Is it normal to take 4 Tries and Catheters to finally get it right?

Nurses General Nursing

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Oh Lord, do I ever feel stupid. It was my first try at it today. SHE was definately not easy to get at. I was really focusing on the sterile technigue rather then just using 1 catheter tube. BUT, is there anyone else that did this in Nursing School, I feel like an idiot. My instructor was there and she was soooooooooooooooooooooooooooooo sweet about it and very supportive. I could not get it in, I had 3 tubes in her sitting there, all were in the lady parts and finally she said, here let me try, I felt so bad, but the lady was so miserable from other pain, she felt nothing and was so thankful when we got it, because within 5 minutes she had drained 1000CC's of urine. Poor thing.

Do you always get it the first try? After it was over, I kept thinking, I want to do this again and do it right and get it myself, but dang, how much can one person take before enough is enough.

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I can tell you that the the ladies are hard to two. I can do a male no problem. next time have someone hold her apart so you can see better you will do better next time. :)

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Specializes in Med/Surge, Psych, LTC, Home Health.

Let me tell ya, I consider myself pretty good at getting catheters in women, and I STILL rarely ever get them the first time! Ladies are hard to get, especially older ones or overweight ones. Men are much easier, though they can be difficult to get the catheter in if they've had prostate problems.

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Don't worry. It takes a while to figure out what you're looking for. The more you do the easier it is, although having said that- sometimes you may need a few pairs of eyes to help you - some people have unusual anatomy.

My three hints are 1. Spread legs etc apart as much as possible.

2. Take a torch/lamp to shine from below.

3. Look higher - you're looking for the 'twinkling star".

Good Luck next time.

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Specializes in Pediatrics, Nursing Education.

if anatomy is weird... sure it is normal. especially in older ladies, the anatomy can change and the meatus is down farther near the lady partsl area... the effects of having lots of babies!!

i had one where I actually sort of had to hook around to get in there! so don't feel bad...

Men are easy. Ask for a guy next time to build up your ego.

So, in short, don't feel bad! Good luck. :chuckle

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Specializes in Trauma, Teaching.

No, been doing this more than 20 years, and sometimes still get into the lady parts. Jeepgirl is right, sometimes the meatus is so far down that the only way to find it is by touch. I have put caths in little old ladies strictly by feel! If you can't see it, very gently slide your finger down to the top of the lady parts (sometimes in a bit), and feel for a tiny ridge, then go just past it, use the other hand to push the cath along the finger and use the finger to nudge the tip into the ridge so it can't go into the lady parts. This is only for those retro ones you can't see!

It just takes practice, and the only way to get it is to keep trying. You'll get there! :)

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cathing women can definitely be hard- and working in OB, I ONLY cath women. And they're all completely different. Someone told me when I first started that if I could cath a woman right after delivery (all swollen from pushing, sore from pushing & lacerations) then I could cath anyone.

Although last week, I was trying to cath a pt and I could not find "the wink". The midwife was looking over my shoulder and said "go for that" pointing at what I though was the privy parts. I tried over to the side of it first, nothing there, tried her spot and voila!

Getting an extra person in can be so beneficial. Even if you just have someone spread the labia with a couple 4X4s, that can be a great help

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A OB head nurse gave me this tip once. Spread the labia and lift slightly. By lifting, the meatus presents itself better.

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Wonderful advice! I usually will have a helper if I can and have them hold a light for me if I can't find the spot easily. I do the same technique as mentioned about going below the privy parts with labia spread. The light really helps because it can hide really well in folds even well spread...easy to miss.

Another thing I have done on my harder to find patients is I will do a cleaning with cloth and water first...I try to find it then so I know the general spot to seek when I get into my sterile technique. Sometimes that really helps, especially in older ladies where general tone seems to create a lot more folds to contend with.

Don't get yourself down, bring yourself up by giving yourself credit for learning from this, and asking for help! :)

Heck, I felt horrible the first time I put an IV in...oh man so many tries and I was hurting the patient...I finally had to give up and ask an RT to help (he got it time one!).

OH and my first nasogastric tube...holy cow! I was very calm and focused, but once I saw the tube curling out his mouth I about lost it!!! LOL! I stayed calm though, asked my preceptor "any pearls of wisdom about these to make it less time consuming" as she noticed what happened, she calmly took over and even she had a hard time. Turns out he was a stabbing victim (I was in ED), and he was internally bleeding and the pressure was severe, we barely got it in! We got the doc, he went to x-ray and OMGoodness he was filled! Surgery within minutes of x-ray! Okay there was a reason I didn't do well (my first time too!), but I still felt like an idiot! I got over it though...and after that one, heck...piece of cake!

Sometimes it takes a hard one to learn how to really get the job done :). I know I learn more from mistakes or peoples mistakes than not (sounds bad in our career doesn't it..LOL!)...Lucky for me it has been more horror stories from other medics than my own...LOL!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
cathing women can definitely be hard- and working in OB, I ONLY cath women. And they're all completely different. Someone told me when I first started that if I could cath a woman right after delivery (all swollen from pushing, sore from pushing & lacerations) then I could cath anyone.

Although last week, I was trying to cath a pt and I could not find "the wink". The midwife was looking over my shoulder and said "go for that" pointing at what I though was the privy parts. I tried over to the side of it first, nothing there, tried her spot and voila!

Getting an extra person in can be so beneficial. Even if you just have someone spread the labia with a couple 4X4s, that can be a great help

Oh my my my yes. No two women are the SAME! I once had one who had a urethra IN Her lady partsl introitus. YES, so it took me SEVERAL tries to "get that one right". Don't be hard on yourself. I have been cath'ing women for 7 years and still have some cases where I need a 2nd pair of hands to help me out. And I have had to toss cath kits I contaminated doing it "wrong" after years of experience. So NO----You are NOT "abnormal".
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Specializes in Utilization Management.

Oh, don't let that bother you! Some women have strange anatomy. And some men do too.

We spent about an hour trying to cath one poor fella, finally gave up and had to have the urologist come in and do it. Turned out that the patient had a "blind passageway!" :o We felt awful about trying so hard to get it in.

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Specializes in NP, ICU, ED, Pre-op.

A Urologist told me once that if you miss and put it in the lady parts, leave it in and try again. That way you will have a point of reference for where not to go..

Hope this helps

Bobbi :rolleyes: :rolleyes: :rolleyes:

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