The time is 1:20 am, and I can't sleep. I am bothered by what I did with my patient's condom catheter.
At first, I did what a good nurse should; I explained the need for the procedure, made the patient comfortable, cleaned and dried the genitalia, changed the condom catheter (etc). Everything went fine.
After 30 minutes, the patient called because he " accidentally" pulled off the c.cath. So I taped the sheath back into place, tightened it a little, and reminded him to care for it. But the thing was that he kept calling for the same concern over and over. He won't let anybody but me to do what has to be done. On the 4th time within just an hour that he called for a nurse, I sent the Nursing assistant to check on him; and there he was caught removing the velcro tape. Still he insisted on requesting for me to put the thing back.
I knew I am patient and considerate, but that time my shift was to end in an hour and I still have a lot of documentations to do.
Even so, I went to this patient and said in a very professional manner that he's being manipulative and I won't tolerate it. He smiled and said that I should be enjoying each time I get to hold his genital instead of complaining because it is my job to give "pleasure" to my patients. I felt insulted, really, that I taped his pubic hair to the sheath. He did not buzz anymore.
I know it will be really painful each time he attempts to pull off his condom catheter.
I endorsed it to the in-coming nurse though.
I cannot rationalize for what I did. I feel guilty.
Do you also do things like this with patients who in all means are suppose to be understood and cared for by their nurse?
Whoa, some posts here are against what you did!! I find myself sitting here, thinking, Gee that was a nice get back for what he said to you!! I WOULD DO IT AGAIN TO THAT BASTARD!! Am I wrong, I wouldnt feel guilty at all. I do think Im a fairly nice person if you dont screw with me like he did. Does this make me a mean person to think this way?? Hey thats just the way i am! You did great!
Do not feel badly,we have all had that type of manipulative pt,and you may have actually saved him more pain in the long run! by him continuously having the condom changed or maneuvered he could easily have irritated the skin to the point of an open sore...compared to having pubic hair pulled out once. I had a pt who had hx of occasional retention,and had talked doc into writing for straight cath prn. Well,he would call for the nurse at shift change,check us out for desirability I guess,and if we met his standards he would call every 30 mins for a straight cath,and would be waiting in bed naked and "happy" :imbar! First I educated about infection and what he was setting himself up for by demanding this this frequently,it went nowhere:banghead:. We had 1 male nurse,and the staff quickly agreed that when pt X called for straight cath we would send in the male nurse...he called once,refused when he saw a man show up,and after a few times he got the picture...
Hm, not what I would have done or what I would recommend, but certainly not the worse crime against humanity. Could you have gotten an order for a Foley? I doubt he'd be pulling out a Foley for attention....
Specializes in psychiatric nursing, med/surg adult care.
Hm, not what I would have done or what I would recommend, but certainly not the worse crime against humanity. Could you have gotten an order for a Foley? I doubt he'd be pulling out a Foley for attention....
Thank you. My patient is on IVF challenge. Fluid I & O is strictly being monitored. He is post CVA with residuals, left hemiplegic and is incontinent. He refused indwelling foley catheter insertion, thus the order for condom cath.
I'd have probably done the same. Gotta do what ya gotta do to keep the thing on, and if it takes taping it to a "stickier" area, then that's what you gotta do.
Remember a middle aged guy that had trouble holding his member in his urinal, well, that is until we started sending a male tech in every single time he called. That cured it quite nicely.
Specializes in psychiatric nursing, med/surg adult care.
I'm wondering if some of his behavior could be driven by his neuro status.....
That's a possibility.
Then was his 3rd day of admission, 2nd day in c.cath. His nurses before he was assigned to me didn't encounter a similar problem but noted that the patient tend to argue and complain a lot.
Sigh...
Persons under the sign of Virgo are truly intelligent and logical. Cheers to you!
After the 2nd cath came off, especially if you were reasonably cetain the pt was doing it deliberately, you should have called your supe, and the MD. Let them know what is going on. Do not let any other pts waste you very precious time in this manner. And document everything. "CNA observed patient was removing the velcro from the condom cath when she entered the room. Pt is AAO, and understands what he is doing"
OMG, I can't believe that you would do something so terrible to a pt who is post CVA. He obviously didn't know what he was doing and you should have the compassion to go back into his room and gently replace it each and every time and re-educate him.
I'm wondering if some of his behavior could be driven by his neuro status.....
Probably not. Seems like he knows what gives him pleasure. Take it for what it was- sexual harrassment. Should be reported to manager and some male should go in and read him the riot act. We happen to have a male director of nursing which works out perfectly.
Do not feel badly,we have all had that type of manipulative pt,and you may have actually saved him more pain in the long run! by him continuously having the condom changed or maneuvered he could easily have irritated the skin to the point of an open sore...compared to having pubic hair pulled out once. I had a pt who had hx of occasional retention,and had talked doc into writing for straight cath prn. Well,he would call for the nurse at shift change,check us out for desirability I guess,and if we met his standards he would call every 30 mins for a straight cath,and would be waiting in bed naked and "happy" :imbar! First I educated about infection and what he was setting himself up for by demanding this this frequently,it went nowhere:banghead:. We had 1 male nurse,and the staff quickly agreed that when pt X called for straight cath we would send in the male nurse...he called once,refused when he saw a man show up,and after a few times he got the picture...
lina.561
171 Posts
Whoa, some posts here are against what you did!! I find myself sitting here, thinking, Gee that was a nice get back for what he said to you!! I WOULD DO IT AGAIN TO THAT BASTARD!! Am I wrong, I wouldnt feel guilty at all. I do think Im a fairly nice person if you dont screw with me like he did. Does this make me a mean person to think this way?? Hey thats just the way i am! You did great!