Ethical delema

[Cclm]

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.

What do some of you think?

Thank you.

[smudges.blips]

I am going to disagree with the majority of the advice here. As a future nurse I think it is your responsibility to make sure that this does not happen to any future patients despite what may happen to you personally. As a nurse this is part of the job. You need to get used to speaking up in difficult situations. You will run into doctors that you need to question. You may run into coworkers that you may need to call into question. You have to be prepared to do this for the patient safety. The patient comes first always. This isn't a personal thing against your instructor it's a safety issue, cut and dry. This should be reported to whom ever is head of your instructor.

[direw0lf, BSN]

I didnt say keep your mouth shut because then you'd be finished as a student. I said focus on making sure you don't fail or since you withdrew to avoid an F focus on the area you needed improvement on. I suggest working on that chip on your shoulder if this is the biggest backstabbing you've seen and has you this unprofessionally flustered. I might sound harsh but think of a situation you need to keep your head about you and advocate for the patient, calmly and professionally.

I've witnessed a few codes and watched the nurses and other team members. Some I guess from experience or just their personality act very calm and competent. Then others are like a jumping bean and "bark" commands or suggestions. They just turn up the anxiety for everyone, and that won't benefit the patient. Take a deep breath. You're like a jumping bean right now. You will see a lot worse, from physicians who disagree with a nurse out of spite then the patient doesn't get the best outcome, to babies born addicted to drugs but dyfs keeps the family together, to nurses doing the wrong things and not taking accountability, the list goes on. How do you want to respond? Find out what your hospitals policy is. Yours also probably has anonymous report lines.

[Cclm, LPN]

I am very sad that I will "see worse" and with all due respect and thank you for taking time to respond, I don't think this falls to the category "chip in my shoulder"..

If that was the case, I would have already have said something to fill that chip.

This isn't really directed to you but we all know there is un fair, malicious ****** out there and although there's allot in denial in their compentency, I think the majority of the complaints about un fair treatment and railroading are legit. That's from students and established nurses.

Yet, we all jump on that band wagon of blamming the student/nurse of denying their accountability while doing the exact same thing.

[rhinoroc]

I'm sorry that this happened and that you were there. I think it's a learning experience but I agree with you, it creates a HUGE ethical dilemma and it's hard to just sit back and wonder and wonder and wonder. Yeah you will eventually see A LOT more "shady" stuff but that doesn't mean you shouldn't speak up. I commend you for even considering it, especially when it seems like so many would rather turn a blind eye. Be careful out there and good luck with school!

[Cclm, LPN]

Thank you for this comment Rhinoroc!

[Skippingtowork]

One of my concerns here is that OP stated more than once that another nurse is being blamed for the incident. All the people involved may not know what the facts are. Yes, as a student OP should not offer any information, unless it is anonymous, but this should not be considered the ethical thing to do. Someone may have been written up over this, which would be unjust. Too often we find it easier to be quiet and watch someone sink, rather than speak up and risk our own future, well-being or career. There are choices to be made every day and the right answer is not always readily apparent. Unfortunately, administration, both in schools and institutions, do not side with students, even at the peril of patients.