Saturday, September 22, 2012

Catheter

I put in my first urinary catheter today. Hey, I'm a late starter.

I was trying to arrange transfer for a dialysis patient who I've come to know well. Speaking with the physician on the phone, I was on top of things - I knew his vitals, knew his blood results, knew all of his medications. Hell, I even knew what kind of car he drove (not that they asked).

And then the physician threw me with one question.

"Is he making urine?"

I heard him tell the nurse that he passes urine, so I answer "yes".

"How much?"

He doesn't pee in a bottle near the bed. He doesn't have a catheter. He goes to the bathroom all by himself. It isn't measured.

He's a dialysis patient, so I hazard, "minimal amounts?"

"Then why is he on dialysis if he's still producing urine?!"

"Because ... the renal physicians started him on dialysis?"

And then he tells me the patient will need a urinary catheter before he's transferred. I quickly set up and tell the patient what's happening. I do all the right things - sterile technique, clean the 'area', lignocaine gel, catheter. It's all straightforward.

Except there's no trickle or gush of urine through the catheter. The bladder is empty.

I feel bad for the patient who's now got a catheter in his willy for no good reason. I've just made a fool of myself, but that's nothing new. But then I see it - a tiny little blob of urine sitting in the catheter. If that's not "minimal amounts", I don't know what is.

1 comment:

PTR said...

Gee, and I thought I was dodgy - not doing a catheter until my first day of internship. Luckily I had a 4th year student handy to show me how!