Thursday, October 17, 2013

It's a Drain
One of the physicians who worked at our hospital was an older urologist. He was notorious for the bloodiness of his T.U.R.P.s. Transurethral prostatectomy is a procedure where the physician passes an increasing diameter instrument that has a roughened surface much like a file or rasp up the urethra and removes bits and pieces of a man’s prostate gland.

 through and through catheter was placed up the urethra and allowed fluid to be instilled to flush the bladder and empty into a catch bag. The fluids that drained through the catheter after his procedures were always dark, grossly bloody, and filled with clots. Even with the irrigation and continual flushing of the bladder, we had to manually irrigate the system with a Toomey syringe to keep it open and free flowing. If we didn’t flush frequently, the clots would block the catheter, the bladder would fill, and the pressure would cause the patient increasing pain. Each time we would round, we would describe what the urine would look like and the work that we had done to keep the catheter open and patent.

One patient, on whom he had done surgery, was a good friend of his. When he rounded the next morning, Angie, the assistant head nurse was with him. He pointed to the bloody drainage bag and roared, “Why wasn’t I called last night about this bloody urine!”
Angie wasn’t intimidated at all. She looked down through glasses perched on the tip of her nose at the drainage bag, then looked the physician in the eye and said, “Frankly doctor, I don’t see any difference with this patient than your others.”
With his tail between his legs and chart under his arm, cowed he left the room.

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