While I was at my last clinical the patient I was assigned had dementia and pulled her foley out prior to day shifts arrival. The nurse taking care of the patient had let me watch her put another one in and was fantastic about explaining the procedure to me. As the morning wore on the patient complained more and more often of needing to go to the bathroom and feeling a lot of pressure. I palpated her abdomen and it was slightly distended and firm. The foley bag only had a tiny amount of urine in it after being in for hours. I was worried about the placement (At that point I had not had a catheter lab and was unsure of the proper amount that was supposed to drain and if you could misplace a catheter.) I alerted her nurse who came in to assess the patient. She told me that the foley was okay and it was probably the balloon that was causing the pressure.
All though I have grown friendly with this nurse and feel like she is a great RN I was uncomfortable and went to my instructor who also came in to assess the patient. Instead of telling me that I was right or wrong she asked me what I thought my best course of action would be. I decided to get the bladder scanner and see how much urine was actually in the bladder before I went back to get the RN in charge of the patient.
As it turns out, I was wrong. There wasn't a huge amount of urine in the bladder, the amount of urine in the bag was normal and I felt like a complete idiot. To make matters worse, while we were doing the scan the RN came in and stayed for the entire time. I was so embarrassed and apologized to her once we were out of the room and said I was out of line for questioning her.
To my complete and total amazement she told me not to ever apologize for advocating for my patient. That I didn't actually do anything wrong and if I was concerned about a patient and felt like something was the matter to always go with my gut and not to ignore a potential problem because I didn't know as much as the person that was in charge. Then she winked and said don't ever question me again though and it was over.
My instructor congratulated on beginning to think like a nurse and even though I still feel like a moron for the whole thing it did end up boosting my confidence in myself.
I know situations like this don't always end up on a positive note and I understand that not everyone would react as the RN did when she was questioned by an SN but it taught me a powerful lesson on what it means to be a patient advocate and learning to trust my judgement (even though I was wrong) when it comes to caring for another person.
