How long can a patient go without urinating after receiving a Duramorph spinal?

[willyRN86]

I had a patient come back from a TKA at 1500. I'm a new grad, and this was my first fresh ortho surgical that I've had. He received a Duramorph spinal as well as general anesthesia. The patient did not have a foley. I asked if the patient peed in recovery, the surgical nurse stated no. He had 2400 mL of fluids in during the surgery and he was a very large gentleman and had peed before they took him in at 1200, which the surgical nurse told me it was fine if he didn't pee for awhile. I had the patient try to pee at about 1830, even though he couldn't feel like he had to pee. The patient had full sensation back from his spinal (another story all together). The doctor came in at 1845 and was furious he hadn't peed yet. How long is it OK to wait for a patient to pee after getting a spinal?? Any thoughts? I felt terrible!

[ken1955]

Not everyone pees the same. I had a heart ablation done on the 28th of November. the procedure was 9 hours. They put a catheter in for the procedure and it was taking out when I woke up. The 2 nurses one male one female told me if I don't pee within 4 to 6 hours they would have to catheter me. I only pee twice a day and I don't pee on demand. When I go to my urologist I take a urine sample with me. They keep on coming and asking me if I went yet. The female nurse even had a catheter in her hand. She kept telling me she was going to put it in if I don't pee and I told her no your not. Not without my permission. I peed about 100cc about 5 hour later. They finely left me alone I went home and have no problem. No one does anything to me unless they have my permission. I was upset when they put a A-line in me for the surgery. I would have like to know about it. I know they were trying to be safe but tell a patient he told me everything else. Ken

[Kooky Korky, BSN, RN]

I had a patient come back from a TKA at 1500. I'm a new grad, and this was my first fresh ortho surgical that I've had. He received a Duramorph spinal as well as general anesthesia. The patient did not have a foley. I asked if the patient peed in recovery, the surgical nurse stated no. He had 2400 mL of fluids in during the surgery and he was a very large gentleman and had peed before they took him in at 1200, which the surgical nurse told me it was fine if he didn't pee for awhile. I had the patient try to pee at about 1830, even though he couldn't feel like he had to pee. The patient had full sensation back from his spinal (another story all together). The doctor came in at 1845 and was furious he hadn't peed yet. How long is it OK to wait for a patient to pee after getting a spinal?? Any thoughts? I felt terrible!

It wouldn't hurt your prima dona surgeon to write a specific order.

Next time someone has a fit, calmly ask him or her to help you know exactly what they have in mind, as you are a new grad and want to learn the right way.

What was pt's blood loss during surgery? PACU nurse should have told you, but it's on the Anesthesia Record in case you don't get it in Report.