Ever have a patient comment on his lack of size?

58flyer · Mar 27, 2008

I felt so embarrassed. :imbar
I had to cath this man who was in his 40's, he ended up having to go for emergency surgery, he was in agonizing abd pain with a perfed bowel. When I went to cath him he managed to mentioned that it was all shriveled up. (Incidentally, he actually appeared to be a normal sized male)................

Just out of curiosity, was it known when you cathed him that he was going to have surgery? If so, then why not wait until he was under anesthesia before placing the cath? If that were the case, it would have saved him some pain and embarrassment, and saved you from having to deal with an comfortable situation.

FireStarterRN, BSN, RN · Mar 27, 2008

Just out of curiosity, was it known when you cathed him that he was going to have surgery? If so, then why not wait until he was under anesthesia before placing the cath? If that were the case, it would have saved him some pain and embarrassment, and saved you from having to deal with an comfortable situation.

No. He had a PRN cath order, and nightshift reported that his HR was increased because he was trying to urinate. He was in excruciating pain with HR in the 130-140's at that time. So, first thing I did was cath him because he was unable to void, with a 500cc return.

After that his HR still continued to climb, I informed the surgeon, who was trying to have him transfered to a larger hospital, and he decided to do the surgery here. He had been perforated for probably a week. We are a rural hospital.

leslie :-D · Mar 27, 2008

I'm sorry that the general opinion of the anecdote as presented, is that my preceptor was some kind of barbaric nurse who should have her license revoked (not your post Leslie) for her participation. However, the usual response to this would be to provide enough details so that the rest of the nursing world could understand the behavior of the two nurses involved. I'm not going to do that because the details are such that people don't need to know them. The phone calls involved, the physicians involved, the particular social situation of the patient in question, all had some impact on the way the events unfolded. None are relevant here except that if I hadn't been there, if I hadn't taken numerous actions to protect that patient, he would most certainly have been in worse shape than he was during and after the catheter insertion.
I regret that such bad thoughts are being had towards my preceptor but she is and was, a very good nurse. Many people have been helped by the examples she set for me. The man who to this day, was the worst catheter insertion I have ever seen, enabled me to be a better nurse because of what transpired. I guarantee you no patient of mine will have that happen again, but I also won't say bad things about my preceptor and I won't bring the story up again here. If we can't vent, tell a few stories (identifying info left out), and learn from each other then what are we doing on this bulletin board, eh?

thank you, indy.

i wasn't aware there were extenuating circumstances.

and i'm equally relieved to hear that you recognize the atrocities of the implications.

i appreciate this post, and you.

leslie

Code_VSA · Apr 4, 2008

I went to cath an elderly gentleman. Was gathering all my equipment and explaining what I was going to do. Right as I picked up the catheter he said, "I'm not very big down there." Thinking he was anxious, or might have a stricture or some weird hypospadias going on....I looked at this urethral meatus in my left hand, checked my foley catheter size, and said to myself, "No, this 16 F will go in easily." Out loud, to allay his anxiety, I said, "No, your average just like everyone else." I slipped the catheter in....no problem. But then the gentleman said in a most eager voice, "Really??" Still not catching it I said, "Yes." Looking at him he had this little smile on his face and was looking off dreamily. I'm thinking, "what's up?" As I was cleaning up I took a really good look at his member, just not the urethral opening and realised he had a very small member. Bless his heart.....for once I was happy there was miscommunication. I had made his day.

harley94xl · Apr 4, 2008

I felt so embarrassed. :imbar
I had to cath this man who was in his 40's, he ended up having to go for emergency surgery, he was in agonizing abd pain with a perfed bowel. When I went to cath him he managed to mentioned that it was all shriveled up. (Incidentally, he actually appeared to be a normal sized male)
The surgeon actually wasn't sure if he was going to survive surgery, but he did come back with an A-line, CVP line, and a brand new ileostomy. On the second day I had him, he managed to go more in depth into the fact that he "doesn't have much down there that any girl would be interested in" and comments like that. Honestly, this man was totally average looking.
He was a very gentle man, mid 40s, gainfully employed, who still lives with his mother, who was really nice. I just didn't know how to handle this. I think this must have been a life long insecurity. I almost said to him that he wasn't actually small, he really wasn't, but I didn't want to act like I really notice this. But, I do have vast experience with this aspect of nursing, I do notice if a man looks either unusually larger or smaller than the average, and this man definately was actually probably better than average, especially since he was in a cold hospital room in agonizing pain.
Anyone ever run into this issue?

Being a male nurse, I can't say I ever have run into that issue. :lol2:

But, with that being said, I have had female patients (older than I am) make comments about how good looking I am. :uhoh21: Oh well, I guess that is life sometimes when you are dealing with people.

ToxicShock · Apr 4, 2008

Wow, I have no idea what I would have done in this situation, but I'm sure it probably would have been inappropriate like, "don't worry, honey, it's not the size that matters, its what you do with it", haha.

Ok kidding, but I think you handled the situation as well as can be expected. Maybe next time you can say, "try not to worry about that, I'm not here to judge you, I only want to help you get better" or something along those lines.

I think most men have some kind of insecurity about their size, especially with all the emphasis ON size, with stupid ExTenze commercials, Viagra and Cialis commercials, and Media. I think every guy I have ever dated has had some kind of preoccupation with their size, and these guys (most of them) had perfectly normal, abuse-free lives.

RNfor26 · Apr 5, 2008

How about the other side of the coin? I have worked on a Surgical floor for years and given discharge instructions which include lifting restrictions. I have had more than one man ask me, when told not to lift more than 10#, how will I go to the bathroom? :nono:

One particular patient comes to mind. He was a very sarcastic "gentleman" who had a TURP. While I was removing his foley I attempted to keep him covered as much as possible. He pulled up his gown and said, "You can look if you want." I pulled his gown back down and said, "Don't want to."

Later, while giving discharge instructions, he used the "how will I go to the bathroom" line. I said, "Remember, I've seen it and it's not 10#."

Unprofessional? Perhaps but his wife thought it was tremendously funny and almost peed her pants laughing. :chuckle

rnheart · Apr 7, 2008

oh thank you so much I work in ob as well and that is exactly why