I work on a rehab unit and had a pt with Guillan Barre with neurogenic bladder who had his foley dc'd in the am by nightshift with orders to I&O cath for residuals greater than 250ml or no voids after 10 hours. I am new to the unit and this night-shift RN is one of those who has it out for anyone new or "eats the young." Anyway, she said that the pt had not voided for her, so she bladder scanned and there was 600ml for her, and she cath'd and got 600 out, no prob. I had the pt the day before when he had the indwelling. So all day, the pt tried to void, and did a pretty good job using the bedside urinal. I used our ancient/old haggard bladder scanner just to ease my mind, and there was only 196 around 10am, so we were good to go, no need to cath. Encouraged him to drink a lot and try to go on his own several times, and he did. Then, in the afternoon, he complained of feeling the urge to go, but could not. He was terrified of getting cath'd, so I gave him some time to keep trying, but by 6p, I scanned him. It showed 690ml. I told him we would have to cath, but offered the PRN lidocaine. He was happy that I offered that, as the cranky night shift RN never even gave him that option. Anyway, went in to cath him, felt resistance a bit, asked him to take a deep breath and exhale, advance and got past the resistance, and NOTHING. No urine. I know how to cath. New nurse to this unit, but not a new nurse. I mean, I have been a nurse for 3 yrs now. Cannot figure out what is going on at this point. Asked him to try a few more times to take a breath. NO URINE. Finally I took it out, b/c I wans't going to cause any trauma or pain. So I asked my experienced charge nurse what she thought. SHe said try to rescan. So I did. When I took the scanner in, an error message came up saying it needed to be recalibrated and to take it in to be fixed, then showed only 90ml!!!! So was there 690 ml in the first scan in that bladder or 90 ml and that's why I got no urine? When I told hateful night shift RN this she said "Oh that thing has said that for 3 years it works just fine for me and I cathed him just fine." So I can't figure this out. I have cath'd ped's before. What is your take???
Help!! Did I screw up, or what are your thoughts?
I work on a rehab unit and had a pt with Guillan Barre with neurogenic bladder who had his foley dc'd in the am by nightshift with orders to I&O cath for residuals greater than 250ml or no voids after 10 hours. I am new to the unit and this night-shift RN is one of those who has it out for anyone new or "eats the young." Anyway, she said that the pt had not voided for her, so she bladder scanned and there was 600ml for her, and she cath'd and got 600 out, no prob. I had the pt the day before when he had the indwelling. So all day, the pt tried to void, and did a pretty good job using the bedside urinal. I used our ancient/old haggard bladder scanner just to ease my mind, and there was only 196 around 10am, so we were good to go, no need to cath. Encouraged him to drink a lot and try to go on his own several times, and he did. Then, in the afternoon, he complained of feeling the urge to go, but could not. He was terrified of getting cath'd, so I gave him some time to keep trying, but by 6p, I scanned him. It showed 690ml. I told him we would have to cath, but offered the PRN lidocaine. He was happy that I offered that, as the cranky night shift RN never even gave him that option. Anyway, went in to cath him, felt resistance a bit, asked him to take a deep breath and exhale, advance and got past the resistance, and NOTHING. No urine. I know how to cath. New nurse to this unit, but not a new nurse. I mean, I have been a nurse for 3 yrs now. Cannot figure out what is going on at this point. Asked him to try a few more times to take a breath. NO URINE. Finally I took it out, b/c I wans't going to cause any trauma or pain. So I asked my experienced charge nurse what she thought. SHe said try to rescan. So I did. When I took the scanner in, an error message came up saying it needed to be recalibrated and to take it in to be fixed, then showed only 90ml!!!! So was there 690 ml in the first scan in that bladder or 90 ml and that's why I got no urine? When I told hateful night shift RN this she said "Oh that thing has said that for 3 years it works just fine for me and I cathed him just fine." So I can't figure this out. I have cath'd ped's before. What is your take???