Foley Position

nursedawn67, LPN · Aug 23, 2003

Originally posted by QUEENIERN
WE HAVE ALWAYS PUT THE FOLEY UNDER THE LEG WHEN PATIENT IS IN SUPINE POSITION. BEING AN OLD MED SURGE NURSE THIS IS WRONG. GOES OVER THE LEG. ANYWAY NOW ALL OF A SUDDEN A CERTAIN CRNA AT OUR HOSPITAL HAS A PROBLEM WITH THE POSITIONING OF THE FOLEY AND IS CAUSING PROBLEMS WITH CIRCULATORS AND RNFA. SOMETHING IN WRITING ALWAYS GETS HIS ATTENTION SO I AM WONDERING WHAT POSITION OTHERS ARE USING OVER OR UNDER.

Well i'm not in OR, but I was always taught over the leg, under can cause pressure sores. But like I said I'm not OR. I work in Geriatrics. :)

shodobe · Aug 23, 2003

Just tell him to butt out. He is just another nurse and isn't in charge of the room. I have little respect for CRNAs who think just because they can put people to sleep that makes them more of a nurse. I work at one hospital with CRNAs from Kaiser and they are on an equal basis with us and we respect each other. Most of the surgeons I work with want the foley under the leg. I know, this is wrong but in their instance they are in charge. I personally don't think you really have to documentation to justify your reason. If you have an aging, I am included, OR staff just ask for a concensus. Does this CRNA have a power or control problem? Does your nurse manager let him get away with this? Both you and he are responsible for the well being and safety of this patient and I know you will do what's needed. Good Luck! Mike

cwazycwissyRN, RN · Aug 24, 2003

most generally under the leg. It is not easy to see the cath or check its' position, after the patient has been draped. Under the leg offers stability for the cath:)

jenac · Aug 24, 2003

In school, I was taught over the leg. Prevents cinks/improper draining. In LTC , I've also seen too many people with perfectly shaped tube-like indents from pressure. And I sure as heck don't need anymore areas to worry about!

QUEENIERN · Aug 24, 2003

THANKS FOR ALL THE ADVICE! AND YES THIS CRNA DOES HAVE A BIG PROBLEM. IT'S CALLED LITTLE MAN SYNDROME. AND TO MAKE MATTERS WORSE WE HAVE NOT HAD A MANAGER SINCE MARCH OR A DON SINCE THE END OF MAY. THINGS ARE REALLY TOUGH LATELY. IT'S ALWAYS THE LITTLE STUFF THAT IS SENDING US ALL OVER THE EDGE. THANKS AGAIN FOR YOUR HELP. STAY AROUND I'M SURE I'LL NEED YOU ALL AGAIN.

Mimi2RN, ASN, RN · Aug 24, 2003

I don't work in OR but it makes sense to me to have the foley under the leg during surgery, out of the way. It's a short term situation, should not be a problem, as it will be over when the pt goes to the floor.

crissyb · Aug 24, 2003

I worked OR for 10 plus years, we always put the tubing under the leg, or if possible, straigth to the end of the or table.

chartleypj · Aug 24, 2003

Under the leg @ the knee checking to be sure the flow of urine is not impeded in any manner.

Gently remind the CRNA that you are confident in your ability to position a foley cath on your surgical pt. I have been positioning this way for over 26 years.

Paula

FlightRN2B · Aug 24, 2003

My question to you is, does your facility have a policy in place? if not, maybe it should. Ask the educator. I have been taught that for men you should always tape the foley upwards and downwards for women. I'm not so sure I would worry about a pressure sore unless the surgery was going to be a long one. Also what area of the body is being operated on, and what is the rational behind the tube being under or over other than being in the way of the surg. Things that make you say hummmmmmm.

Pam RN · Aug 30, 2003

I was taught in the OR to position the tube under the knee with sufficient slack on the foley cath itself. That was the foley isn't pulled to hard on the bladder wall and is loose enough for flow. Usually, people have some space between their knee and the bed so the urimeter tube can fit nicely.

Circl8r · Sep 8, 2003

The only time we put a foley over the leg is during an AP resection, or any other perineal case where a foley must be in place. Otherwise, the drainage tubing goes under the leg, usuall near the knee which in turn causes minimal tension on the catheter itself. We have not had a problem with pressure marks or diminished urine flow because of this practice.