Foley catheter insertion and dc

Woodenpug, BSN · Mar 16, 2010

I like to be sure they are voiding before sending them home.

Deb123j · Mar 16, 2010

1 - I usually insert the foley several inches more once I get urine return. Inflate the balloon and then pull back till I meet resistance.

2 - We dc the foley once we have the physicians order. Some nurses like to wait till the end of their shift so they don't have to worry about the pt voiding on their own. (not a nice thing to do to the oncoming nures) If I had to choose, I would rather dc the foley the night before, that way the pt has more time to be able to void on his own. Sometimes they need to be st cathed a time or two before they are able to void on their own. HTH

~Mi Vida Loca~RN, ASN, RN · Mar 17, 2010

I am still a student but we have done foley's at school and in clinicals. For girls it was about 2 inches once you get urine, I feel safer doing a couple extra. With men I get right up to the Y site.

We get Dr's orders for DC'ing, most discharges in my experience have happened during the day and sometimes it isn't decided until that day. I wouldn't do it the night before if it was up to me ONLY because I have seen a few people thought to go home and the doc ended up keeping them longer and then you might have to recath them. But at our hospital the choice isn't up to us anyway, we do it when we get the orders.

CaDad · Mar 17, 2010

I have been reading that the use of caths was being phased out. Can't happen fast enough as far as I'm concerned.!!! Probably one of the most despised things that can happen to a guy in a hospital. :devil:

~Mi Vida Loca~RN, ASN, RN · Mar 17, 2010

I have been reading that the use of caths was being phased out. Can't happen fast enough as far as I'm concerned.!!! Probably one of the most despised things that can happen to a guy in a hospital.

Getting phased out to what? What will they do instead? They are no picnic for females either, especially since people seem to miss a heck of a lot more with females.

NSALVADORE · Mar 18, 2010

Yes, though not pleasant procedure to have done, it is very necessary!!

I agree, as a student I go 2in past.

We also get a doc order to D/C so that's when we do it. But as others have mentioned you want to make sure they are voiding before they leave so the sooner the better. I have DC'd right before sending someone out the door but they were going to a nursing home so there are nurses at least to monitor voiding.

awalker1015 · Mar 18, 2010

We learned to do it to the bifurcation. As far as DC, at my facility we do it the day before discharge to make sure the pt voids on his own.

If they discontinued Foleys, what would be used? That doesn't really make sense. Some form of urinary catheterization is sometimes necessary, no matter how uncomfortable...

CaDad · Mar 18, 2010

AHem: well I may have painted my comments with a broader brush then I intended.

From what I have read recently, there's a lot of cathing that does not need to be done and in those circumstances

it is being discontinued. To many Doctors have been ordering foley's when it just is not necessary.I am sure you would all agree there are several situations when it is just not necessary. :cool:

awalker1015 · Mar 19, 2010

Well, CaDad, I totally agree with you there. I have seen them ordered when it really did not seem necessary. To me the risk of infection is too great to order them lightly...

akillinger · Mar 19, 2010

In school we are taught to insert to the bifurcation.

As for d/c, I do it as soon as the doctor puts the order in and according to protocol the patient must void within 6 hours.

Snwbdr · Mar 20, 2010

I am still a student but we have done foley's at school and in clinicals. For guys it was about 2 inches once you get urine, I feel safer doing a couple extra. With woman I get close to the Y site.

isn't this kind of backwards? the male urethra is much longer than the female, therefore I would tend to go all the way to the bifurcation on the male, to make sure I'm not inflating a balloon in the urethra (which I heard a new grad did to one of my patients in clinicals).....with the female urethra being so short, I don't think it's necessary to go ALL the way to the bifurcation.....just a few inches past the start of urine flow