I harmed my first patient today.

[starwarrior]

I am a nursing student, and I made my first mistake. My clinical instructor gave me permission to remove a Foley catheter on a male. I've done several times before by myself. Long story short, I deflated the balloon and pulled back on the syringe to make sure all of the saline is out. After I was sure the balloon was deflated I tell the patient to take a deep breath in and let it out, and as he exhaled, I pulled the catheter.

When I pulled it out I saw blood. It was not a lot but it was enough for me to be concerned about. Also, my patient was in pain.

I cleaned him off and called for the nurse. And she assessed him and said that everything was going to be fine. I apologized 1000 times to the patient. He was understanding and said that it did not hurt that bad.

I informed my clinical instructor of the situation. And we went through the steps that I had taken to see where it went wrong. All I could do was cry. I just harmed a patient.

Later that afternoon I checked on the patient again to make sure he was feeling okay. He reassured me that he was fine, and said that I should not let this weigh on me.

I feel terrible for causing the patient pain.

This is the first time I've ever messed up. I thought I took all of the correct step, but I still caused my patient unnecessary pain.

Please offer any advice or words of wisdom that might help me learn from this and move forward. Again I was taught to attach the syringe, let it fill with NS, and then aspirate to make sure there is no more fluid left in the bulb. If you have another technique that will prevent this from happening again, please share!

[BuckyBadgerRN, ASN, RN]

Oy. You didn't HARM a patient. At most, you hurt him and you're going to do that a thousand more times in your nursing career. Blood draws can hurt. IV starts can hurt. Inserting an NG tube is unpleasant. Heck, removing an IV dressing is going to cause some patients to cry.

Your patient told you several times that he was fine. Take his word for it and move on. Truly

[Libby1987]

What did the catheter tip look like to you? Besides the little bit of blood.

[kaylee.]

You seem like a very sensitive person, I am the same way. I hate pulling tape off people! As you continue on you will discover many things you have to do that either directly or indirectly cause pain to patients. For me I have had to work on better managing my sensitivities and emotions for the sake of the patients and my own mental well being.

A few months back I had a patient with dementia who required an emergent cardioversion. He was chattering away blissfully unaware while we were prepping him. When I asked if she wanted me to get morphine, to pre-medicate him, the cardiologist said she felt it was too urgent. So all of a sudden she shocked him...and immediately he started screaming and pleading and crying, and was repeatedly saying he didn;'t know what he did, and that he was sorry, and he would behave better, just as long as we didn't "do that again!" In his confused, child-like state, he thought he was being punished for something. Anyways, it basically broke my heart. I will never forget it. I just kept trying to comfort him as we wheeled him to ICU.

I had a really strong reaction to inflicting his pain, while others involved didnt notice. Which kindof made me mad. But I buried it all away in the moment because I needed to be fully focused on the emergent situation...Thought about it alot after though. Sorry about the personal tangent, it just came to my mind after reading your post.

[lunchboxRN]

Did he have the foley strapped to his leg? Foleys can be irritating to the urethra just from the friction caused when moving around, turning, and so on.

We have to cause pain in the course of helping people heal, whether it's turning a hip fx pt q2h or cleaning and packing a wound. I try to 1. medicate prior if possible 2. warn them it may hurt 3. do my best to be gentle 4. distract them with conversation if possible. It sounds like you are an empathetic person, that's good! Don't lose that, but don't let it stop you from doing what needs to be done for the interest of the patient.

[djh123]

From your detailed description, I didn't see where you did anything wrong. You say in one of your replies further down that apparently there was a little saline left in the bulb, but you said you'd tried to aspirate it after the first time you emptied the syringe. It's good to be very concerned, but you did your best, asked for help when you thought something was wrong, and as another person or two said, you didn't do anything wrong on purpose. And you learned from the situation.

[dianah, ASN]

Removing the foley cath hurt the patient.

It did not HARM the patient.

Sometimes as nurses the tasks we are required to do WILL hurt the patient. Occupational hazard.

We can forewarn the patients and make things as easy as we can.

Lots of good replies here. :)

[starwarrior]

Thanks so much for sharing your experience. That would have broken my heart too! I am sensitive. I know if I don't take control of my emotions the very thing that I love will turn out to be what drains the life out of me!

[canigraduate]

I am saying this for your own good and please take it as intended.

You cannot freak out anytime you hurt a patient. It is our job to hurt them to make them better.

You have to stab them to start an IV line. You have to hurt them to change dressings.

Just keep in mind that what you are doing to hurt them will result in greater good for their condition.

If you freak out every time you hurt a patient to help them, you are going to spend your entire career miserable, unless you find a job with no patient care included.

[starwarrior]

Did he have the foley strapped to his leg?

He did have the Foley strapped to his leg. I used an alcohol swab to decrease the amount of pain the patient might experience from the adhesive.

[TamiRN]

No worries, you did not intentionally hurt your patient and he said he was ok. This will not be the last time you may cause your patient some pain. Next time tell the patient " this may cause some discomfort," before hand so they know what to expect.

[starwarrior]

you learned from the situation.

I have learned a lot from this situation! I am very grateful for your (and everyone else's) support!

[starwarrior]

Next time tell the patient " this may cause some discomfort," before hand so they know what to expect.

I warned him that it may cause some discomfort. From my experience (which isn't much), it isn't painful to pull out. Usually the adhesive hurts worse than pulling out the catheter. I was alarmed when it was painful to my patient, and especially when I was blood!