Leaving a patient foley in

Nurses General Nursing

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Specializes in Orthopedics.

As a new RN, I hear in report often "I left the foley in because they are getting blood" etc. if there are orders to d/c a foley, what are treatments/conditions you should let finish before taking the foley out and why?

Specializes in Emergency, Telemetry, Transplant.

Not really a treatment, but at my one job, the residents on our service would round sometimes late in the evening. At 2300, they would write an order to "remove foley, notify HO if pt does not void in xx hours." Why would I wake a patient up to remove their Foley, and then return multiples times though the night to wake them up to try and get them to pee? No thanks…that one can wait until the morning.

I don't think I have ever heard of not removing a Foley until blood is complete, but I'm sure it has happened somewhere--especially if they get Lasix after the transfusion (or between units, etc.).

Specializes in Family Medicine.

Probably bc:

1. When you give a patient blood, they get a lot of fluid

2. This fluid will make the patient pee

3. Often, Lasix is given post-transfusion, this will make the patient pee even more

4. Many times, the patient is on bedrest due to a low hemoglobin

5. It sucks to make a patient pee on a bed pan over and over again

6. If they're incontinent, if makes it difficult (impossible) to get an accurate output sans foley

However, according to the Foley police, the Foley should come out regardless of above reasons.

If there is an order to discontinue a foley timed for 0000, I wait until 0600 to take it out so that day shift has pretty much the whole shift to monitor voiding or not.

Specializes in Oncology.

Foley gets d/c'ed at 1845. A bit sooner if their night shift nurse tends to be early.

I jest, I jest.

Specializes in Hospital Education Coordinator.

paur facility has a take out order unless certain circumstances exist. This has to be documented frequently. Nurse's convenience is not a condition to retain foley cath

I work in ICU but before the patient leaves, we take the Foley out. If the doc orders Lasix before patient is due to be transferred, I wait until I give the Lasix, they diurese and then take it out and then ship them out :) oh and if a doc orders to remove the Foley, but is adamant they still need to be in icu, then they get a phone call saying of they are sick enough to be in the ICU, then they are sick enough for strict I/Os, so Foley stays in. :) it's funny how quickly that patient gets transfer orders to go to the floor after that (one surgical service is notorious for leaving their surgical patients in icu just because the care is better....sorry these beds are for sick people!)

oh and if a doc orders to remove the Foley, but is adamant they still need to be in icu, then they get a phone call saying of they are sick enough to be in the ICU, then they are sick enough for strict I/Os, so Foley stays in. )

This doesn't work in my ICU. I will tell them, however, that I refuse to be chastised for inaccurate I/O without a Foley. They acknowledge this and it's never been an issue.

Specializes in Acute Care Pediatrics.

With our ortho patients with complex surgical repairs - we wait until PT clears them. Because I need them to be able to get to the toilet. :p

Specializes in PACU, pre/postoperative, ortho.
With our ortho patients with complex surgical repairs - we wait until PT clears them. Because I need them to be able to get to the toilet. :p

What is the typical time frame to be cleared by your PT? Wondering because to meet core measures/SCIP, foleys are to be removed by POD2. We usually remove them POD1; it's good therapy for a pt to have to get up to a commode or bathroom.

As a new RN, I hear in report often "I left the foley in because they are getting blood" etc. if there are orders to d/c a foley, what are treatments/conditions you should let finish before taking the foley out and why?

Follow orders. I believe each facility has their own policy on how long you have to carry an order out. Otherwise you are just leaving yourself hanging in the breeze for the snotty co-worker who wants to go after others and will write you up.

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