Urinary cath rant!

[DedHedRN]

I feel like ranting a little bit here.

I am appalled at the amount of times I come on after a nurse who put in a urinary catheter and I have to do it over. Let me go over the main reasons this happens.

1. They didn't see urine when putting it in.

Duh, if there is no urine, its probably not in the right spot. I cannot tell you how many catheters are in the lady parts or sitting somewhere along the urethra track after no urine output. Uh, yes actually I can tell you, how about every time? 99% of pts not in renal failure will have at least 30 mls, enough you can see it in the tubing.

2. Frank blood when inserting.

I hate this one the most. If a pt is bleeding frank blood when you put in a catheter, and they never had frank blood in urine before, its probably because you inflated it in his urethra! Deflate that sucker and advance it a little! Better yet, inflate the balloon slowly and watch their face and ask about pain, it it is painful while you inflate the balloon, its probably in the wrong spot, so don't inflate when in pain, and advance it a little, some men have a very long urethra.

Please visualize the urethra when putting a catheter into a female, I believe this may be the number one reason people are putting them into the lady parts. Also, if you want control of it, hold it very close to the tip, then you can guide it into the urethra much easier. Also make sure you see some urine for Christs sake! If its not there, then something is not right!

Seriously, this is such a easy thing to do, its not that hard for me to come along and do it again, but dang it, think of the pts, those poor poor pts who end up with a catheter stuck in their lady partss for half a day wondering why they are soaking wet! Or the poor guys who now have a 10ml plug in their urethra's! Get it right the first time please!

[SHGR, MSN, RN, CNS]

I have run into catheters placed incorrectly three times this week! I will talk to management about it.

Picture all of us standing behind you backing you up!

[Umberlee]

I tore a young incomplete quad patient's urethra once. I did not insert to the hub (and his anatomy was, ahem, undersized). I definitely got urine return first but wasn't careful about keeping the cath stationary and he must have spasmed a bit as I was chatting with him because it had definitely ejected itself from the length I inserted a bit. I should have put it in further and been sure I secured it to be sure it didn't slip out of place. Anyway, when I started to fill the balloon BOOM, blood, patient starts screaming and crying seeing blood coming out of the end of his member, I panic because this has never happened before, much calamity ensues. Ended up being okay in the end, but after that awful experience I started sticking my tubes in close to or all the way to the hub. Well, then had a female S/P cath client where I stuck the tube in the SP meatus and threaded it in, in, in and didn't get any return--the tube had curled itself perfectly down OUT of her urethra and was between her legs! Wow, was not expecting that.

[DedHedRN]

These nurses are charting that there is no urine when they insert Foley and leave the home, telling family to call night shift if there is no urine. I get called in later because no urine ever goes into the cath bag. Every single time its because its not placed properly. I have redone probably 25 catheters in the past six months. Every time its because they did not place properly, and when I come redo it, I am always able to get urine output. I wouldn't leave a catheter in a pt if I cant get urine output, but that has not happened yet.

[NanikRN]

[quote they insert Foley and leave the home, telling family to call night shift if there is no urine. Quote

Best cath insertion tip ever- came from this site. I apologize because I don't remember the poster but thank you! I helped a nursing student put a difficult cath in last week and it worked like a charm

While area has betadine on it, ask pt to cough. Meatus will "wink" or show sm amt urine.

Thank you unnamed poster

[1fastRN]

[quote they insert Foley and leave the home, telling family to call night shift if there is no urine. Quote

Best cath insertion tip ever- came from this site. I apologize because I don't remember the poster but thank you! I helped a nursing student put a difficult cath in last week and it worked like a charm

While area has betadine on it, ask pt to cough. Meatus will "wink" or show sm amt urine.

Thank you unnamed poster

I'll have to give that a shot. I usually find it easiest to put the little old ladies in trendelenberg, bend their knees n spread em. Best way to get a visual. And always aim up!