Ever hear of this?

[Peds_Nurse]

Hello all...

Have any of you ever heard of "burping" a Foley?

I'm a fairly new nurse and the other night, I had one of my aids ask me to help her with a patient's foley. She said that the urine was backing back up into the patient's bladder and that I needed to "burp" the tubing to make it drain properly. I've never heard of this before, so I asked her if this was normal practice and she said yes, she does it all the time.

"burping" was simply disconnecting the bag tube from the catheter briefly while the urine emptied from the tube into the bad, then reattaching it. It didn't harm my patient, so I didn't think it was wrong to do.

Can anyone give me some insight?

Also, this is the same aide that I usually have difficulty with, she tells me how to take care of my patients and when I am firm with her or give her work to do, she disappears on me. I'm at my wits end trying to be nice to her so she doesn't disappear from the floor. We are so short handed as it is.

Thanks!

[Boog'sCRRN246, RN]

i've never heard of "burping" a foley. i'd first have to ask how the aide knew that urine was backing up into the patient's bladder. unless the bag is completely full, or the patient had clots in their urine, i'd kind of have to doubt that the foley wasn't patent. i've seen urine in foley tubing before but i've just rearranged things and it usually drains into the bag, no problem.

""burping" was simply disconnecting the bag tube from the catheter briefly while the urine emptied from the tube into the bad, then reattaching it"

so the catheter was left in place while the clear tubing was disconnected and then once the urine that was in the tubing drained into the bag, everything was reconnected? how often is this aide doing this? i would think that it would leave the patient open to a higher risk for a uti. unless you're irrigating the bladder or instilling some kind of medication via the catheter, the tubing should really be left alone. jmo, of course

[TheCommuter, BSN, RN]

In the textbook world of nursing, a closed indwelling urinary catheter drainage system shouldn't be opened or disconnected because doing so might expose the inner aspects of the tubing to microorganisms, which might lead to infection in the patient.

[systoly]

It is normal for the tubing to have some urine in it, especially when it is properly coiled. The urine drains per gravity and can back up only when the collection bag and tubing are handled improperly and placed above the level of the bladder. If it is necessary to do so, the tubing needs to be clamped. If the foley is not draining or if there is leakage from the meatus, check the tubing for proper placement or kinks. If this doesn't resolve the issue try to irrigate (you may need to get an order first). Some patients need their foleys changed more frequently and usually have standing orders for this, but be sure you're not dealing with a severe case of BPH or other obstruction before you yank the old one. The urine collection bags are often changed on a routine basis, but care must be taken to avoid contamination. If alcohol wipes are used, the alcohol needs to dry completely before the tubing is reattached.

[Peds_Nurse]

Thanks all for your replies. I actually talked to our DON (who is also an RN) and she never heard of doing this either. The aide was brought in and we asked her why she thought the urine was backing up into the patient and she said it was because the tubing was full of urine and the collection bag wasn't very full. We both explained to her about the risk of UTI due to opening the system. The DON further explained to her that a nurse is the one to determine if there is a problem with the foley, not the aide. If she thinks there is a problem with a foley, to bring the issue to the nurse's attention and not to make a determination of the course of action to take.

Hopefully, she will stop "playing" nurse and do her duties to the best of her ability.