Instructors advice re difficulty voiding appropriate??? - page 3
Ok so I have an instructor who pulled another student aside last week to ask her how she would help her pt. to void. She told him she would run the faucet and force fluids. The instructor then took... Read More
Nov 2, '06Quote from jodyangelThat is great that she protected you guys... and so swiftly too.I got to class yesterday. They fired him!! Our teacher just made an announcement that the women in his group would be reassigned. And that it was because there were some Very Inappropriate and that it was dealt with swiftly. And she said that we are like her children. She would protect us at all costs and that if anything like this would happen again that we should Know we can go to her.
Nov 2, '06I am so glad that the students were listened to, and action taken. I hope I'm lucky enough to get an instructor who cares about her students like that when I'm in school...still waiting on the *#@(! letter....
Nov 2, '06Quote from jodyangelWooHoo!!!! How nice to have an instructor that is on top of things!I got to class yesterday. They fired him!! Our teacher just made an announcement that the women in his group would be reassigned. And that it was because there were some Very Inappropriate and that it was dealt with swiftly. And she said that we are like her children. She would protect us at all costs and that if anything like this would happen again that we should Know we can go to her.
Nov 2, '06If a stranger pulled on my pubic hair I would deem that as assault. Now, when I pay the salon to wax my hair that's a different story. By making the appt and paying her I'm giving her permission.
You did the right thing by reporting this. If this happened to a loved one or to me I'd be speaking to dept heads.
Nov 3, '06Quote from traumaRUsI am not sure where this came from it was just something mentioned by the instructor and was not something we were really taught or encouraged to do. Nor was it in any of our test books. I would never personally do this I was just saying that I have heard of it but in no way would actually promote anyone doing this.EMLLPN - I've never heard of this! Can you ask your instructor what the source of this information is???
There is NO reason to pull pubic hair when inserting a foley! What are these poor students being taught?
Nov 3, '06re this article:
(page 4 of the following PDF)
Maintaining Low Bladder Pressures
[FONT=Book Antiqua,Book Antiqua]A primary concern with women with neurogenic bladder is to maintain low voiding and storage pressures in the bladder. High pressures lead to reflux of urine, dilation of the ureters, pyelonephritis and renal damage. Women with reflexic or uninhibited neurogenic bladders are at risk. Detrusor-sphincter dyssynergia (DSD) is a common finding, where the detrusor muscle and urethral sphincters fail to work in coordination during storage or voiding, and instead contract in spasms against each other. DSD can be definitively diagnosed only through urodynamic testing (Chancellor, 1996), (Weld and Dmochowski, 2000).
Some women may use manual techniques to aid in bladder emptying, such as the Crede method of applying direct pressure over the bladder with a fist, using the Valsalva maneuver, or triggering the voiding reflex by pulling on pubic hair or stroking the inner thigh. However, these techniques can be dangerous in the presence of high bladder pressures, as they can cause reflux into the kidneys. The Crede maneuver in particular should be reserved for bladders that are known to be areflexic or flaccid. Urodynamic studies are the only way to verify this with certainty.
Nov 5, '06if there are any nurses who work with spinal injuries please put in your two cents!!
what i found is, just to make it clear in case anyone gets the urge to try this intervention... don't!
i did a quick search on ebscohost on triggered reflex voiding and all i can find regarding it are a few articles. they were about using this method in patients with spinal lesions, not your everyday patient.
"spontaneous voiding with and without triggered voiding and/or bladder expression has proven to be less safe except in well defined patients with regular urological follow-up. nowadays, intermittent catheterisation and self catheterisation with and without bladder relaxants are accepted as the methods of choice." from the abstract of "conservative treatment of the neuropathic bladder in spinal cord injured patients." spinal cord (spinal cord), 2001 jun; 39(6): 294-300 (44 ref) the other articles also indicate an increased rate of infection in the population studied when triggered reflux voiding was used.
*to summarize: pulling on someone's pubic hair is not a recommended intervention when someone can't pee with those few uro-dynamically stable exceptions mentioned above in which case, they can do it themselves.
Nov 5, '06Quote from jodyangelGood! You are very blessed to have someone so willing to protect you and an administration that is willing to act. Good luck with the rest of the semester!I got to class yesterday. They fired him!! Our teacher just made an announcement that the women in his group would be reassigned. And that it was because there were some Very Inappropriate and that it was dealt with swiftly. And she said that we are like her children. She would protect us at all costs and that if anything like this would happen again that we should Know we can go to her.
Nov 5, '06Quote from lady_in_redthat's what i was taught as well in my neuro lectures.i found a few things on this.
pulling on the pubic hair is one of the techniques used in triggered reflex voiding. however, there has been some concerns about the techniques. if the patient has a high bladder pressure, the urine could reflux back into the kidneys. (page 4 of the following pdf)
the technique should only be used with "patients whose situation has proved to be urodynamically safe and stable" (rigby, d. p.62 or 6 in the following pdf file)
Nov 7, '06Quote from jmgrn65OMG, that is sexual harrassment. That was the most inappropriate response I have ever heard, and YES! I would report that &%)(* immediately!sounds like sexual harassment to me. It should be reported immediately!