Female foley and witness

  1. Does anybody work at a facility that has a policy requiring you to have a witness for a foley start? I'm on a travel assignment, fairly new to my current facility. Someone (who was not a superior or lateral to me "rank" wise) decided to suggest I get a witness after they discovered I started a foley alone, then later decided to inform me it is policy after I explained to them I rely on my judgment to decide when it is necessary.

    Policy can't be argued, not looking for an angle there. Not looking for a lecture as to why it is a good idea to have one. I get it, and trust me I get a witness more times than not. I do have a gripe requiring it to happen every single time for various reasons.

    Interested in the discussion
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  2. 22 Comments

  3. by   hppygr8ful
    I get you - There are times when a foley must be started immediately with no time to run around and find a witness. Still I am a female nurse who was accused of rape by a demented old lady who had the smallest urethra I have ever seen we ultimately had three different nurses looking so plenty of witnesses there.

    Hppy
  4. by   Rose_Queen
    My facility requires that 2 RNs be in the room for a foley insertion- the gender of the nurses or the patient doesn't matter.
  5. by   Nalon1 RN/EMT-P
    Quote from Rose_Queen
    My facility requires that 2 RNs be in the room for a foley insertion- the gender of the nurses or the patient doesn't matter.
    2 RN's?
    Seems a bit excessive. I understand 2 people (RN and a tech/CNA) for placement, but requiring 2 RN's seems to be a waste of resources.
  6. by   jive turkey
    Quote from hppygr8ful
    I get you - There are times when a foley must be started immediately with no time to run around and find a witness. Still I am a female nurse who was accused of rape by a demented old lady who had the smallest urethra I have ever seen we ultimately had three different nurses looking so plenty of witnesses there.

    Hppy
    A prime example of a patient I would voluntarily get a witness for. Confused patient, young patient, psych patient, rude-grouchy-mad at the world patient, language barrier patient, cultural considerations, hx of abuse patient. ....just to name a for example, i get that witness. Making it a standard across the board gives me concern for witnesses becoming arequirement for so many other tasks we perform that result in the exposure of the pudenda.
  7. by   Rose_Queen
    Quote from Nalon1 RN/EMT-P
    2 RN's?
    Seems a bit excessive. I understand 2 people (RN and a tech/CNA) for placement, but requiring 2 RN's seems to be a waste of resources.
    CAUTI initiative. We got hammered for several years. Have since gotten much better, so who knows, maybe that will go away at some point.
  8. by   akulahawkRN
    While I'm reasonably adept at placing Foley catheters in both males and females (I'm male by the way), I prefer to have a witness in the room as an extra set of eyes for two reasons: one so that I have a second set of eyes verifying that I'm not doing anything other than placing the catheter and the other reason is to keep an eye on my aseptic technique. I expect the other person to notify me if something occurs that would compromise good technique and therefore potentially lead to a CAUTI problem. If I'm signing off that I inserted a Foley, I'm signing that I did the technique perfectly well and I therefore do not expect a CAUTI problem to develop as a result of my actions.
  9. by   HalfBoiled
    In my unit, if a male nurse was going to insert a foley in a female patient, it is strongly encouraged to have a female witness the action. At any time a female patient can accuse the male nurse for sexual assault.
  10. by   NurseCard
    Hm. I've never worked anywhere with a policy REQUIRING a witness when placing
    a foley. I've placed plenty of them myself.

    I can see where it would be a really good idea in many cases though.
  11. by   jive turkey
    Quote from HalfBoiled
    In my unit, if a male nurse was going to insert a foley in a female patient, it is strongly encouraged to have a female witness the action. At any time a female patient can accuse the male nurse for sexual assault.
    Key words there are "at any time". It doesn't take starting a catheter for someone to decide to lie. I support the idea of a facility strongly recommending a witness. I don't like the idea of it being a policy. This opens the door for witnesses being required for a multitude of other things we do. If I have an alert, oriented patient of sound mind and we have established a good rapport, asking their consent along with a thorough explanation of the procedure and what to expect should eliminate any confusion of sexual misconduct.

    It's unfortunate we live in such an unforgiving, punitive society. This is really what fuels men feeling compelled to have a woman verify he's not a sexual predator.
  12. by   KindaBack
    Quote from Rose_Queen
    My facility requires that 2 RNs be in the room for a foley insertion- the gender of the nurses or the patient doesn't matter.
    Quote from Nalon1 RN/EMT-P
    2 RN's?
    Seems a bit excessive. I understand 2 people (RN and a tech/CNA) for placement, but requiring 2 RN's seems to be a waste of resources.
    Ours does, too. It's made a measurable reduction in CAUTI rates within a week after insertion.
  13. by   HeySis
    Quote from Rose_Queen
    CAUTI initiative. We got hammered for several years. Have since gotten much better, so who knows, maybe that will go away at some point.
    Same here. 2 RN's to insert due to CAUTI's. The rate of CAUTI's has not dropped significantly with the policy change.
  14. by   azhiker96
    Worked at hospitals by three large employers and none of them have that policy.

    I recently had a female pt who was very uncomfortable with 900cc of urine in her bladder. She had none of my usual triggers to motivate me to get a witness (psych, dementia, youth, expressed desire for a female RN, spidey sense) so I did a straight cath. She was very appreciative and would not have wanted to delay until a second nurse could be free to come witness.

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