I had a patient who was scheduled for discharge with an indwelling Foley catheter (IFC). Since the catheter was due to be changed the following day, I decided to replace it prior to discharge. I’ve only done 2 female catheterizations up to this point.
I removed the existing catheter without clamping or kinking it beforehand to retain urine in the bladder. About three minutes later, I inserted the new catheter. However, there was no urine return even after advancing the catheter fully. During balloon inflation, I constantly asked whether they feel pain or discomfort. The patient did not report any. After gently pulling the catheter back until resistance was felt to secure the balloon, the external catheter length appeared similar to the previous Foley that had been removed. This happened approximately one hour before the end of my shift.
Later, mere minutes before my shift ended, I went back into the patient’s room and noticed there was still no urine in either the tubing or the drainage bag. The patient did not have IV fluids running for about a day already, only on heplock, and was only waiting for ambulance transport for discharge. I did not recheck the catheter placement before leaving.
Now I’m worried that the catheter may not have been inserted correctly, and I have a bad feeling it may have been placed in the vagina instead of the urethra. What should I do? What if the patient was already discharged?