Foley Insertion

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I inserted a Foley into a male patient with my instructor. We did not get any urine output does that mean it wasn't in the bladder?

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Specializes in med/surg, telemetry, IV therapy, mgmt.

what did your instructor think? maybe the catheter wasn't inserted far enough into the urethra.

there is a video of a male foley insertion posted on this sticky:

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My instructor thought it was in the bladder because as she let go of the foley it would slowly come back out. Do you understand what I'm trying to say?

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Pt already had a previous Foley which was pulled out and as a result some tissue trauma occurred, and blood was escaping the member. Maybe a clot had formed and it did not allow the urine to flow? My instructor decided to inflate the balloon.

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Specializes in med/surg, telemetry, IV therapy, mgmt.
My instructor thought it was in the bladder because as she let go of the foley it would slowly come back out. Do you understand what I'm trying to say?

Yes. The foley was not in the bladder. If it was slowly coming back out, it was coming up against a narrowing or an obstruction, maybe a clot closing off the passageway. Eventually, this patient is going to become distended with urine. He will require catheterization with a caude to get the catheter past the narrowing.

Did you watch the video? We were taught to inject 10cc of lidocaine or water based jelly directly into the male urethra to help the passage of the catheter. However, if there is narrowing the catheter may not pass and will just coil up and you will get trauma, bleeding and no urine return.

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It was slowly coming out before inflating the balloon. Are you saying if it were in the bladder before inflating the balloon the foley wouldn't have moved.

We were never taught to inject 10cc of lidocaine but we did lubricate the catheter. What do you think will happen to us? I had a feeling the foley was not in the bladder. It was the first time I have ever put a foley in. I should have advocated. What if they deflate the balloon once they notice no output has been detected?

When we inflated the balloon it wasn't painful for the patient, but that's because they gave him morpine 15 mins prior so I couldn't assess if the patient would have been in pain .

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I do not understand why an order was placed when the patient had a previous injury. Wouldn't they want that to heal? The problem was this was not my patient. And my instructor was looking for someone who had never placed a Foley. Will the patient have to suffer more with a( caude catherization). I do not know what that is. I looked it up in google and no results. I'm still downloading the foley procedure. Is there a slight chance the foley could have been in the bladder and still get no urine output?>

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If an elderly gent, I am willing to bet his prostate is swollen, and you are not getting in. (obviously if theere was previous trauma, someone elese had athe same problem, makeing it 2X as difficult for you, with 2 different problems.) I sure hope there is no further injury from the 2nd inflation, but I would bet dollars to dimes that there will be. If I couldn't get it in all the way, I would change out the tubing, lube up big time and give it another shot or get help/ collaboration before inflation. I will have to remember the lidocaine.Thanks Daytonite...

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Specializes in neuro, critical care, open heart..

Yes, it is possible that the Foley could be in the bladder and no urine was noted, however, that usually is not the case. I have inserted MANY a Foley in my days, and have ran across a couple that had no urine return. Is it possible that this particular pt happens to be on Dialysis? It is usually better to re-insert a Foley ASAP after a Foley has been pulled out. Espicially if it was a traumatic removal. If you wait too long, there will be swelling of the urethra making re-insertion more difficult.

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We did immediately re-insert the Foley after the Foley had been pulled out.

Do you think if a suit is filed, I'll be kicked out of nursing school?

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We did immediately re-insert the Foley after the Foley had been pulled out.

Do you think if a suit is filed, I'll be kicked out of nursing school?

If you were there with your instructor, following his or her orders and direction, it is their license and career on the line. Not yours. If you had done it on your own, or made a decision to do something you shouldn't have, then it would be your problem. You are practicing under your instructor's license and he or she is liable for anything you do.

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oh ok... I understand now it's my instructor license on the line, but I wouldn't want my instructor to lose her license. I might have misunderstood why she thought the Foley was in the bladder. She is full of knowledge, and has been a nurse for a long time! And I'm confident she knows what she is doing. I just need to ask her again why she thought the foley was in the bladder.

Thank you all

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