"Hospital injury"

A new (to us) Clinical Assistant came in and asked about my husband’s morning hygiene. I explained that I had previously been shooed out to the Socialisation Space while two staff carried out the procedure for him, but that I was willing to observe or assist as I had carried out personal care for him before his hospitalisation and would do so again after his discharge.

The Assistant received approval for me to help this time. All was well until we checked his catheter tube and urethra. There was staining on the pad he had been wearing and an 8 to 10mm tear in the lower part of his urethra. We completed the hygiene and I asked that a doctor be informed. I was told that he would see us shortly as part of his rounds. The doctor agreed with my suggestion that we restart intermittent self-catheterisation (which had been the system at home for the past 10 or 11 months). Some analgesic was applied to my husband's urethra.

Previously two days before he had complained of soreness in that area whilst he was being hoisted into the bedside chair. I alerted the physiotherapists as to the likely cause … his indwelling catheter being pulled by the under-leg sling.

The day before I saw the tear, a staff (I cannot recall which one) member referred to his catheter and some blood. I made the wrong decision to assume that this meant blood in the urine which sometimes happens, rather than investigating further. Had the morning hygiene staff carried out a thorough examination, the source and the cause of the blood would surely have been discovered and remedial action taken. Also that day he was unwilling to do physio, more than likely because of the above, and so a day’s opportunity was missed through this trauma not being identified.