[LanaBanana]

: : Okay, I'm working on a chapter on urinary care right now, which includes catheter insertion. We're not actually going to practice the skill until the fall, but I have the book work now which is making me nervous. Here's the deal : I'm nervous about having to do perineal care on men and catheters. In my CNA clinical I ended up caring for all women. Does anybody else have this issue? I know I'll face it at the nursing home during those clinicals. The hospital where we do most of our clinicals (and where I hope to get hired) doesn't have females do male peri-care and catheters, and vice versa (catholic hospital.) But how do I get over this fear? It's not like I can just go ask a bunch of guys to whip out their penises to let me practice!

[ICURN_NC]

I don't think you can really "get over" this until, well, you do it. During your clinicals ask the instructor/employee/another student to show you their technique. Then at least you won't be alone during your 1st "moment of truth." After seeing/doing a few times, it really won't be as bad, I promise.

And someday, it'll seem like nothing at all! You will have accomplished so many other things that are so much more difficult.

My weird thing: asking pts about their bowel habits. I have just never found a way for me to comfortably ask, "When did you last poo?" LOL

[BirthingBabies]

It's not nearly as bad as you think! I worked Med-Surge for a year and a half as a PCT, so I got a bird's eyes view of those things and most men will just whip it out and never think twice.... haha I have had some make funny comments though during the procedure and I've turned beet red!

[wickedrn]

Lana, I think your reaction is perfectly normal. Just try to handle the situation (when it arises, no pun intended) as professionally as you can. I can remember the first time I had to give a man a bath as a CNA all the other CNAs thought it was a riot and I got teased etc. I just went in there did what I had to do and that was it. I think the patient is just as nervous or embarassed about the subject as you. Maintain a professional attitude you will do all right.

[Daytonite]

Well, Lana, I guess I got over any trepidation I had about men and foley catheters when I worked on a med/surg unit and we had postop TURPs who had to be hand irrigated frequently or their catheters got clotted up. If that happened a call went out to the doctor and the defecation really hit the ventilation! A really nice GU surgeon took a couple of us on rounds with him and taught us everything we needed to know about keeping these catheters open as well as how to cath a male. He was so cool about it that the idea that we were women and the patients were men wasn't even an issue. I would actually rather cath a male than a female--so-o-o-o-o much easier if you know what you're doing.

You have to not let your shyness or embarrassment show. Just act like you've done it a million times. Talk about what is on TV. Drape the poor guy so as little of him is exposed as possible. I always keep an extra towel over his penis until I have my supplies opened and I'm ready to start.

Here's a trick that will save you mounds of trouble. Your nursing instructors may not go for it, but once you have your license I would remember it. The GU surgeon taught us to take the syringe with the 10cc of sterile lubricant in it and inject the whole thing gently into the male's meatus (after cleaning with the antiseptics first, of course). The foley catheter will literally slip through the urethra as long as you are holding the shaft of the penis and pulling it straight up at a 90 degree angle. When you have to insert the large 24 and 26 gauge foleys after TURPs, this lubricant injection technique works really good. Most men will thank you and let out a big sigh when you are done.

Always make sure on uncircumsized men that after you move the foreskin up to clean the head of the penis and the catheter during foley care that you also return the foreskin down to it's natural relaxed position.

I've had only one creep in all the years I've done male caths and foley care, and I had to do plenty in the nursing homes. If it happens you just remain businesslike and don't acknowledge their bad behavior.

[MU/WVUGRADRN]

LanaBanana,
I ditto the posting by Daytonite. I have been a nurse over 30 yrs on med surg units and done lots of urology, and her posting is right on track. Print it off and keep it with you. Best part of her post "Drape the poor guy". This sets the atmosphere from the beginning of the procedure. It shows him you will respect and protect his privacy: no matter how difficult.

I would volunteer any day for foley cath insertion over cleaning someone's dentures.

[firstyearstudent]

As students, we are all doing things that are freaking us out. The penises don't bother me a bit, but I'm sweating IV insertion and we won't even be doing that until next semester!

Just take things one day at a time and try not to get to ahead of yourself. Anticipation makes things so much worse. Try putting this dread out of your mind and then just be present when you get to those scarey places.

Anxiety in new situations is natural. When you feel yourself getting uptight about something, acknowledge the feeling, trudge forward, and don't forget to congratulate yourself afterward on your bravery.

Now, if I could only take my own advice...

[LanaBanana]

Thanks guys! I'm trying not to think about it. But like you've all said it's just something that has to be done and then you move on. After all, as a nurse I'll be dealing with penises for the rest of my career! yippee!

[58flyer]

Originally Posted by LanaBanana

After all, as a nurse I'll be dealing with penises for the rest of my career! yippee!

Lana, Please be careful about being too gleeful about your access to penises. Just remember that these guys (male patients) are placing an incredible amount of trust in you and your professional skills. As a man I don't give privileged access to my body to just anyone. If you talk that way in practice it just sends up a warning flag. It speaks volumes about your maturity level. Guard that trust to the utmost! Just imagine how you would feel about a male nurse cathing you!

[EricEnfermero]

As the previous poster suggested, you have to keep the patient in mind. Being cathed by anyone (much less a student) would probably be a highly stressful event. The patient is likely to be ten times more scared than you are. Tell yourself that if the patient can do it, you can too.