foley bag tubing

[ohmeowzer RN, RN]

this is a crazy question.... do you place the foley bag tubing ontop of the pt's leg and below the pt's leg to down drain? i always put it over their leg so it drains, i had a pt's mother tell me ( who has taken care of her sick daughter for years ) that i am wrong , it goes under their leg? i thought it would not drain? what do you all think? thank you all in advance:nurse:

[nightmare, RN]

If they are lying in bed then putting the tubing under the leg can cause pressure areas,allergic reactions to the tubing and,if the patient is heavy bad flow from the tubing.

[JennRN65]

I place it above the patient's leg when they are in bed. If it is under their leg, they would be placing pressure on the tubing causing indentations in their leg which could lead to breakdown and poor drainage especially if the patient is of a larger size.

[CorgiMom]

Over the leg.

[yeSICU]

Considering that you place the Stat Lock retainer clip on the top of the pts leg, I would say that the accepted position for the foley tubing is over the leg. Plus If it ends up under the leg, which often happens with the neuros, you will find that it ends up around the foot and yanked out. Definitely over the leg is best and accepted practice.

[Sterren, BSN, RN]

over the leg for sure.

[ohmeowzer RN, RN]

thank you all so much.. this mother would put it under her daughters leg everytime i put it over her leg correctly... i think the mother just didn't like me , and was nasty the whole shift to me i tried to explain to her the rationale about putting it over the leg and she just ignored me..

[Lafawnda]

I suggest running tube down between their legs and around their foot to the bed.........most tubing should be long enough that way it is not over the leg or under the leg

[Blee O'Myacin, BSN, RN]

this is a crazy question.... do you place the foley bag tubing ontop of the pt's leg and below the pt's leg to down drain? i always put it over their leg so it drains, i had a pt's mother tell me ( who has taken care of her sick daughter for years ) that i am wrong , it goes under their leg? i thought it would not drain? what do you all think? thank you all in advance:nurse:

I'm thinking that no matter what you do here, it's not going to be OK with the patient's mother. I think that we are all in agreement that the proper placement is over the leg, and I am assuming that this child has an indwelling catheter at home that Mom cares for. So if it doesn't directly violate your unit policy to have it under the leg (look it up) and the flow isn't being blocked by a heavier leg, then I'd say to pick your battles with this patient's family.

I'd run it past the wound care nurse if your hospital has one also. Since we are oh so customer driven these days, I'd want my behind covered either way it goes. You can be dinged for not following policy and giving mom her way (and a possible hospital acquired pressure ulcer for the sick daughter) or you can be dinged when Mom writes an angry letter to the non-medical powers that be. There is no graceful way out of this one other than charting your butt off.

Good luck.

Blee

[yeSICU]

Yeah you learn quickly that it doesn't matter how long you have been a nurse or how many years of education you have... The patients FAMILY knows best. Harsh reality of our job (especially in the ICU and peds). Does your facility have Stat lock devices? You could show it to the mom and explain the benefits of using it. You might get her on the same page. Just don't do it in a "You're wrong" way. Just tell her you have a new tool that will prevent pulling/kinking of the cath and decrease risk for infection. http://www.statlock.com/pdf/foley_slick.pdf

If you dont have them, I wouldnt bother pushing the issue. It isnt worth the energy honestly, because she is set in her ways, and as mentioned above managment isn't going to back you on such an issue if the mom gets irate or insulted by your insistence.

[Daytonite, BSN, RN]

i have always placed it over the thigh for the same reason everyone else is giving you--to prevent skin breakdown by the patient's leg lying on top of the plastic tubing. the skin will stick to the tubing and one good move of the thigh and that foley and balloon will get a good tug on it. patient's families develop some odd beliefs about nursing care that left uncorrected over time they believe are the right ways. probably the only way you will be able to change this mother's mind is to find a fundamentals book with a picture or show her a written policy that clearly explains this. but i would be very tactful about it so as not to disturb her self-esteem or get her dander up.