Foley placement

[mymichael2009]

I'm a new nurse and of course my first day off orientation I place a Foley without incidence with no urine return..I checked with bladder scan approx 100 cc in bladder..pt was elderly and agitated..dementia...septic..kept pulling at the Foley..I checked Foley placement again after noting blood coming from tube..very minimal blood however flushed fine...told my preceptor was who working to check it as well and doc saw the blood in the tube...no one seemed concerned as it was shift change I passed info on...should I be worried this is going to come back on me...do u all think the Foley could have been pulled out by pt ...ummm..should I have removed it right away

[mymichael2009]

Pt condition acute kidney failure..septic..1500cc with minimal in bladder via scan..asked other RN who said no urine is possible

[dishes, BSN, RN]

When did the 1500cc of urine drain?

[mymichael2009]

Idk it was shift change

[dishes, BSN, RN]

Did the 1500cc of urine drain after you inserted the catheter? (on the shifts that followed your shift)

[imintrouble, BSN, RN]

Was the patient on blood thinners? High INR? I recently had the same thing happen to me. So much blood it was difficult to see there was urine mixed in.

[FurBabyMom, MSN, RN]

I have never inflated a balloon on a foley catheter in a male without urine return. I have had to flush the tubing with saline and/or draw off the port to ensure urine return. My usual tricks are to hold the catheter in place and drop the bag and/or have others push on the patient's abdomen. I have put in plenty of foleys since going to the OR (we're lucky in that our patients are almost always under anesthesia when we put foleys in). We expect a lot of patients to have procedures ≥3 hours and/or there are other reasons to put a foley in (ex laparoscopic cases). Generally RNs try for foley placement twice, then we defer to a resident/attending - sometimes they do it and sometimes we call urology.

If it weren't for not having urine return - I would say that the patient might have caused the trauma and bleeding if they were confused and pulling at lines/tubes. I don't know, I still wouldn't have put the balloon up without urine return.

Another poster put commented that something like what the original poster posted about wouldn't require an incident report be filed. I suppose that depends on what your facility wants reported. I work at a facility that wants everything that could POSSIBLY result in ANY patient harm or anything that is a deviation from policies reported. There are some things our institution wants reported that would be asinine to report on, but something that might have harmed a patient? I'd probably write it up for no other reason than knowing our organization uses the information to help determine what education needs offered to staff (and maybe we need more education on it).

[blondy2061h, MSN, RN]

They had 1500ml of urine? Or they got 1500ml worth of fluids? I've found bladder scanners to be quite inaccurate.