Nursing Error

yes. If the patient was tensed up good enough or has a sphincter issue, or perhaps cath size needed to be smaller, then you may have irritated the lining of the sphincter. As long as the bleeding slows down--pink tinged in 1-2 hours--then not really an issue. Longer, the MD needs contacted. Make sure that you documented this.

I don't know if I would call this a nursing error ....maybe an unexpected consequence......

Sometimes things don't go the way we planned. No procedure is without risk.

Has this ever happened to you or are you speaking of an experience that you've heard of. This has never happened to me. I am freaking out!! The doctor was notified and she stated that she wasn't giving any orders because it was close to 5pm on a Friday afternoon and instructed family to take pt to the hospital if need be but the family didn't feel it was necessary. I, on the other hand, did!!

I have worked to hard for my license to lose them! Plus, the fact that I'm a worry wart doesn't help either!!

I've had it happen before, a few times in fact. As I said in my original post, document this, and watch to see if the bleeding slows down. Contact MD if needed, etc. You won't lose your license over this.....take a deep breath, relax. Just make sure that the patient is kept comfortable, not freaking out, and explain as best as you can--I know some spina bifida patients have learning difficulties and it can be difficult to explain, but I know you'll do your very best. Really, it's okay.

Thank you so much!! You don't know what that means to me!!

KCB007

Anyone inserting a catheter can cause trauma, so don't feel bad. Catheter trauma is a risk associated with catheter insertion and urologists who work with patients who have neurogenic bladder are well aware of this problem. The patient's urologist should be notified that the patient had hematuria post cather insertion. Likely, the urologist will arrange for the patient to have a cystoscopy in a week or 2 to assess the trauma and rule out whether or not a stricture or false passage was created.

The cystoscopy is usually done about 1-2 weeks after the trauma to allow enough time for healing to occur and to prevent further bleeding when the cystoscope is inserted. It is important for the patient to know if there is a false passage or a stricture before resuming intermittent catheterization.

One final tip, sometimes it is better to let patients who self catheterize insert their own indwelling catheter because they are usually very experienced with their own body and can tell if the resistance feels unusual and this makes them less likely to cause urethral trauma.

Kindest regards

Dishes

Well this pt does not do self caths. The doctor sent an order for an indwelling foley to be placed. I'm not this patients primary nurse. I was only trying to help out another nurse because she was busy at the time and needed someone else to place the foley for her. Well, after all this is said and done, I call the primary nurse and let her know what happened, she comes over, we contact the MD, and the primary nurse removes the foley. Blood comes pouring out. It starts to slow down and then stops. The primary nurse placed the foley again and gets more blood and urine back. So she then thought it was best just to remove foley and have pt transported to ER but the family didn't want to take the pt to the ER, even though we both, the primary nurse and I, suggested them to do so. But the pts father use to be an MD and felt that going to the ER was not necessary. But what bothers me is the fact that this happened to the pt about 3-4 weeks ago in the hospital, per the family, and they failed to tell us about it until after the fact.

Well it doesn't sound like an emergency. I would just monitor it to see if the bleeding stops. Is the pt on coumadin. I would be concerned then but if it stops then no reason to go

No, they're not on coumadin. It's just that I've always taken pride in taking good care of my patients. Now I feel like I've failed!!

You did take good care of him! :)

An unexpected outcome happened during the same exact care you've given before without any unexpected outcomes. It happens!

it happened to another nurse i worked with and a doctor told her to irrigate her foley with normal saline. can this be done with your patient?