Difficult Foley insertion

Published

Call me indifferent but my graduate coworker nurses claim the DON told them to put the foley in the freezer to firm it up, not the refrigerator, not cold water, but the freezer, before inserting into a difficult male client, because he proved impossible to cath with a flimsy catheter. Seems to me this could fall under many titles such as abuse, it could cause perhaps shock, and this is a LTC skilled facility not a OR or carefully monitored situation. It Seems wrong and I would like someone to prove different.

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Specializes in Med/Surg/.

Just by the sound of that I would say he is meaning put it in the freezer to get cold faster not to freeze it. That's what I would do if I had known of that suggestion. A cold foley is not going to make him go into shock. I frozen one would not be pliable. Common sense here I am afraid!

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Specializes in Hospice.

Sounds like he may have had a prostate issue and a coude may have been in order, but that is a decision for the doctor. I have never placed a sterile supply into the fridge or freezer or even ice. Doesn't sound very aeseptic to me. I would be afraid of causing a CAUTI.

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Dafab....Well that is the difference between you and me I am not doing anything I wasnt taught in school or have been in serviced on as a new and accepted technique in nursing.

Cardiacfreak ..I'd Love to have the old scoop cath but my facilty says not in budget. I just reposition the buttocks a couple times and have them cough hard it usually pops under. But no its not a prostate issue. Also if resistance continues I send to ER. I was taught not to force.

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Specializes in ER.

I wouldn't do it either without an order.

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Specializes in retired LTC.

Personally, I think that that's a rather novel idea. The cath is straight and will 'soften' in about 30 seconds or so.

Do any of us more senior nurses remember doing something similar with the 'red rubber' NG tubes?

I don't recall ever reading in any textbook about flushing GTs with ginger ale, but staff do it. And they use scissors to cut the inflation port on foleys for removal - not in any text I read.

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The urinary tract is not some bothersome path to be plowed through in any ham-handed fashion, it's living tissue. The idea of freezing a catheter to make it strong enough to shove through some anatomical challenge is appalling. Reposition the patient, reposition the member, use more lube--but don't apply the "if-it-don't-fit-force-it" philosophy in nursing, please!

Good grief. If your DON really advises this, s/he needs a spanking.

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Specializes in ER.

In 24 years of inserting catheters I've never heard of freezing or cooling them to make them more rigid, so thank you for a novel idea. Completely rigid seems very dangerous because of the built in S-curve at the end of the straight away. Priming the pipe with a lidocaine urojet and chasing chasing it immediately with a #16 or #18 coude works about 98% of the time. On the extremely rare occasions when a urologist got involved, he always went larger (#22-#24) and more rigid (silicone). Ouch.

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Aside from that pesky sterility issue, that just sounds downright barbaric. At my facility routine catherization is performed at bedside by the nurses, but If it's a confirmed enlarged prostate in there, the urologist has to put it in, because it will be extremely difficult to insert.

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Specializes in Med Surg/ICU/Psych/Emergency/CEN/retired.

If I had difficulty, I would try a coude. One trick was to hold the member perpendicular, if that makes sense. But I would never force an insertion and notified the urology resident or urologist if I was unsuccessful. Usually a coude was successful. Putting the catheter in a freezer? Nope, I would not recommend it or do it.

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Specializes in Short Term/Skilled.

Works like a charm!

My Dad had to have one inserted when he was started on hospice because narcotics caused him urinary retention. The hospice nurse used this trick and it didn't bother him at all.

His situation was rather urgent, he was really uncomfortable and this was attempt 3, a coude wasn't available. I'd certainly only use this as a last resort but it did indeed work.

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In 24 years of inserting catheters I've never heard of freezing or cooling them to make them more rigid, so thank you for a novel idea. Completely rigid seems very dangerous because of the built in S-curve at the end of the straight away. Priming the pipe with a lidocaine urojet and chasing chasing it immediately with a #16 or #18 coude works about 98% of the time. On the extremely rare occasions when a urologist got involved, he always went larger (#22-#24) and more rigid (silicone). Ouch.

Ditto. Never heard of any of this; I'm guessing because it's something we wouldn't do in the hospital (?).

But I'm curious about this issue of not being sterile after the freezer trick - - if it was otherwise determined to be an acceptable intervention, why wouldn't the practice simply be to put it in the freezer with the sterile packaging intact?

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