Enemas, Catheters , and OTHER embarassing things in nursing school

[RNinJune2007]

hey you guys! I was just going through our list of papers and stuff and for skills that we get "checked off on" during our first semester. They said we would not all get checked off on everything, for example not all would get a chance to perform a catheterization etc.

How do you learn these EMBARASSING thingS?! I mean I keep telling myself obviously it's not embarassing, because it's for people's health. My biggest fear though is "learning" how to do these on real people. Especially on a guy! *SIGH*

I'd love to hear how you learned how to do catheters, enemas (dummies, etc) and then about maybe the story of the first time you performed it on a person to give me a different perspective. I am dreading it!

[GrnHonu99, RN]

Great post! I did my NG tube today and will do enema and cath the end of this week. We also use dummies that are anatomically correct. I have clinicals tomorrow night and am really hoping they don't have me do an NG tube. My school is kinda weird. Once we learn and check-off on the skill we are expected to do it in clinicals.

same with us...some reason practicing on those dummies doesn't make you feel that confident when you are facing a real pt.!

[RNinJune2007, RN]

This has been the question on my mind with doing caths with males... (or anything that deals with handling memberes of men!)

Have you ever had them get an erection? That seems like it would happen regardless, but I haven't heard anyone mention it!How do you deal with this?

Thanks.

[estrogen]

This has been the question on my mind with doing caths with males... (or anything that deals with handling memberes of men!)

Have you ever had them get an erection? That seems like it would happen regardless, but I haven't heard anyone mention it!How do you deal with this?

Thanks.

...Nope, I havent :) It's a rather uncomfortable procedure an not it the least sexy, ya know... And don't forget, on a med-surg floor 99% are going to be elderly, many of them unconscious or confused or demented to the point that they are not really aware of what you are doing. I only did one cath on a young guy in my two years in med surg. He was about 25, his girlfriend was holding his hand and the only emotions he had that were aparent to me, were anxiety and then relief when it was over... I just walked in, matter of factly explained to him what I need to do and why. (ie: I'm going to stick a tube up in your bladder through you member to drain your bladder, because right now it's not draining on it's own. I'm going to use lubricant, It's going to be a little uncomfortable, you might feel some pressure but usually it doesn't hurt.)

If I ever encountered an erection issue, I would probably just say (matter of factly again without trying to embarass the pt.): "You know what? Let's just cover you back up for now and I'll come back later, okay?"

[student4ever]

I'm not even in the clinical program for nursing yet, but I do caths and enemas all the time at my job - and for the most part, it is the patients who are more embarrased than I am. I was embarrassed the one time I had a 90 year old guy tell me that "it's a good thing I can't get it up, 'cause as young and pretty as you are, you wouldn't be able to put that thingy in me - I'd be hard as a rock!!!" The only thing that makes caths harder when patients are embarrassed is that they're most likely not going to hold their legs open wide enough to easily be able to see your "target" - that, and the obese people. Women can be so hard to cath because of their varying anatomical "shapes." Some women have so much labial tissue that it's very difficult to get it all spread enough with just your one unsterile hand so you can see where you're going with your sterile cath. But unless you have a squirmy or combative patient, it's really not that hard - just try and calm yourself down - cause I know from experience, if you're shaking, you'll probably break your sterile field, spill all your lube all over the patient, knock the tray holding your betadine covered swabs all over you, or all three at once!!!! Just relax and know that it will come with experience - and I second the idea that you've got enough things on your mind (keeping sterility, can you see the "target," are you in far enough, etc.) that the last thing on your mind is "Oh my gosh, I have someone's genitals in my hand!!" With enemas, I try and tell the patient to take a deep breath and relax - and as I'm saying it, I will do the insertion part of the task - that way they are concentrating on what I'm saying, and they're not taking a deep breath and WAITING for me to stick a tube in them. I do try and keep them as covered as I can during the process, because I know especially for adolescents, it's uncomfortable enough to have a stranger touching, poking, prodding their private areas without having their whole body exposed in the process of such uncomfortable things.

[Daytonite, BSN, RN]

This has been the question on my mind with doing caths with males... (or anything that deals with handling memberes of men!)

Have you ever had them get an erection? That seems like it would happen regardless, but I haven't heard anyone mention it!How do you deal with this?

Thanks.

Yes. There was a gentleman in the LTC I worked who needed his foley catheter changed every month. The man was kind of a difficult patient and would only let the dayshift supervisor change it. He said everyone else hurt him. We were finally able to get him to let me change his catheter on a regular basis. One time he got an erection and it was embarrassing to both of us. Neither of us said anything. I did talk to the dayshift supervisor about it and she told me that that had happened frequently when she had changed his catheter in the past and that is why she was more than happy to let me do it. I would say that about 1/3 of the time this happened. Years ago we had a comatose young adult in the acute hospital who had some foley problems that required a couple of catheter changes and he got erections every time which freaked out the nurses doing it. Yes, erections happen with catheterizations.

[MIA-RN1, RN]

so...its okay to cath a male if he has an erection? It's possible?

[Daytonite, BSN, RN]

so...its okay to cath a male if he has an erection? It's possible?

Well, I can't say. Maybe a nurse working with a urologist has the answer to that. I know that I cathed the nursing home man a number of times when he got an erection and it never seemed to be a problem--just embarassing, I think, for both of us. I did what I was taught to do years ago which was to inject the 10cc of lubricant directly into the urethra before inserting the catheter so that the tube literally slides into place. The other thing is you have to pull up on the member in order to straighten the urethra so the tube goes in around that bend easier. That is probably why the guys get the erection. :imbar

[Ronold]

I just finished my ER extership and I had to put in foleys on the codes that were coming in. You get used to having people around in the ED during the codes because I would have 4=5 people in the room with me while doing the foley's. Micro caths are great if your just doing a stright cath to get a sample.