Graduate nurse never inserted foley :/

[NikiChiki]

How common is it to be in this situation? In clinical only a few people had a chance to insert (I think 2 or 3 out of 8 in my group). Not only have I never inserted a foley, but I've never inserted or D/C'd an NG tube, among other skills. The only thing I have done is a dressing change, meds obviously, D/C of a foley, D/C of IV, and trach suctioning.

I'm kinda worried about what my preceptor will think when I tell her than "this will be my first time doing ......______"

Any comments would be appreciated.

[Jasano]

Isn't that book knowledge rather than technical skills like inserting a foley?

Yes, but it's still practical and medically based knowledge rather than the "caring paradigm" and "reflective praxis" and other such gobbly gook, that won't help nurses interpret lab values, assist patients, OR insert a foley. All that filler could be filled up with much more valuable things.

[Tweety, BSN, RN]

Yes, but it's still practical and medically based knowledge rather than the "caring paradigm" and "reflective praxis" and other such gobbly gook, that won't help nurses interpret lab values, assist patients, OR insert a foley. All that filler could be filled up with much more valuable things.

I see what you're saying. Thanks for clarifying.

[BigB]

Inserting a foley should be a required skill to graduate nursing school.

[NikiChiki]

Inserting a foley should be a required skill to graduate nursing school.

we did it on dummies but not everyone got a chance to do it in the clinical setting. i do agree with you though.

[Kris10lp]

We are about halfway through our LPN program (graduate in June) and done with our second clinical and I have not yet seen an actually Foley or NG tube. A few people in our clinical have. We have to be checked off in the lab on the dummies that's what is required to graduate. They say they hope to get everyone to do at least one actual one before we finish. I am concerned about making sure I get to do it so I am going to remind my next clinical instructor that I still need to do it. With all those students they have asked us to remind them if you still need to do something and they will keep a look out for it.

[flwannaB]

We are in week 7 of our program. So far we have learned Bolis feeding, NG tube insertion, wound cleaning and dressing, IV drip calculation and rate, Foley cath insertion (today) and of coorifice all of the fun ADL's. Next week we will be doing injections. As I stated before, I am only in week 7. I am very surprised that they do not teach you those skills.

[Mandylpn]

we did it on dummies but not everyone got a chance to do it in the clinical setting. i do agree with you though.

:bowingpur Niki: OK! thankfully you did insert one in a dummy in lab, I was just going to ask you if you had at least been checked off on that! :chuckle I was lucky enough to do a female cath with my preceptor and have since done a couple on the job.

[epiphany]

We do enough catherization that sterility is a must. For women, I look for the meatus before starting the procedure, to limit fumbling around. Then, I like to open the labia (or pull for the foreskin) in one move with my non-sterile hand and keep it open as I clean and insert. To help me with this maneuver I use a pair of sterile gloves that fits me snugly, rather than what comes in the box, which is often too loose and awkard.

I never put in an IV till I started work either, but it's only scary the first few times. Find someone you feel comfortable to guide you if you can, and don't let yourself be rushed. The first few times, I was sloooww, but it was important that my technique was perfectly sterile. Hope this helps.

[MeLisPsaN]

catheterization is nothing. Just bring another expierienced nurse with you and have him/her walk you through it. It always helps if someone, for women, holds the labia apart for you so you can see the urethral opening. Also, make sure patient's knees are up so the entire perineal area is exposed.

it'll take a few attempts/times but you'll get it. :)

[Wind_Dancer]

I think it's pretty common, as one already said here. While ideally it would be wonderful if each student in a class could do each procedure once, but that doesn't always happen. There may not be enough patients that need a catheter. There are many, many procedures that you won't do in school but will learn how to do on the job. The best thing to do when you get a job is to admit you've not done a certain procedure before but you have watched (do that as often as possible) and studied (that too) and want to learn. Never attempt to do a procedure by yourself if you are not experienced at it. Ask your charge nurse or supervisor to go with you to assist or be a guide for you when the time comes.

At the hospital where I worked for years, doing the more common procedures was part of a new hire probation. One had to do a procedure three times satisfactorily with a supervisor or charge nurse then it was signed off and you were free to do one on your own. Let me give you a tip....you can do hundreds of these things but that doesn't mean you will always be successful. Despite what the textbooks say, you will eventually run into an oddball patients like I did a couple of times. One had a double urethra (eeny meeny miney mo?) and one's meatus was so low it was practically inside her lady parts. We frequently worked in pairs anyway...one to hold the flashlight and one to do the procedure. Trust me. You will need that flashlight many times...even in the middle of the day.:imbar

[NikiChiki]

Thanks for the tips!