For overseas nurses especially those who are used to American way of practice be aware that trial of void does not involve clamping of the urine catheter tube. The approach of bladder training in Australia is different, when you see a note or your team leader inform you that your patient is on trial of void, do not immediately clamp the urine cath tube. Ask if you are not sure on how to do it in this country. Trial of void here involves removing of the urine catheter, and encouraging the patient to drink ample amount of water. Providing them a urine bottle or pan for you as a nurse to measure it. You should monitor the urine output of the patient after four hours, if no urine output after that, DO NOT panic. Majority of nurses in Australia immediately panic that the patient never pass a single drop of urine. Assess the patient, ask them first, do not force them to urinate. You can wait for 6-8 hours for the patient to pass urine, if no urine coming out, then do bladder scan. Make sure that when you perform bladder scan, you know how to read it. Remember, the white spot should be at the middle of the target symbol. If you do not know how to do it, ask someone. Once you noticed any residue that is normal, inform the team. The patient might need to have the catheter reinserted which is very inconvenient or encourage to open the bladder not literally means of surgery, but pass urine.
What are the disadvantages of the trial of void practice here in Australia:
- Early removal of catheter, possible reinsertion
- Uncomfortable for the patient
- Urinary bladder retention
- Patient might refuse reinsertion of the catheter
Other countries approach of trial of void.
Mostly, in other countries, trial of void is by way of clamping the urine catheter tube. Informing the patient of the simple test. Once the patient have urged to open the bladder, the nurse will unclamp the tube, and then repeat it for the 2nd time and third time. Once the patient was able to pass urine at the accepted level, the catheter will then be removed. Simple and not to much trouble with patient.
Advantages of the bladder training as practiced in other countries:
- not that so uncomfortable to patient
- does not require reinsertion of catheter after the trial of void
- save the government from too much waste in the hospital equipments that is unnecessary