What's ok and what's not?

  1. 0
    New in this type of field and just want a general understanding of what I can or cannot perform. Read over the BRN site but it seems open ended still.

    Situation: My patients POA wanted to have the foley removed because of fear of UTI and because the reason it was in has resolved itself more or less. The story is that the patient went home from the hospital and another nurse was supposed to DC it that weekend (doc knows). Now that nurse decided not to work for them for family reasons and here I am. They want me to DC the foley but theres not an official order and I am just going by what they are saying.. it's not a hospital setting but I do not think this patient needs one indwelling still.

    Can I just remove it and chart that it was under my own assessment and prevention of disease and the doctor was previously aware?


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  4. 6 Comments so far...

  5. 3
    In order to protect yourself, I would attempt to have a conversation with the doctor. Explain this to the family. The other nurse should have left some form of documentation stating that she had received an order from the doctor. Absent the order, you are really putting yourself out there by doing it only on the word of the family. Families are always telling me to do what THEY want me to do versus what the doctor may or may not have ordered. I make certain I document accordingly. But in this case, I would not take action without the doctor's order, especially since you disagree with the action.
    Last edit by caliotter3 on Dec 12, '10
  6. 1
    I would want to talk to the doctor first, too. It isn't unusual for families to tailor the information they give you along the lines of what they want or don't want to do, and if it turns out to be wrong you've left yourself vulnerable by doing something without an order.
    WI_home_RN likes this.
  7. 0
    Quote from nursel56
    I would want to talk to the doctor first, too. It isn't unusual for families to tailor the information they give you along the lines of what they want or don't want to do, and if it turns out to be wrong you've left yourself vulnerable by doing something without an order.
    I strongly agree with the above post. Just remember that we the nurses are the professionally trained party, not the family. Your license is your lifeline, don't play Russian roulette.
  8. 0
    Quote from advocated
    situation: my patients poa wanted to have the foley removed because of fear of uti and because the reason it was in has resolved itself more or less. the story is that the patient went home from the hospital and another nurse was supposed to dc it that weekend (doc knows). now that nurse decided not to work for them for family reasons and here i am. they want me to dc the foley but theres not an official order and i am just going by what they are saying.. it's not a hospital setting but i do not think this patient needs one indwelling still.

    can i just remove it and chart that it was under my own assessment and prevention of disease and the doctor was previously aware?

    never do anything without a doctor's order. patients will tell you anything to make you believe it is "ok" because they want what they want, but without an actual order, it is not ok. shame on that other nurse for leaving the job without charting the supposed order. always watch your back, its your license on the line.
  9. 0
    Discontinuation of a foley requires a Dr.'s order. You cannot take Dr.'s orders from family members. Suppose there are no wounds, no need for accurate I&O, and no retention, so there really is no need for a foley. If you discontinue it, you are out of compliance. You either find a Dr. on call or the foley stays in, unless of course the balloon leaks, the foley comes out while the patient coughs and then refuses to have a new one anchored.
  10. 0
    Quote from nursel56
    I would want to talk to the doctor first, too. It isn't unusual for families to tailor the information they give you along the lines of what they want or don't want to do, and if it turns out to be wrong you've left yourself vulnerable by doing something without an order.
    I whole heartedly agree with this!

    Have an actual conversation with the doctor. I personally wouldn't dc it without an order. One of the cases I've worked before, the family and other nurses would digitally disimpact him three times a day, without an order. Luckily, I was never scheduled on those shifts, because I would've refused. I've also refused to give enema's without an order even though the daughter said it was ok and the other nurse did it all the time. Cover yourself, don't risk your license!


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