I worked in a SNF before coming to med surg. Bladder training then consisted of taking someone to bathroom every 2-3 hours during the night/day.
Yesterday, on med surg unit, I was told a patient of mine was on bladder training. He had his f/c taken out. I was wondering how in the world I was going to get this man OOB as he is big and heavy and he is verrrrryyyy incontinent of BM and urine. Needless to say, I was not successful lastnight.
When I went to give report, the seasoned nurses informed me that he wasn't on bladder training anymore because he doesn't have his f/c in any longer. They said you have to clamp the catheter, etc, etc. I was thinking, "What in the HECK are you all talking about." "I have never heard such a thing." I am serious.
I've heard on I&O caths and residual caths, but never this. I was embarrassed. I've looked it up but cannot find much on this at all. Can someone please share with me how you bladder train someone with a f/c in.
Sep 16, '06
First off, don't be embarrassed that you didn't know a technique. At least you are being honest to yourself in admitting that there is something that you don't know, smile.
Usually, when a patient has had a catheter in place for an extended period of time, before removing or D/C'ing the cath you would like to have the bladder regain some muscle tonus or tone. To do that you would clamp the foley cath for 2-4 hours, release the clamp and note how much urine is returned into the foley bag. Some hospital policy can be a bit different from others. Mine (policy) would be to clamp for an additional 4-6 hours, release clamp, note how much urine is returned, then gradually increase the hours between clamping. Hopefully, the patient can tolerate the foley being clamped for up to 8 hours without distress, pain etc.
Some institutions would have you clamp the foley 24-48 hours intermittently, then remove said foley. Again, hoping that the patient will be able to void spontaneously without residuals or retention of urine causing discomfort.
I need to leave but I will see if I can find something written and send you either the text or the web page.
And please, don't be SO hard on yourself. Learning is a constant.
Last edit by athena55 on Sep 16, '06
: Reason: I forgot to spell check!