For some reason I have difficulty placing foley catheters; I have been a nurse for 5 years and work on a floor that most of the patient come up from the ED with one placed. When I dod need to place one I seem to have a problem; which makes me feel inadequate; does anyone have any litlle tricks or suggestions thanks so much for your input

Well, it never hurts to have someone else in the room with you--even just to help position the patient. Sometimes that makes all the difference in the world.

Get everything--and I mean absolutely everything set up. I attach the syringe and inflate the balloon to make sure it inflates and then leave the syringe attached so once the foley is placed--voila--I only have to push the NS in.

I have put patients in Trendelenburg before if I had a hard time seeing.

Turn the bright lights on and say a prayer

if you do a search on these forums, you'll find a lot of advice. To me the key is practice. Spread the word that you need to brush up your FC skills and in anyone on your unit has one to be done to let you take a crack at it. When cathing a female before i even unwrap the foley i like to take a look at the anaotmy - i hate going in blind and trying to locate the urethra with sterile gloves and slippery betadine covered skin. Males are of course easier because there is only one option -but the prostate may be enlarged or there may be a narrowing of the urethra causing your problem. I find that a little pressure at teh base of the member seems to get the tough ones in. Also reminding your patient to relax and take a few deep breaths is incredibly helpful - often the problem is just them being too nervous.

Sometimes for female insertions, I like to make them cough, you will see the meatus open and close...then go for it!

Always take 2 caths to the bedside with you, if you catheterize the lady parts leave that cath in place to help you visualize the anatomy. Elderly women may have abnormal landmarks with the urinary meatus actually in the anterior lady partsl wall. Practice.

i have very little experience with foley caths also.....is it painful to the patient ???

praiser :heartbeat

Always take 2 caths to the bedside with you, if you catheterize the lady parts leave that cath in place to help you visualize the anatomy. Elderly women may have abnormal landmarks with the urinary meatus actually in the anterior lady partsl wall. Practice.

yes, i bring 2 caths as well.

and op, spread that labia...open it to its max capacity (up and out) and get a good grip (it's slippery).

support their tush on a pillow, so hips are positioned slightly upwards.

an assistant holding a flashlight, is often helpful too.

but the most helpful for me, is to really spread open the labia.

you just can't miss it this way.

leslie

i have very little experience with foley caths also.....is it painful to the patient ???

praiser :heartbeat

insertion can be uncomfortable. some nurses use a sterile lidocaine jelly for the lubricant in an attempt to improve comfort, i am not sure of the efficacy of this practice, but it sounds nice. if the patient is alert and cooperative the controlled breathing can be helpful. if they are too young or confused to understand...just get er done as quickly as possible.

i have very little experience with foley caths also.....is it painful to the patient ???

praiser :heartbeat

not "painful" but yes, it's uncomfortable.

i warn my female pts, they'll get this incredible urge to pee.

leslie

I bring 2 catheters, a flashlight, and a helper to hold the other leg. Some of the float nurses I work with say you can find the urinary meatus with your finger then slide the catheter down your finger and into the bladder. I have never tried it before. When I have a sneaky meatus I aim upward toward the bellybutton and usually find it.

Some of the float nurses I work with say you can find the urinary meatus with your finger then slide the catheter down your finger and into the bladder.

oh my gosh, your post reminded me of when i was a new grad in hospice, and a pt had a new onset of vag or rectal bleeding...

i didn't know the source, so i inserted my (gloved) finger into her lady parts, and it came back bloody.

when the nm found out what i had done, she flipped on me, saying how inappropriate it was to use my finger.

ever since then, i have NEVER used my finger on that part of the anatomy...

but to this day, am not sure if i was right or wrong.

my point being, i wouldn't use my finger to find the meatus...

only because my nm said no.

leslie

oh my gosh, your post reminded me of when i was a new grad in hospice, and a pt had a new onset of vag or rectal bleeding...

i didn't know the source, so i inserted my (gloved) finger into her lady parts, and it came back bloody.

when the nm found out what i had done, she flipped on me, saying how inappropriate it was to use my finger.

ever since then, i have NEVER used my finger on that part of the anatomy...

but to this day, am not sure if i was right or wrong.

my point being, i wouldn't use my finger to find the meatus...

only because my nm said no.

leslie

This was a new one for me, leslie. As you can imagine, as an old OB nurse I have assessed many a lady parts with a gloved finger. I am not certain what the rational was for her concern (unless she expected that there could be some risk of increasing the bleeding) but would be interested in hearing it...

I have located the urinary meatus within the lady partsl vault by finger touch, without incident. In fact, the first time I did it the little lady told me it was the quickest and least uncomfortable catheterization she had ever had...probably cuz it was so fast once I located the meatus.

interesting.

Denise

For the female insertion I recon the meatus. Before I open up the sterile stuff I get the pt ready and in position. I do a good peri care or if she/he can I ask them to. Next for the female I just say I am going to make sure I have the right area to insert the foley and use a flashlight to get a visual on the meatus and get help if need be. Evere since I take the time for the visual no problems.

On another note I had to do an insertion on a pt with foreskin the other night. Make sure to gently get the head of the member out before you attempt. I know this sounds remedial but for some reason I forgot the other night and had to get a second cath. Definatly worth it to bring two in as previously mentioned.