses have an opportunity to do more. My point is that if the issue is causing trauma, you would want the person with the most experience to do it. That would never include an MD. Unless you are going to put a scope on the end of a catheter in order to visually guide it in past the prostate, I don't see how having an MD put in a foley is going to lower any risks. As a student I freely admit that I am a newbie and don't know it all though, so to all you experienced nurses out there, what am I missing? :uhoh21:
    Actually, I sort of don't understand your point about MD's not having the experience. I understand the nurse is the one around constantly with the patient all the time, but the MD certainly has experience with patients. In both of the hospitals where I've done my med surg rotations 1 and 2, I was assured from my assigned RN that the MD will put in the male foley. Maybe they don't do them as often as the RN in some places or even at all, but I observed a doctor in my med surg I rotation insert a male foley. That was the first "live" male patient I observed with foley insertion.
    Again..I am ONLY going by what I have been taught in school. This obviously seems to be the wrong information and so I will double check on this on Friday in my clinical
  6. by   smk1
    Quote from StudentNurseBean
    Actually, I sort of don't understand your point about MD's not having the experience. I understand the nurse is the one around constantly with the patient all the time, but the MD certainly has experience with patients. In both of the hospitals where I've done my med surg rotations 1 and 2, I was assured from my assigned RN that the MD will put in the male foley. Maybe they don't do them as often as the RN in some places or even at all, but I observed a doctor in my med surg I rotation insert a male foley. That was the first "live" male patient I observed with foley insertion.
    Again..I am ONLY going by what I have been taught in school. This obviously seems to be the wrong information and so I will double check on this on Friday in my clinical
    Maybe it is different in other areas. Here I have never seen an MD touch a foley. CNA's can D/C them, and in some institutions it is delegatable. So my point is that out this way, it would never make since to have an MD put in a foley to avoid trauma to the patient because they are so "green" at doing it that they would probably cause MORE harm.
  7. by   ohiorn_78
    Wow! I couldn't imagine the alternative in inserting something else other than a foley. Would they outfit those with BPH with a suprapubic cath instead? Think of the possibilties. Our urologists snicker at this proposal.:roll
  8. by   carolinapooh
    http://www.health.state.ny.us/profes...e_of_tasks.pdf


    According to this, which was published in 2006, home health aides can insert Foleys in NY....

    Sorry, ya'll, I just thought this was weird....
  9. by   CityKat
    Quote from carolinapooh
    http://www.health.state.ny.us/profes...e_of_tasks.pdf


    According to this, which was published in 2006, home health aides can insert Foleys in NY....

    Sorry, ya'll, I just thought this was weird....
    Weird? why? This is what my school is teaching us and so, I am asking about it. I again asked and I have received the same information and this time, it was from my nursing program director. *shrugs* So, I'm guessing it's different protocol with each hospital. It is sort of frightening since I haven't been allowed to insert one and now I have this fear of hurting the bladder (it was not the prostate..my clinical instructor said it is the bladder). My mistake. Soo..
    I don't know now, I have to go with what they teach me I guess When the time comes to insert one, I will just get help
  10. by   cardiacRN2006
    Quote from carolinapooh
    http://www.health.state.ny.us/profes...e_of_tasks.pdf


    According to this, which was published in 2006, home health aides can insert Foleys in NY....

    Sorry, ya'll, I just thought this was weird....

    I don't know why it's weird either. Like I said earlier, I've put most of my foleys in as a tech.
  11. by   smk1
    Quote from StudentNurseBean
    Weird? why? This is what my school is teaching us and so, I am asking about it. I again asked and I have received the same information and this time, it was from my nursing program director. *shrugs* So, I'm guessing it's different protocol with each hospital. It is sort of frightening since I haven't been allowed to insert one and now I have this fear of hurting the bladder (it was not the prostate..my clinical instructor said it is the bladder). My mistake. Soo..
    I don't know now, I have to go with what they teach me I guess When the time comes to insert one, I will just get help
    So is the fear due to the postioning of the bladder in the male anatomy? I know you need to insert it quite a few more inches on a male that you would on a female but I am still not getting the "why" and "how" for making this a risky procedure....
  12. by   wonderbee
    You do get some misinformation in NS. I think some of the lecture instructors are rusty. One of m instructors told us to clamp off a foley if we get a liter or more of urine in a one hour period because the pt. will go into shock. When I came onto my current unit, everyone had a good laugh at that one. Clamping off a foley's not going to do anything but rupture the bladder.
  13. by   traumaRUs
    RNKittyKat - I can attest to this thinking - it used to be that yes, you did clamp the foley after a liter was released with the thinking that releasing all the urine would result in shock (honest).

    However, nowadays that is known to be erroneous and we just insert a foley and let things drain.

    Medicine and nursing have changed tremendously even since I became a nurse in 1992 and its every-evolving. This just points to the fact that you must always continue your education - read professional journals, take additional courses, attend conferences. You must always strive to stay current.

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