Enemas, Catheters , and OTHER embarassing things in nursing school

BETSRN · Aug 22, 2005

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!

Catheterizing a male is a lot easier than doing a woman, I can assure you. You'll learn.....don't worry. Just take any and every opportunity you can to get all the diverse experiences that are available to you. The first tie you do anything is tough.

How do you think docs learn? They learn the same way................see one, do one, teach on. That's the way we all have to get our experience.

Daytonite, BSN, RN · Aug 22, 2005

We did a lot of procedures on each other: bed baths, occupied bed linen change, transfers from bed to chair and back, repositioning each other in the different positions (recumbent, Fowler's, prone, left and right side lying position).

We practiced doing TPRs and blood pressures on each other in our nursing skills lab. We gave our first intramuscular injection to another student before the end of our first semester. I still remember it! My thumb was shaking so bad I could barely push down on the plunger to inject the normal saline into my partner. My goofball partner decided she wanted to do a Z-track injection on me. Instead of injecting the saline, removing the needle and then letting the traction on the skin go, she injected the saline and let go of the traction. It hurt while she took the syringe out. I was so-o-o mad at her. We were among the first few couples to volunteer to demonstrate the injection to our instructor so we wouldn't have to sit around and worry about it. It was interesting to watch how the other students were handling their anxiety over it. My first actual patient wanted his shot of Demerol in the arm (deltoid muscle) and I freaked because I worried about accidentally hitting the brachial nerve in his arm.

I think I did two catheterizations on patients during nursing school. I learned how to do male caths about 3 years after graduation when I worked on a unit that had a lot of post-op TURPs (Transurethral Resection of the Prostate). The surgeon that did them personally showed each of us how to cath a male without causing a lot of discomfort. He shot the entire 10cc syringe of lubricant into the patient's urethra and then inserted the catheter. They went in quick as you-know-what through a goose!

I learned how to suction and do trach care in the second semester. The hospital had a long-term patient that needed suctioning and trach care and we all got our turn with this patient. A very kind respiratory therapist was watching me struggle to get a suction catheter down the nose of a patient and showed me how to do it with a minimum of discomfort for the patient. This also applied to inserting nasogastric tubes. HINT: look at a picture of a side section of the mouth and throat to see exactly the course the tube will take and point the tip of the tube downward.

For enemas, we did one (without fluid) on Mrs. Chase (the dummy) in the lab. I worked in a nursing home after graduation and got plenty of experience with these! Just follow the steps of the procedure.

I've been a patient a couple of times. I guess the most embarrassing thing is to be catheterized or have an enema. At least with an enema you won't be having the patient looking at you. It was really nice if the nurses used blankets to cover me up except for the immediate "target area" and made me feel like I was as covered up as I could be. It's cold when you're lying in a bed with your skin all exposed. I had a colonoscopy last year and I swear that when the nurses were getting me turned on my side and I was waiting to be sedated my behind was covered the whole time.

Every student has different experiences because each gets different patients. Even if you don't get to perform all the different procedures you are going to study, don't fret about it. The people who hire new graduates know that this happens. The main thing is that you understand the principals of asepsis and sterility and you apply them to procedures as appropriate. Don't be a wallflower. Keep your eyes and ears open when you are in a clinical area. If you hear about a procedure that is going to be done, call your instructor and tell her. If you're lucky you may end up being the one doing it. Perfection of any procedure is due to performing it over and over and over. . .

Danianne · Aug 22, 2005

In terms of caths...how painful is it for patients? Do they have a hard time dealing with the pain?

It is not usually painful so to speak but more uncomfortable for them unless of course you inflate the balloon too soon. :eek:

Fun2, BSN, RN · Aug 22, 2005

It is not usually painful so to speak but more uncomfortable for them unless of course you inflate the balloon too soon.

It is somewhat painful, but I agree with the earlier post of saying that usually the patient is in so much pain or sick, they really don't care.

I think I was told to do deep breaths as well for the one when I was not sedated.

blue eyes · Aug 22, 2005

I mean I keep telling myself obviously it's not embarassing, because it's for people's health.

That's pretty much what our lecturers tell us we're usually told that it's 'all for the patients comfort'. re: Bed baths, showering someone enema suppository and anything else that might be embarrassing/feel awkward-

Btw, we're doing enemas/suppositories this Thursday in lab (as well as bladder, bowel, adn specimen collection). :uhoh3:

MIA-RN1, RN · Aug 22, 2005

>

Daytonite, I have a specific ? re: male caths.

A tech I work with puts lidocaine on the cath of men w/ prostate troubles, he said it numbs it and makes it more comfy for the pt.

Aside from the obvious legalities of a TECH administering meds, have you seen that technique used?

Thanks.

Daytonite, BSN, RN · Aug 22, 2005

A tech I work with puts lidocaine on the cath of men w/ prostate troubles, he said it numbs it and makes it more comfy for the pt. Aside from the obvious legalities of a TECH administering meds, have you seen that technique used?
Thanks.

Yes. What does he do, carry a tube of it in his pocket? It takes a doctor's order to get it. He really should have an order for each patient he uses it on if it's not in the policy and procedure manual that it's OK for him to use it when he caths males. We used Lidocaine Injectable for numbing IV sites before inserting an IV. We were supposed to get an order for each patient we wanted to use this on because the hospital would not include it in the official policy for starting IVs. But, we all carried a vial of it. You just hate to throw a good thing away. (I'm being funny here.) :chuckle

Works2xs · Aug 22, 2005

It is somewhat painful, but I agree with the earlier post of saying that usually the patient is in so much pain or sick, they really don't care.

ROFL. Probably more accurate to say too sick or injured to be ABLE to care. I know when I had this done I was in so much pain I was praying for someone to knock me out or hand me a sharp object to open a vein (hell, even a spoon would've been welcome!). I might not have been up to saying too much but rest assured, as soon as the word "catheter" was said, I was intensely aware of what was going on.

All kidding aside.. speaking from the male point of view, it's more the fear and uncertainty of the procedure. Embarassment regarding being exposed takes a back seat to the worry about somebody doing something unpleasant to a rather important (to us anyway) part of our anatomy. Think about the times you've heard a nurse threaten, "Sir, if you don't give a urine sample, I'm going to have to cath' you."? It's not the fear of embarassment that motivates.

So, like any uncomfortable procedure, use all those caring, confident, ect. skills to help your patient. Personal modesty seems to act inversely proportionally to level of sickness and/or pain. Well... for me anyways.

MejiaStudentRN · Aug 22, 2005

I have a wonderful husband who actually let me practice catheters on him. Enemas too. Now if could just talk him into NG tubes and IV starts I'd be set.
Melissa

:bow: WOW! I could never get my husband to do that, He would have to be unconscuious before he would let anyone -stick anything- anywhere! :sofahider

MejiaStudentRN · Aug 22, 2005

It is not usually painful so to speak but more uncomfortable for them unless of course you inflate the balloon too soon.

Unless it is a male with an enlarged prostate! Than you can almost expect tears :bluecry1:

estrogen · Aug 23, 2005

You received some wonderful input here, but as you can kind of see from most of the posts here, after a while (but I would say from my personal experience almost immediately with my first or second clinicals) nurses don't think about the fact that "they are holding a STRANGER'S member in one hand while inserting something in it with the other, allthewhile they are making eye contact and are having a conversation!!!" That's what a NORMAL PERSON would think about, but nurses think about aseptic technique, proper procedure, the patient's reaction an how to chart the whole thing. :chuckle It's almost some kind of instinct, second nature that you automatically acquire as confronted with the situation. Now that's a good thing because it helps us to remain professional, set aside any feelings of embarrassment and discomfort and hence put the patient's feelings at ease.

As I said, it happens almost automatically with your first procedure... At least for me it did. And I had the same feelings as you have going into it.

pinkdiamonds · Aug 23, 2005

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.