Foley placement BEFORE anesthesia??

RNnicu42 · Feb 7, 2013

For scheduled C/S's and non-emergent C/S's, we always put foley in after anesthesia. There is no need to put mom through that when there is no urgency. If it is an urgent case that has time for a spinal, we will sometimes put it in before we move them into the OR. But most of our pt's already have epidurals in place and therefore already have foley's in place. I do not think there is any reason why the f/c should be put in before the spinal. It just makes the mother more uncomfortable and anxious.

klone, MSN, RN · Feb 7, 2013

Where I started as a nurse (smallish community hospital) they put in foleys pre-anesthesia as well. Our C/S were handled by the regular OR staff, not L&D, and we were told that the regular OR staff was too impatient to do it for us. However, if a patient REQUESTED foley placement after spinal, we would always accommodate (and basically tell the OR staff "too bad, so sad" when they got annoyed at having to do it.

WHere I work now, it's always placed post-spinal, in the OR (except for in emergencies, of course) and it's just how it's done. Now that I've seen that for the past two years, the old way seems mean and barbaric to me. There is no good reason why it cannot be done in the OR after spinal, except in the case of emergencies.

Fyreflie · Feb 8, 2013

Even in the small hospital I worked in (separate OR staff) it was done post spinal. Why put someone through the discomfort and anxiety?

jodyangel, RN · Feb 8, 2013

Ahhh Klone am I working in your old hospital? Lol! Yeah well I think it's terrible personally. The first section I went into my orientator said she wasn't placing it beforehand. So I placed it after they got the spinal in. I'd rather they change the policy than be defiant...new kid on the block you know?

jodyangel, RN · Feb 8, 2013

Klone I say that cause the regular OR staff does the sections as well.Weird lol.

jodyangel, RN · Feb 8, 2013

Foleys hurt. I can safely place one in about 2 mins...

kirsnikity · Feb 8, 2013

Foley is placed after spinal is in, unless mom is getting general anesthesia. It takes less than two minutes to insert and you can't prep the patient immediately after the spinal anyhow. It's insensitive on the OB's part to insist on inserting the foley first.

jweichman · Feb 8, 2013

If you think about it, if the patient was having a different surgery she would not recieve a foley until anesthesia was initated. Why do we expect a pregnant patient to suffer through the procedure?

subee, MSN, CRNA · Feb 8, 2013

It's easier for EVERYBODY after the spinal. But the second issue is that the conditions are cleaner than in the patient's room. People are wearing masks, gloves as part of everyday sterile practice. It's a no brainer and shame on the people too lazy to do their own jobs and pass it on to the floor nurses.

monkeybug · Feb 8, 2013

Depends. If the patient requests, then post-spinal. Otherwise, before they hit the OR. I had one, it's not that bad. The trade-off, as I often explained to the patient, was privacy. If done in her room, it was me, her, and whoever of her family she wanted in the room with a door that stayed firmly closed. If done in the OR, it was her, me, anesthesiologist (usually male), CRNA (often male), sometimes the NICU team (with occassional males) and no way to screen her from view. Also, I'd usually have a doctor there tapping their foot while I tried to do it as quickly as possible. I didn't care either way, I'm happy to do it in the OR.

brownbook · Feb 8, 2013

Where I use to work, from 2001 to 2005, for the first few years pre-op put in the foley for scheduled c/sections. . Finally, thank goodness, the chief OB attending was made aware, the unwritten policy was changed, and OR was putting the foleys.

I didn't mind doing it, it is good to keep up all of one's skills, however the moms hated it more than the IV.