trouble with male catheters

[rn-jane]

I recieved a male pt from the er with mental status changes. The placed a foley catheter, that originally brought yellow urine. I guess during the next hour in er the patient was tugging at the catheter and caused it to have bloody urine. When i recieved this patient he was crying in pain, the penile area was engorged and blue in color and there was dk red blood pouring into the foley. Well i removed the foley before talking with the charge nurse. the patient had frank red blood after it's removal for aprox 3 -5 minutes. We tried several times to reinsert and a urologist had to reinsert due to the inflammation, i was told he had scar tissue from chem that caused this problem, not relayed by our er nurse. The charge nurse was nasty the rest of the evening and wrote me up, i know that foley was in wrong, was i wrong to remove it? Need opinions please? I've been a nurse for 8 years in tele step-down/med surg.

[ktwlpn, LPN]

I recieved a male pt from the er with mental status changes. The placed a foley catheter, that originally brought yellow urine. I guess during the next hour in er the patient was tugging at the catheter and caused it to have bloody urine. When i recieved this patient he was crying in pain, the penile area was engorged and blue in color and there was dk red blood pouring into the foley. Well i removed the foley before talking with the charge nurse. the patient had frank red blood after it's removal for aprox 3 -5 minutes. We tried several times to reinsert and a urologist had to reinsert due to the inflammation, i was told he had scar tissue from chem that caused this problem, not relayed by our er nurse. The charge nurse was nasty the rest of the evening and wrote me up, i know that foley was in wrong, was i wrong to remove it? Need opinions please? I've been a nurse for 8 years in tele step-down/med surg.

I think a verbal warning would be sufficient if this is your first incident.......Check your administrative policy and procedures-disciplinary actions have to follow the facilities protocol...A written warning is kind of excessive in a case in which the pt really was not harmed...But-I think that a call to the doc really was warranted--why increase the chance of infection by removing and re-inserting a catheter unless you really have to? A call would have probably gleaned the info regarding the scar tissue and saved the guy a bit of trauma....Again check your policies-is it in your policies that you can irrigate? ....Did you think the balloon was pulled down into the urethra and causing the bleeding? I think I would have deflated the balloon and repositioned the catheter before I would have pulled it out.......I don't know-if I had a fella writhing in pain with a BLUE WILLY :uhoh21: I might just have pulled that foley out....Hind site is 20/20------If I were you I would look into the disciplinary policies and try to get her down to a verbal warning-check with your human resources dept......good luck....of that written warning stands you can write a statement to go into your file with it.....

[meownsmile, BSN, RN]

I agree check your policies. Myself i too probly would have removed the water from the balloon and tried to reposition first rather than taking it out completely. But i didnt see the patient either. You did what you felt was necessary and the urologist was able to reinsert it. It didnt cause him to have to be taken to surgery for a supra-pubic or anything. It's over, dont worry about it now.