question about foley catheter insertion

suzanne4, RN · Feb 5, 2005

Hi! I just got home after working tonight as a tech on a med-surg floor. I am a senior nursing student and saw something tonight that I am questioning! I have done a couple of foley's before and I swear that I thought that if you "miss the hole" then you are supposed to get a new one because it is then contaminated from being in the lady parts. Well the nurse that I was helping missed the urethra SEVERAL times and just kept fishing until she finally got a return. No wonder this woman has an infection!!! She has to be cathed every pm. So anyway, I am right on my thinking or can you really do that?
Thanks!!!

Once it has been inserted, it is considered used and needs to be replaced, if it didn't get to its proper place. If it didn't go into the urethra, then it other touched skin or went into the lady parts, which contaminated it either way. The nurse that you were with was 100% in the wrong.

ItsyBitsySpider, BSN, RN · Feb 5, 2005

That's just bad news. I was taught that if you go in the wrong hole you leave the cath in and get a new one and insert it then remove the first. Has anyone else been taught that way?

Tweety, BSN, RN · Feb 5, 2005

You're right and that nurse was wrong.

safewaygreenbox · Feb 5, 2005

I work on a urology ward and ItsyBitsySpider is right. If you insert it into the lady parts by mistake you leave it there to help guild you with the next catheter then you take the original one out.

Kay x

lisamc1RN, LPN · Feb 5, 2005

Definitely, if you contaminate, you get another catheter! That poor woman! Is there something you can do about it? Can you report the nurse? She needs to be retrained or something because she is most likely infecting her patients!

CNM-to-be · Feb 5, 2005

That's just bad news. I was taught that if you go in the wrong hole you leave the cath in and get a new one and insert it then remove the first. Has anyone else been taught that way?

This is exactly how I was taught. All I can say is I feel sorry for that poor pt.

safewaygreenbox · Feb 5, 2005

Well, I wouldn't go as far as reporting her. Perhaps you could show her an article with research relating to this area or have a chat when you are alone together. That is what I would like a student of mine to do if she were unhappy with anything regarding my practice. Then take it from there.

Thats what I think anyway.

Kay x

jennielynn · Feb 5, 2005

As a first year nursing student--I'm learing that things aren't always done on the clinical unit the way we are taught in class!!! You are right--you leave the cath in and get a new one. This way you won't "hit the wrong hole twice". You take the mistaken one out after you get the cath in properly! I've seen RN's do this without even using sterile technique. I cringed the other week while watching an RN clean a fresh abdominal wound with an alcohol wipe--and not aseptically either!

studentnurse74, LPN, LVN · Feb 5, 2005

I see this happen ALL the time. I questioned a nurse about it, and she told me they were expensive. :angryfire

cnolan · Feb 5, 2005

I see it all the time- the first time I did was actually when a fellow student of mine did it in clinical! It was awful- I had had the patient the week before, and she was a VERY VERY modest woman preacher, who, I'll admit, was quite quite confused and was in severe stages of dementia.

At any rate, my clinical instructor had a male student nurse attempt to put the foley in, and for 1, the woman resisted and asked for a female nurse, a request that was denied due to her being "confused". Now, confused or not, this poor woman had rights! If she was with it enough to ask for a female, then she was with it enough to get it. But other than that...So, my instructor, Rich, had Brandon insert the foley, and my friend Emily and I hold this woman's legs apart. They inserted it into her lady parts and didn't start over.

Two strikes against both of them, eh?

That was last year.

This year, I attempted to put one in a woman who's anatomy was definatly ... less than text book! I missed, and went to waste the contaminated foley, and the nurse who was with me took it, with NONSTERILE gloves, redipped it in the lube, missed twice and finalyl got it in.

No wonder 50% of nosocomial infections are UTIs.

~*Charity*~

ASN Student

Semester 4/4 U. Pitt-Brad

Bring on graduation, baby!

Fiona59 · Feb 5, 2005

If its an in and out cath. you don't always need to use sterile technique. Most people who self-cath at home don't use sterile anything, many even wash out the catheter and reuse it. They do cost a lot if you are facing a life time of use. Not all insurances will fully cover a year's worth.

Used to work a day program and was always told if they or a family member cath. at home we could use clean technique. And no we didn't have a high UTI rate.