I am not a mind reader!!!

Hi everyone, this is more of a vent than anything... I currently work 11-7 shift as a floor nurse on a subacute unit (Subacute/LTC facility). MD wrote an order to D/C foley at 11pm, which the 3-11 nurse did prior to the end of her shift. The order then stated, "Monitor for voiding/do PVR: if 350mL or more, leave Foley in, OR if no voiding after 8 hours, reinsert Foley." So Foley was removed at 10:45pm. I monitored for voiding, and the patient was assisted to the toilet on my shift, but did not void at all. So at 6:45am (8 hours after removal of Foley), I put a new Foley in him. The output was 350mL immediately after insertion.

Usually, in my facility, MDs tend to write the order to D/C foley at 6am (or so) then monitor for voiding during 7-3 shift, when the patient is awake, more active, drinking more, etc., which makes more sense to me. However, this order was very clear in specifying that the foley be removed at 11pm and if no voiding after 8 hours, to reinsert foley. So that is what I did.

However, when the MD came in that morning, she basically scolded me for putting the foley in, and stated that she "intended" for it to be done on 7-3 shift, "some time after breakfast," when the patient was more awake/drinking more, etc. So pretty much, she wanted to wait until around 9-10am or so to put the foley back in if needed.

First of all, I am NOT a mind reader, and I will not ASSUME what you "intended," when the order CLEARLY states to remove foley at 11pm and if no voiding after 8 hours reinsert foley. If I had NOT put in a new foley, wouldn't that have been an error on my part? According to the order?

This is an ironic post ...unless, of course, you expressed these ideas to the offending MD and are just feeling a bit ranty this morning.

In my facility it's God forbid you question the MD... however, after being scolded, I did slip in a little "Well, the way the order was written..."

And yes, I do feel a bit ranty this morning...

Sounds like she meant to write 11 a.m. originally?

Either way - I pleasantly do not accept scoldings for things like this. If there is a concern about what I've done, I will invite the person to review it with me. And I will say, "It looks like you wanted the foley removed at 11 pm? And then reinserted if no voiding after 8 hours? I'm sorry, but I don't know of any other way to interpret what you wrote here."

Step 2: Let it go. I have no more time and no more space in my heart/brain to care about someone's hissy fit when I've made no mistake.