Conflict

Have you ever been in a sticky situation, where it called only for split seconds to make decisions? I often find myself doing that.


I once had to do a straight catheter on a man who had urinary retention. He'd been calling all shift for assistance to the bathroom, each time with zero output. Bladder scanning revealed 306ml of urine. I obtained an order for a straight catheter, which would immediately empty his bladder and offer relief. I was right INSIDE, about 4-5 inches, when a CNA slowly knocked on the door and whispered to my ear, "Sorry to interrupt, Cherie, but whenever you are done, Ms. X in Room So and So had died."


WHAT? The nearest nurse was a floor away. I told her to call the Supervisor. BUT at the same time, I had to do something, immediately. Pronouncing the dead was one thing. Making SURE that the person was truly deceased was another. To top it all, leaving the present procedure you are doing right in the middle of it just complicates everything else. What to do?


The urine by now was NOT flowing. (And to this day, I wonder why. Catheterization is a very easy procedure, and one I'd done countless of times prior to this incident.) I inserted a little more. Thirty seconds more. None. I decided to withdraw, and explain to my patient that there was an emergency. I said I was going to be back as soon as possible.


I rushed to the said room with my stethoscope, and did my assessment. The patient in Room So And So was really gone. I pronounced her dead by 1:45am. The Supervisor did not show up till after 20 minutes after that. I couldn't have waited that long.


In the meantime, no action from Mr. Catheter's room. Then, about 30 minutes after I left him, his call bell rang. The patient had GONE on his own, for some reason. My earlier poking must have stimulated his bladder, and as a result, he went and WENT, wetting his bed, and everything. By this time, he had also been waiting for me. But the CNA and I were busy with the body. And then I had to do the necessary notifications. It was all bad timing. The CNA rushed to him as soon as she was done. I was fortunate to have worked with a good one.


Needless to say, the gentleman was not very happy. To him, I would always be the nurse who left him, and from that day onwards, would not allow me to do any catheterization on him, although he would let me stick his arm for blood work.


Looking back, given the same unfortunate circumstance, I don't think I would have hesitated to do exactly the same thing. But it is instances like this that leave me bothered, wishing in my heart that things could have happened differently, but also knowing that just at that very moment, couldn't. And I am often left feeling bad about myself, sorry for the whole sick situation.