Incredibly a nurse recently took the bull by the horns a cathed a febrile, elderly nursing home patient for urine and urine culture WITHOUT ME HAVING TO ASK FOR IT!
Seriously though, why are urines mostly sent on young heathy people with no urinary complaints? Simple. It’s the law of Emergency Room Urine which states:
“The likelihood of a urine being sent is directly proportional to the ability of the patient to provide their own urine without assistance regardless of chief complaint”

6 Responses to Miracle

  1. Tog says:

    Well, what else do you expect?

    If it’s easy and fast, we will collect the urine just in case the physician might possibly want the test. If collecting it requires ten minutes of prep and an uncomfortable, invasive procedure, we’re not going to put the patient through that unless we’re sure it is necessary.

  2. ERP says:

    Well I’d like urines obtained when necessary, not when convenient.

  3. Doc says:

    I’ll weigh in too. I just don’t get the wastefulness of sending urines on all these young, healthy asymptomatic patients.

  4. LeShea says:

    That comment was a bit rough…..I am a nurse and I will do those things without an order when I trust the Dr won’t turn on me and deny me the order I need to send the lab or whatever I need to be ordered…I know there are nurses that may deserve that comment but I would venture to say that more often than not the comment was a bit mean and uncalled for …

  5. Tog says:

    I dunno, maybe you’ve got bad nurses. But here’s how things get done in my ED.

    When necessary, it gets done.

    When inconvenient and necessary, it gets done.

    When convenient and *possibly* necessary, it gets done as a bonus, because it’s small cost for a possible benefit.

    When inconvenient and *possibly* necessary, it does *not* get done, because it’s a large cost and still only a possible benefit. If I’m not sure you are going to order the urine, I’m not going to spend half an hour collecting it just for the off chance.

    Besides, I can do a simple urine collection on my own judgement, and order the lab per protocol. But I can’t just go ahead and straight cath somebody without an order. That’s an invasive procedure and my protocols do not cover it. I know most of the docs here aren’t sure exactly what our protocols do and do not cover. How sure are you?

  6. DreamingTree says:

    Most nurses would love to be able to use their own judgement, but if the MD doesn’t back us up, then we are liable. Now, if you were to tell me that you want urine collected under those circumstances, I’d do it everytime without worry. There are lazy nurses, but there are just as many arrogant doctors.

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