Okay so I will try to make this as short and sweet as possible. I work the night shift as a new grad RN at an LTAC. I've been off of orientation approx a month and last week I was assigned a pt who was a quadriplegic for over 30 years. He was admitted for Resp failure. He was actually getting ready to be discharged soon and had his trach capped. Now when I recieved report I was told he had a distended abd and physician was aware. when I did his assessment he was VERY distended. SO distended he looked pregnant. He told me that he had not had a BM in a really long time. I looked up what they did during dayshift- they gave him an enema, lactulose along with ducolax and still no BM. He had hypoactive bowel sounds. Well a little over half way through my shift I noticed he had blood tinged urine. I immediately checked his foley placement and it looked to be in the same position it was when i completed my shift assessment. I notified charge nurse and she said that the foley might have been tugged on while we were turning this pt. (There was always 2 people turning this pt.) I was pretty sure that he hadn't had his foley tugged but decided to go with what the charge nurse had said. As the shift went on he began to have more hematuria. this was around the time that physicians began making rounds so i notified physician when he came up. the physician told me and the pt that the foley had been tugged on and didn't seem to care. I gave report and left for the day. I was off for one night and came back the next and before I could put my things away a nurse came up to me (smiling) and told me that the Dr. was mad at me and the pt was very upset with me b/c he was having severe hematuria. So severe he had to have several blood transfusions and a CBI. Believe me I wish I could've turned and walked right out of work that day. I talked to the nurse that had been my preceptor and she stated that there was no way a foley being tugged could have caused that much bleeding and that I shouldn't worry. Believe me I was upset that whole shift wondering what was going on. When I got off I requested that I be called off the next night's shift. I took the night off and tried to calm down and came back the next night (4 nights after I had originally had this pt). When I came back in I noticed the pt was no longer there and the charge nurse that was there the night all of the hematuria began was working. She caught me and stated the pt had been sent to ICU with a ruptured bladder d/t a huge blood clot in his bladder and stated of course I didnt do anything. We reviewed his CT scans to find his entire colon was approx 4x larger than his previous scans and he had a HUGE blood clot at the neck of his bladder. I felt relieved that I had proof for all the other nurses that I didn't cause this. Well, later on in the shift as the physicians began rounding the charge nurse asked the physician about all of this. THe pt did have a history of severe bladder spasms so the charge nurse was thinking that maybe he had such severe spasms d/t his mega colon that a blood clot formed. The physician stated that no the foley balloon was inside the mans urethra and that the blood had nowhere to go but up into his bladder and eventually it came out. BTW the pt had perfect urine output throughout the shift I had him so I'm not sure why they are saying this. It also started out blood tinged and became frank so Im not sure that this story really holds up in my eyes. I just think that they may be trying to blame the new girl. I'm still not sure why it took 4 days for a CT to be done to find out the cause for all of this hematuria that was so severe that he needed blood transfusions. I'm really not sure where to go from here but everyone is now blaming me and I know that his foley hadn't been tugged. Obviously the pt was told that I was the one who has caused him all of this and now he is quite upset with me. I'm just not sure how to feel any better about this.