Bladder scanner broke or user error?

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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???

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Specializes in Telemetry, ICU.

Sounds broke to me. I bet that the 90mls is closer to correct, and that's why you didn't get anything with the cath.

Usually pieces of technology show error messages because there is something wrong with them... The other nurse probably didn't want to bother with getting it serviced because he/she was on night shift...

Reminds me of an episode of Big Bang Theory-

Sheldon: "You check engine light is on"

Penny: "I know. Its always on"

Sheldon: "Doesn't that means something is wrong and you should get it checked?"

Penny: "No. The light is working just fine"

[car stalls, end scene]

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:eek: Why so little urine? Scr*w the bladder scanner.....lol. Seriously, the bladder scanner may be on the blink, but you got a much more accurate bit of info with zippo from the I&O. Machines break- they are not the grand poo-bah of the nursing info world :) YOU got the valid info. Send the scanner to maintenance. :D And find out why the guy isn't making enough urine to measure with the scanner (from 196 earlier to 90cc, he "lost" urine- :eek: ) :)
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Specializes in Hospice.

Well how stupid you were for wondering if a piece of equipment that came up with an error message and then gave you two vastly different numbers might not be functioning properly (said with sarcasm)! God, I hate nurses who act like that. I am sorry that the nurse you work with is too stupid to doubt the accuracy of the machine that apparently has been broken for 3 years.

That being said, it seems awfully unlikely that this guy would feel the urge to go and not have peed in around 16 hours if I figured correctly with no urine in the bladder. I have had a handful of times where I have cathed someone who I know has urine (due to bladder distention or symptoms) and have not got any urine back. I am not sure if this is from spasm of the urethra that actually kinks it off, or what. The other thing to remember is that men can have very long urethras, so sometimes if an I&O cath does not work for me, I will use a foley cath that is longer.

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Thanks for the replies! Just to clarify. He had voided 1,2000mls between 10a-6p. I only decided to bladder scan due to him stating he "had the urge to go and couldn't get anything out." There was no distention or anything.

And I'm not sure how to handle this RN on night shift. I was "Warned" about her. SHe gave me a TON of attitude. I don't want to let someone walk all over me, but I am also still on orientation and don't want to ruffle feathers. Any suggestions there?

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Thanks for the replies!! Just to clarify. THe pt HAD voided 1,200 ml between 10a-6p on his own. I only bladder scanned b/c he reported feeling the overwhelming urge to go and being unable to do so over the last 2 hours of my shift, so I just wanted to for peace of mind.

As for the mean RN, I had been "WARNED" about her. Not sure how to handle her. DOn't want to be walked all over, but also still on orientation and don't want to ruffle any feathers and risk getting backlash at my 90day review either. Any suggestions??

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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???

i had this happen a few times i thought i was going nuts ! was he laying down? it could be that his bladder was streched out and made two pockits my doc called it a room inside a room and you where in room one and the urain was in room two :yeah: you may want to see if he wants to sleep with a foley in it will help to shrink the bladder . i know in my case if i sleep with one i can pee during the day :)

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I find bladder scaners are never perfect. I always take at least three readings. If they are within a 100ml then fine. But I have gotten 50-600 on the same pt. Even done it on myslef and have gotten 20ml when I thought I was about to burst :smackingf

Good luck, hopfully things get better with your co-worker

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Specializes in Telemetry, ICU.

During our inservice on orientation, I actaully managed to find a pelvic bone, in a 1L bag of NS that we were practicing on... :smackingf

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Sometimes, ya just gotta hose 'em......:)

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