Hello, all my wonderful colleagues. I wanted to ask some of you a question. Why would I need to disconnect a one-way Foley to instill normal saline into the bladder for an ultrasound as opposed to just clamping off catheter tube and waiting for the bladder to fill on its own?
I was wondering why do this just for convenience of the ultrasound technician? Is there something I don't know that I should? If I am wrong, please tell me. I'm not very experienced (2 years experience) and haven't seen a lot. So, if I'm wrong, please tell me. I won't be offended. Here's the scenario.
One of my co-workers had a pt. that was supposed to have an ultrasound of the bladder done. I guess she forgot to clamp the catheter before the ultrasound tech came up or didn't know the patient was supposed to have one. Well, when the ultrasound tech got there he stopped me and asked me about the patient. I went in and saw that she had the foley and proceeded to clamp it. He was like, "I am getting ready to go home, I won't have time to wait for her bladder to fill up. They usually just put about 300 ccs of saline in the bladder." Since that was something I had never heard of or was never taught to do, I went and asked my co-worker about it. She told me to just put sterile saline in through the foley. I told her that the patient didn't have a 3-way foley, so how would I do it. She told me to just disconnect the drainage tube from the cathether and instill it.
Now, I was reluctant to do such a thing for two reasons. One reason was because the patient was unresponsive. The other reason, the MAIN reason was because I felt that was a big way to introduce pathogens to the urinary tract very easily. For liability reasons, I refused to do that and clamped the tube and told the US tech he would have to just wait. Do you all think I did the right thing? I mean, I would be liable if she got a urinary tract infection as a result right? And I didn't have a doctor's order to do so.
I just really felt that it would put the patient at risk for infection just for the convenience of the US tech. There was another tech coming in to relieve him. I didn't see why do that when the oncoming tech could come and do it when the bladder was full. If it had off been a 3-way, i would have had no problem doing it. But since this was a one way, I was scared. Should I have been? Please, your input is needed. Thanx to all who reply. :balloons:
Specializes in ER, OR, PACU, Pre-Op, Recovery, Med-Surg.
I can't do this with you crying, lady partsl muscles are strong and you could crush my hand." A few minutes later she stearnly says, "Ok either we are going to do this or we aren't those are your only options." I asked if i could drink a buntch of water really quick and she snapped at me saying they didn't have time for that. So in goes the catheter and they fill it with saline and I kept saying it felt like I was peeing and they said, "no your not your fine." Afterwards when it was over my whole back side was soaking wet and the table was wet from where saline leaked everywhere. Then the x-ray tech comes in and says that she noticed my bladder wasn't emptying well
Well, I'm not sure what happened here, but your nurse was an idiot. First of all, lady partsl muscles would never be strong enough to crush a hand. Secondly, proper catheter insertion does NOT involve inserting the hand into the lady parts! On 90% of women, the ureter opening (where your pee comes out) is outside the lady partsl opening, and slightly above it. Now, she was right about one thing: in an emergency situation, there is not enough time to drink a lot of water for the ultrasound. Worst case scenario, if the baby was found to be in danger, you may be rushed for an emergency c-section. There was a reason you were in the ER, and it's better to be safe than sorry. Now, the feeling that you need to pee is caused by having the tube in your ureter. And it is normal to have that feeling when the catheter is in. I have often have elderly or confused patients wake up, not realizing that they have a catheter in and telling me that they need to pee....and I tell them that they already are peeing- the catheter continually drains the bladder.
The one thing I am confused about is that you mentioned the saline leaking out on the bed, and the tech mentioning that your bladder wasn't emptying well. I'm not sure exactly what could have caused this, and the only thing I can think of is either the nurse screwed up and inserted it into your lady parts instead of your bladder....or that the little balloon that keeps it in place wasn't inflated enough and saline leaked around the sides. Any of you nurses have any other ideas? I haven't run into that problem before...
KimTheRN
7 Posts
Well, I'm not sure what happened here, but your nurse was an idiot. First of all, lady partsl muscles would never be strong enough to crush a hand. Secondly, proper catheter insertion does NOT involve inserting the hand into the lady parts! On 90% of women, the ureter opening (where your pee comes out) is outside the lady partsl opening, and slightly above it. Now, she was right about one thing: in an emergency situation, there is not enough time to drink a lot of water for the ultrasound. Worst case scenario, if the baby was found to be in danger, you may be rushed for an emergency c-section. There was a reason you were in the ER, and it's better to be safe than sorry. Now, the feeling that you need to pee is caused by having the tube in your ureter. And it is normal to have that feeling when the catheter is in. I have often have elderly or confused patients wake up, not realizing that they have a catheter in and telling me that they need to pee....and I tell them that they already are peeing- the catheter continually drains the bladder.
The one thing I am confused about is that you mentioned the saline leaking out on the bed, and the tech mentioning that your bladder wasn't emptying well. I'm not sure exactly what could have caused this, and the only thing I can think of is either the nurse screwed up and inserted it into your lady parts instead of your bladder....or that the little balloon that keeps it in place wasn't inflated enough and saline leaked around the sides. Any of you nurses have any other ideas? I haven't run into that problem before...