Strict I and O

8 Mar

I just do not understand how Dr Cardiology can write in the same chart on the same patient everyday–“Strict I and O please and document”

What does Dr Cardiology not understand when Nurse tells him that the patient is incontinent especially while coughing? (A river comes out)

We all understand that medicare will not pay for hospital acquired urinary tract infections but this is ridiculous! If you want strict output for very good reasons ie: The patient is on a lasixgtt then please give us, the nurses the green light to insert the catheter! How else will you know if the plan is working? By daily weights alone? Give us a break! Be brave young cardiologist you know the patient needs it.

I mean how is it possible to have a patient, on lasix IV and dobutamine IV in severe uncompensated CHF and not have a foley catheter in, urinating all over the bed half in the bottle half on the chux pad? The output will be documented in number of pads, not volume of urine.

And yet 450 pound chronic pain patient who refuses physical therapy has foley catheter in for days and days and days and days and days. (?) No sense. How did that patient even get a foley cath inserted?

I must have missed a point somewhere. errr.

4 Responses to “Strict I and O”

  1. Wanderer March 8, 2009 at 03:47 #

    It’s better when that order is already part of the admission order set. They have to write it just to prove they’re actually doing something for the patient. Guess they think we shold be weighing the incontinence pads and briefs of our LOL/Ms that can’t seem to hold it in…

    • seejanenurse March 9, 2009 at 01:28 #

      Exactly. Almost like…I know it is impossible but I have to CMA.

  2. Strong One March 8, 2009 at 22:48 #

    The foley order used to be a part of many order sets until the ‘never-event’ days began. H.A. U.T.I.’s are a BIG deal these days. So I feel your pain. It’s amazing how we are expected to do our jobs efficiently with our hands tied behind our backs.

    • seejanenurse March 9, 2009 at 01:27 #

      I know and the worst part is I am not a “foley advocate”, you know the nurse who thinks every patient needs a foley… but there are situations that require accurate output! I want those order sets! Also…I heard that (from a urologist) that we like to call them “infections” but really they are colonized foreign objects inside a body. hmmm….Of course they are going to be infected even when placed appropriately.

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