I have a huge issue as a nursing student. I will describe the incident in question factually as possible.
Myself and another nursing student were instructed to insert a Foley catheter into our male patient. All was going well except we met with some resistance when inserting it into his urethra.
Nursing instuctor took over and. Was able to advance it further into his urethra. She stopped with at least 4-6 inches of the catheter lumen remaining from out of his urethra.
She then instructed the other student to inflate the balloon with 10 ml NS. I asked if we are in the bladder as no urine was produced from the lumen? She said yes and the other student began to administer the NS and the patient yelled out in pain. This patient was confused but my instructor said if it was still in his urethra he would have screamed in more pain. Being this the first time administering a Foley, against my instinct, I accepted her rational.
Still no urine from the foley, another nurse came in and proceeded to flush the catheter with 60 ml of saline. (lpn and out of her scope and no order to flush) This again was very painful for the patient. She tried to pull back the 60 ml and got nothing back. She had no idea where the saline went. So she removes the catheter and out comes a large amount of Frank blood.
I honestly believe the balloon was inflated in the urethra rupturing it and possibly injuring his prostrate.
Us students were kind of rushed out of the room and I noticed a Dr attend the patient.
We were given no explination but my instructor spend the rest of the day and the next blaming it on the second nurse who tried to flush the catheter.
My delema. We all know the nurses code and being a student in a smaller town could possibly get me black balled from the health athority if I report it. I also had issues with this instructor who is trying to fail me.
I think I know the correct thing to do even if it ruiins my career that I haven't even started yet.
As previously stated, this is being addressed by everyone concerned. If they need any further involvement from you or the other student, you will be approached.
Actually, I'm going to disagree with everyone on this thread. I DO think you should discuss this with your nursing faculty advisor- not because of this patient or his care- but because there's a nursing instructor out there teaching students dangerous procedural techniques. If her instruction regarding indwelling catheter placement goes against best practice, what other incorrect information could she be spreading? This incident should be reported to the nursing school administration/faculty out of concern for the quality of clinical education and safety of other patients that these students might care for.
If she didn't run around blamming it all on the other nurse(the one who flushed) to everyone and anyone, I might not feel so conflicted over it. She's done other shady things too. We all know how nursing school is. I have to go back to that hospital for another clinical, same one she failed me for, she'll know and completely destroy me. I'm okay with that if it saves anyone from getting hurt.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Well I guess I don't have an obligation to report.
As a student it is probably best to keep your thoughts to yourself. I suppose you could go to your program director and tell her your story but be sure your concern over reporting this isn't because that instructor is trying to fail you.
There are standards of care but the policies about how these are followed will vary hospital to hospital and state to state.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
If she didn't run around blaming it all on the other nurse(the one who flushed) to everyone and anyone, I might not feel so conflicted over it. She's done other shady things too. We all know how nursing school is. I have to go back to that hospital for another clinical, same one she failed me for, she'll know and completely destroy me. I'm okay with that if it saves anyone from getting hurt.
If you are sure your concern is to be sure the right thing is being done, and not because the instructor is "trying to fail" you then talk to your program director. You should NOT speak to the hospital yourself
I'm sorry if I sound heartless but here goes. Your instructor is "trying to fail you". That means there's some area, personality clash, lacking in a skill, or whatever she's not happy with about with you. Instead of wasting time by over scrutinizing and worrying about this catheter incident, instead spend that time on improving whatever area you need to in order to pass.
The catheter mistake was not life or death, and everyone (nurse, MD) was already involved and aware. You have the opportunity to evaluate your instructors for your school, use that opportunity to rate your instructor. If the majority of students rate her the same, the school will hopefully take actions. Do yourself a favor and concentrate on passing while being safe and ethical. If no one else knew about this incident, it would be a different story.
She didn't fail me the clinical is over. I opted out and now she's running around calling me a hero for this or that and how accountable and responsible I am. Really it's quite bizar. I'm not the first one but it's really hard to get clinical instructors so the school is always siding with them.
I knew when I wrote this I was going to get the feed back of "if she's failing you""focus on yourself" and the undertones of "yeah right you can't handle the truth" "you're not taking accountability " ......
When this is true in allot of cases, I don't know if being almost 40 will give me more credability.
Isn't this the problem? How many times has someone like me not said anything to save their own ass, or to not get completely torn down to nothing, and a patient has been harmed because of this fear of self annihilation?
Or other nurses assuming you are just a disgruntled student?
Seriously it's like the mob!
So, I say nothing=someone may or may not get hurt.
Or there ends up being an investigation and I violated my duty to report. =I'm done.
When will this "take accountability because if you don't then you're not accountable because this is nursing politics and nobody will take accountability but YOU have to" bull stop??
This isn't intended to be katty and I appreciate everyone's time that has responded to my post even if I don't agree.
Thank you everyone for making an effort to leave a response.
I perhaps have a slightly different perspective, as a nursing instructor and practicing NP. Facilities get to agree whether or not they will take students, and they can also refuse to allow certain instructors to come to the facility (ie "We will allow your students to do clinicals here but so-and-so instructor is not permitted here.") So if that instructor gets a "reputation," the problem will be taken care of. The facility knows what instructor was there when the incident happened, and they do NOT want problems (trust me on that.) However, I WILL say I cannot believe an instructor did not know how to insert a Foley catheter safely. Our instructors have to have two years' floor nursing experience before they are permitted to work in our program. That should not have happened.
She was a nurse at the hospital getting paid by the school. The dr, other nurses knew about it. I want to believe with all who are involved wouldn't be dishonest. However I don't know what to believe anymore.
Never in my life have I ever seen so much undermining backstabbing crap in my life.
These are people who we trust with our family members.
If I were you I would keep my mouth shut. I know it sucks, but you said yourself you're from a small town and you don't want to get black balled as you called it. As others have stated, the patient's nurse and doctor were involved and they will work out any reporting among themselves. I've seen nurses do things they weren't supposed to and I wish I could say something, but as a student, I'm keeping my mouth shut unless it's something really really serious.
Cclm, LPN
786 Posts
Well I guess I don't have an obligation to report.