Foley placement BEFORE anesthesia??

Specialties Ob/Gyn

Published

Ok where I'm working atm they put the foley in the mom BEFORE the spinal. Yeah in the triage room where she is waiting to go back for her csection.

I think its crazy. I was use to placing the foley immediately after they laid her back after her spinal.

One of my orientators said she always just waits until then..but the OB (the one and only lol) gets all annoyed when she does lol.

I would like to raise the question with my manager...but wanted to know what the norm for all of you are?

I've had two C/Sections. One for Fetal Distress, the Foley was in but, I had already been given a spinal narcotic. So, no pain.:)

The second, was a scheduled C/Section for a complete placenta previa (Nurses are so lucky). This was at a different hospital and they put the Foley in me before giving me anesthesia. It hurt...a lot...:(

EBP-Is there any reason to put the Foley in before surgery? :no:

Specializes in ER, Peds, Informatics.

I've had 2 C/S. My OB placed the foley both times in the OR after I had a spinal. I didn't care who saw me, so privacy wasn't an issue. I just wanted baby out.

Well, I don't know about C/S, but I just had a colon resection (genetic colon cancer, caught very early, resection was all that was needed, no chemo or colostomey), and they didn't put the foley in until until after I was unconscious, for which I am very grateful.

Seems like its scut work that doc wants to push to a nurse. Thing is, in the OR or surg procedure area, they will get what they want. So if they just want to cut, clip, write the note, and move on, they will streamline. Its a surgical mentality though...when they are cutting, they feel that they should get what they want. If not done before, they will be a pain to whoever is functioning as circulator.

Personally, it's nice to be numb when people are doing stuff to you like that. On the other hand, epidurals never worked on me anyway.

Shoot, I don't even fly without some sedation--mostly cause I hate long flights.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Seems like its scut work that doc wants to push to a nurse.

I'm confused by this statement. Foley placement *is* a nurse task, regardless of where/when it's done. When it's done in the OR, it's not done by the physician, it's usually done by the circulating nurse as soon as she is lying down after spinal placement.

Specializes in OB/GYN.

I've never seen a foley inserted preop! As soon as we lie her down for the spinal we put in the foley, the grounding pad for the bovine machine, the venodyne boots....all whelp anesthesia is testing her level so really no time is "wasted". The circulator, charge RN, baby RN, and OB resident are usually all in the OR at this time (and usually all female) so we just work together and divvy up the tasks. I'm sure most women will sacrifice privacy in exchange for comfort.

For non-scheduled C/S, everyone almost always has a foley since we put in an indwelling after epidural, and if its arrest of descent, we put the foley back in in the LDR.

Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
I've never seen a foley inserted preop! As soon as we lie her down for the spinal we put in the foley, the grounding pad for the bovine machine, the venodyne boots....all whelp anesthesia is testing her level so really no time is "wasted". The circulator, charge RN, baby RN, and OB resident are usually all in the OR at this time (and usually all female) so we just work together and divvy up the tasks. I'm sure most women will sacrifice privacy in exchange for comfort.

For non-scheduled C/S, everyone almost always has a foley since we put in an indwelling after epidural, and if its arrest of descent, we put the foley back in in the LDR.

You have a charge, baby and circulator? Wow! We have 2 nurses during delivery. The rest of the time...there may only be 1 RN. The nurse that was assigned to mom is the one responsible for mom and baby and room. Sorry to get off topic.

We do foley before in many cases and after in a few. It depends in what is going on.

We have 3 RNs for every CS--scrub, circulate and patient care (assists anesthetist and recovers patient). It's lovely.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

We have the circulator, and then usually the charge nurse comes in and assists with tasks, prepping, etc. A nurse for the baby doesn't come in until the very end, along with the NICU team.

Specializes in L&D.

Well I think it's just pure control of the one and only OB. I've never had a foley...but I'm Sure they're quite uncomfortable.And as the nurse who goes along to the OR to do the baby, I'm more than happy to place the foley quickly after the spinal.I just might address this with my boss..

Specializes in L&D/Maternity nursing.

the only time I have ever dropped a foley pre-op is if the pt already was laboring for awhile with an epidural. Other than that, I do it after the spinal is placed.

We too have the scrub tech (one of our LNAs), the circulator (me), our charge and a nursery RN (or a staff RN) to catch during our sections. Its nice.

Specializes in Labor and Delivery, Orthopedic.

Interesting...Obviously since they are going into surgery it makes sense to place the foley after anesthesia. No need to make things any more uncomfortable then they have to be.

That being said...although I work in L&D now I came from 9 years in med-surg. We place foleys all the time with the patient awake and aware. It's uncomfortable but not that big of a deal. No worse than placing an IV typically.

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