Foley Catheter Insertion:An independent or Dependent Nursing Role?

[agrj]

I just want to impart a situation where in a nurse inserted a foley catheter to her patient with verbal order from the resident doctor due to his busy situation in ER. After insertion, urine was noted clear yellow on the tubing but was not drained till the bag though the bladder was distended. After 30 minutes still patient complained of fullness and urine bag still empty. Catheter was removed and noted clot on the catheter tip and minimal bleeding noted on the orifice. When the doctor saw it he consulted to the Specialist surgeon and the specialist inserted. Presently the resident denied his verbal order to the nurse. The Specialist also was about to document his insertion but found out that the resident didn't make any notes. They argued and read my friend's notes that there was a verbal order of foley catheter. Do insertion of foley cath is an independent or dependent role of the nurse?My friend is so worried that the case will be investigated. Need your opinion guys. thanks

[SouthpawRN]

Sound like to OP may practice outside of the US. I have heard these terms used by UK nurses.

Nope: currently this is standard terminology taught in nursing programs here in the USA, Dependent needs an order, independent is nursing judgement or something that can be done without an order and interdependent is with a multiple disciplines involved like, RT, MD, social work etc.

[JKL33]

Nope: currently this is standard terminology taught in nursing programs here in the USA, Dependent needs an order, independent is nursing judgement or something that can be done without an order and interdependent is with a multiple disciplines involved like, RT, MD, social work etc.

Agreed! I'm surprised this is a point of confusion - - we were taught it years ago. In my observations I think this has become a confusing issue for some because of all the protocols, policies, and standing orders that affect nurses' decision-making now.

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Make no mistake, when you follow a "protocol" you are following an order of the "standing order" variety. These protocols have been written after careful consideration and collaboration between nursing and physicians. A protocol is a standing order that can be implemented when certain conditions are met. Protocols are often called "order sets" in the EMR.

All of that is pretty irrelevant to the OP though. There was in fact an order. It's possible there was confusion between nurse and resident and they were each talking about something different without knowing it, as mentioned above. But either way, this situation should be handled professionally and assertively. This has happend to me one time in my career and never again. I don't tolerate people lying about what they told me to do. I always write/enter the order before I implement it, and may make an additional nursing note if warranted. After that, if someone wants to lie about it, we are going to have an issue that isn't going to be resolved by me taking the blame or accepting discipline regarding it.