First Time male catheter story

Nursing Students General Students

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Hello ladies and gentlemen, this will be my first post on Allnurses. I Figured I would share my experience on a situation I had today during a clinical rotation. I am a student about to graduate in December from the LPN program, and we are doing our hospital/specialties clinical at the moment.

So a little background I have done female Catheters (oddly enough before I did any males.) But today I had my first male and here is the situation I ran in to on my shift. My nurse and myself went to the pt. room, introduced ourselves and stated the procedure to the patient and how it was going to work etc.

(PT information: The pt. is paralyzed neck down for the last 6 years and has required a IN/OUT catheter every four hours. Pt. is in today for pneumonia. The DR orders a 16 Foley to be inserted while he is on the floor. 30-45 min prior the wife of the pt. performed the in/out catheter on the pt. as she normally would). Now lets get onto the situation…

I get everything setup, keeping sterile field the entire procedure. Everything is textbook perfect, insertion is great no resistance is met everything looks and feels great. I inflate the bubble still perfect give it a tug and its nice and snug no retraction. This is where things get hairy as I am cleaning the area and disposing of every thing I notice a drop of blood come from the meatus I stop clearing away and call the nurses attention to the blood.

She states it happens sometimes and don't remove the cath. Not 3 seconds after she has said this, I have blood rush into the tubing. This is not normal I remove the catheter after she states to go ahead and remove. Once removed the meatus spurts blood about 3-4 ft. into the air.

This is the point where it becomes abnormal to the extreme he leaks blood pretty seriously. I grab the member and apply pressure. Yet, the member continues to leak blood heavily. I grab some towels and use it to contain the blood while holding pressure. Pt. is still bleeding 2-3 min later at the same rate.

Dr. is alerted and says to continue pressure. So my instructor comes into the room and we continue pressure for the next 30-45 minutes and soak thru at least 2 ½ towels. Eventually, the bleeding stops I say all this because no one I have discussed this situation has seen that amount of blood come out of even a botched cath. So if this has happened to you I would love to hear about it.

Needless to say the cause of the bleeding was pretty evident, the pt. was on Elaquil and the urethra was irritated and once he started bleeding there was no antidote for that medicine to stop it like warfarin. So, in closing this was a pretty unique first male catheter and thought id share and see what you all thought.

P.S. forgive my grammar hard to set up perfect sentences and structure on a phone :p

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Well at least you got that out of the way the first time. I've never seen that either, but all your future catheterizations have to go better right?

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Specializes in Nephrology, Cardiology, ER, ICU.

Moved to general nursing student

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Wow, I am freaking out and I was not even there

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Yea I doubt it will get much worse than that with a catheter. I saw way worse with a pt who had a stage 4 pressure ulcer on both buttocks. There's was basically just muscle and tendon and a bit of skin left.. It was horrible and then turned him over and notice the head of his member is flopping over and is held on by a 1/4 inch of skin.... He'd had a cath for a very long time and that's the cause of it. I doubt a male could see worse than that ha. But as for being freaked out about the cath, I really wasn't but my nurse almost passed out apparently being pregnant all her hormones kicked in and she had to leave the room

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Specializes in Neuro, Telemetry.

Even urethral irritation would not cause that much blood. Unless it was urine mixed with blood and appeared like there was more. Depending on how big his prostate was, that could cause irritation. You would have had to inflate the balloon while still in the urethra to cause something like that. Or he had a bladder issue.

Was an irritated urethra what the doctor told you it was, or are you assuming?

Also, if there was that much blood and you are a student, where was your nurse? Why we're scans not ordered to make sure you didn't perforate or rupture something? Why was there not more concern from the staff?

Side note: its called a straight cath. Not an IN/OUT. Not being snarky, but don't want you to look silly if you say this to a another nurse.

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Even urethral irritation would not cause that much blood. Unless it was urine mixed with blood and appeared like there was more. Depending on how big his prostate was, that could cause irritation. You would have had to inflate the balloon while still in the urethra to cause something like that. Or he had a bladder issue.

Was an irritated urethra what the doctor told you it was, or are you assuming?

Also, if there was that much blood and you are a student, where was your nurse? Why we're scans not ordered to make sure you didn't perforate or rupture something? Why was there not more concern from the staff?

Side note: its called a straight cath. Not an IN/OUT. Not being snarky, but don't want you to look silly if you say this to a another nurse.

You know I'm going by what the dr told me when he said it was a irritated urethra that's what I go with. I'm not going to argue with a guy who has been to medical school and over ten years of experience, over the terminology they use. In the report he filed it was stated as IN/Out. As for the scans I'm not a physician nor am I about to tell him what to order or when too. He wasn't concerned because the pt had the issue a couple of times before per the pt. when he was asked. Also the nurse was in the room with me until another senior staff member came into the room to relieve her. I was never left alone and the whole procedure was supervised. We had urine return very slight since he had been Cathed previously. Like I stated everything was text book until the end. There was no resistance nothing was forced in slid in great the issue came after.

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Specializes in Emergency.

Any history of BPH?

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Nope none at all. Checked on the pt yesterday. There's no issues they are gonna just keep straight cathing him as he has been doing. They dr checked him and there was no pereforation of anything and noted that he had a history of it. Apparently it had happened more than the once he had said. His wife had a different story but he wasn't on the elequis at the time. So it exacerbated the bleeding issue. So all is well with him.

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Specializes in Neuro, Telemetry.

It actually is going to be your job to question the doctor if you don't agree with his plan of care or if you feel there is a better option. Doctors aren't always receptive if questioning, but having a degree and 10 years experience does not always mean that what they say is the best option. You will learn this when you become a nurse. I question orders often enough when I don't agree with them. At the end of the day, if there is a negative outcome and you are reported to the BON, "I didn't want to question the experienced doctors" will not save your license as you are ultimately responsible for the care you provide and orders you carry out. ge fact that the doctor called it an "IN/OUT" cath is my case and point lol.

Anyway I'm not questioning your story or assuming it is fabricated. It merely seems something went on that you are not aware of and that's ok. Whether you think so or not is moot.

Had you mentioned in your OP that this particular patient has a history of bleeding during catheterization, then the lack of concern by staff would have been less questionable.

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Not offended and I do agree with the questioning the dr. But not when I'm still in nursing school and absolutely have never seen anything like it. Believe me I questioned the crap out of my instructor and the nurses on the shift, about the normality and the reason it happened etc etc . Also I thought I had put that the pt had a history so that's my fault. Sorry about that , and I didn't think you were questioning the story that would be one heck of a story to make up just to make one post í ½í¸‰

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