Understanding Urinary Catheters
Learn what a urinary catheter is, why people have one, what aides do and do not do, and what to report on your first day.
Table of contents
A urinary catheter is a tube that drains urine from the bladder. Some people need one for a few days after surgery. Others have one for life because of a spinal injury, a nerve problem or a blocked urine flow. Aides and nursing assistants help care for catheters every day in homes, nursing homes and hospitals. Done well, this work prevents painful infections and protects someone's dignity.
What You Will Be Able to Do
- Explain what a catheter does and why a person might have one.
- Name the common types.
- Describe the aide's role and its limits.
- State the two rules that prevent the most harm.
- Name the signs that need a call to the nurse.
What the Work Looks Like
You do not insert catheters. In most states that is a nursing task. Your part is everyday care: cleaning the skin around the catheter, keeping the tubing in the right place, emptying and measuring the bag if your training and care plan allow it, and reporting what you see. Exact duties vary by state, employer and role, so check your care plan.
Having a catheter can be embarrassing. Use a calm voice, keep the person covered, and do not make comments about the look or smell of urine. Hide the bag under a cover or clothing when you can.
The Types You Will See
| Type | How it works | Your role |
|---|---|---|
| Indwelling (Foley) | Stays in the bladder, held by a small balloon filled with sterile water | Daily care and emptying the bag |
| Suprapubic | Enters the bladder through the belly, below the navel | Daily care, as ordered |
| External (condom) | A sheath over the penis, with no tube inside the body, usually changed every 24 hours | As your training and care plan allow |
| Intermittent (straight) | Put in briefly to drain the bladder, then taken out | Not an aide task |
What Will Hurt a Patient on Day One
Bacteria reach the bladder by traveling up the tube or along the outside of it. Infection is the main danger. Two rules prevent most of the trouble.
Keep the bag below the bladder. A bag that is raised lets urine flow back into the bladder. Hang it on the bed frame or the wheelchair frame, not on a side rail that moves up, and keep it off the floor.
Do not pull on the tubing. A tug can injure the urethra or pull the catheter out, with the balloon still inflated. Keep the tubing secured with a strap or anchor, and check it before you move the person.
Other habits that protect the patient:
- Clean your hands before and after, and wear gloves.
- Keep the tubing free of kinks and loops.
- Clean around the catheter with soap and water, moving away from the body.
- Avoid opening the system. The tube and the bag stay connected unless the care plan says otherwise.
Warning: If a catheter comes out or seems loose, do not push it back in. Keep the person comfortable and call the nurse.
When to Call the Nurse
Report these the same day, and do so right away if the person seems ill:
- Fever, chills or pain in the low back or belly.
- Cloudy, dark or foul-smelling urine, blood or clots.
- Little or no urine in the bag, after you check for kinks.
- Leaking around the catheter.
- New confusion. In an older adult, this can be the first sign of an infection.
- Redness, swelling or drainage at the site.
Tools You Will Use
Gloves, washcloths, mild soap, a leg strap or securing device, a graduated container for measuring urine and alcohol wipes if your employer uses them. Use a container that belongs only to this person.
Your First Exercise
Without any real equipment, sit in a chair and imagine a drainage bag on the chair frame. Stand, sit and walk through a transfer in your mind. Where does the bag go at each step so that it stays below your bladder? Which step would be most likely to tug on the tubing? Say out loud how you would explain to someone why the bag can't sit on their lap.
Check Your Understanding
1. A client wants the bag resting on his lap so it is out of sight. What do you do?
Explain that it has to stay below his bladder to prevent infection, and offer a cover or a leg bag if the care plan allows it.
2. You see very little urine in the bag and the tube has a kink. What do you do?
Gently straighten the kink, watch for flow and report it to the nurse if urine does not start to drain.
3. A new aide asks whether she can try reinserting a catheter that has slipped. What do you tell her?
No. Aides do not insert or reinsert catheters. Call the nurse.
Key Takeaways
- A catheter drains urine, and it can also let in bacteria.
- Keep the bag below the bladder and off the floor.
- Never pull on the tubing or reinsert a catheter.
- Report fever, unusual urine, low output, leaking and new confusion.
- Your exact duties depend on your state, your employer and the care plan.