suprapubic catheter

[bubbacat]

Need help deciding if I was wrong or not. In my LTC facility where I work we have a resident who has a s/p cath. I was pulling a double last night and in the treatment book it was (s/p cath) designated to be changed with an 18FR. I being a fairly recent grad, & never have done a s/p cath change went to the policy and procedure book to look up s/p cath's. In the book it states under responsiblity as licensed nurse but in parathensis (reinsertion requires physician). I did not change the cath out, my reasoning was the p & p book, and since state is ready to come in on us, how would that look if I did it? I notified the next shift which they were kinda crappy about it and said that the normal night nurse changes it every month. I told them fine if that nurse wants to change it let her, but I am not risking my license. Was I wrong?

[suzanne4, RN]

You were completely within your limits if you had never changed one before.

[leslie :-D]

just like feeding tubes, they can be replaced by nurses, IF they were not surgically implanted. usually these catheters have the balloons that you need to inflate once you insert it, but i have come across a couple that were sutured in. you showed very sound judgement in not doing it.

[TMnurse]

I wouldn't worry about it. You did the right thing. Don't feel bad as changing an SP isn't life or death as long it's flowing correctly. Talk to your manager about changing the written policy.

[jkaee]

You followed policy....therefore you did the right thing. If you're not sure, if you're not comfortable, and if your supervisor isn't there to help, then don't do it. Who cares what the other nurses think!

Talk to your manager about revising the policy, also, finding out how you can tell if the s/p cath is sutured in or if it's just a ballon catheter holding it in place. Not that you see them a whole lot, but it would still be useful to know for any future admits. I can see that "regular" night nurse just yanking the darn thing out on a pt. that has it sutured in. You can never be too sure, and you acted soundly. Now let the NM worry about revising the policy so that you can do it next time.

Good luck, and don't worry!

[bubbacat]

Thank you all for replying. I feel like I did the right thing by not changing it out, and I plan to talk to NM on monday about the policy.

[burger914]

While on the S/P tube subject..I have a question. I know it differs by facility,but what is you protocol for when to change the tube..If they aren't blocked?

[bubbacat]

I spoke with the DON & explained the situation with the policy manuel. She said she doesn't know why it is in there but she will take a look into changing the policy. She wanted me to tell the "regular" night nurse to change it tonight. I did, but the nurse said she wasn't going to change it tonight, she will at some point in time later. She also said we have an order to change it once a month. I still haven't found that order. I guess I will speak to the DON tomorrow again & tell her I will change it out, since she (DON) knows the situation with the policy. I will also document after changing it that the DON is aware of the change. In the treatment book it says to change with 18/fr as needed for malfunction. Obviously they need to change the policy and the treatment book.

[CapeCodMermaid, RN]

I spoke with the DON & explained the situation with the policy manuel. She said she doesn't know why it is in there but she will take a look into changing the policy. She wanted me to tell the "regular" night nurse to change it tonight. I did, but the nurse said she wasn't going to change it tonight, she will at some point in time later. She also said we have an order to change it once a month. I still haven't found that order. I guess I will speak to the DON tomorrow again & tell her I will change it out, since she (DON) knows the situation with the policy. I will also document after changing it that the DON is aware of the change. In the treatment book it says to change with 18/fr as needed for malfunction. Obviously they need to change the policy and the treatment book.

I wouldn't change it if your P+P says not to. Your DON's word isn't the same as the P+P.