Female FOLEY

  1. Please help!!! I completely stink at female foleys. I work in the OR, and before that, I didnt get a chance to do them a whole lot. I guess I have an advantage, because the pt is not moving, but I cant find a urethra to save my life and it is so embarrassing!!!! Please give any tips or tricks or just plain blueprints if you can....thanks:imbar :imbar :imbar :imbar
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  2. 13 Comments

  3. by   Rose_Queen
    One of the tricks that several nurses in the OR where I work is to use a prep stick to mark the vagina if the urethra isn't obvious.
  4. by   epiphany
    I don't know how to search the threads, but we had a foley thread where a lot of good tips were discussed.

    Don't get discouraged. They are not always easy to spot and look different in different women. I find that when you clean the area, it shows up (someone mentioned "winks") because the meatus pulls in the dark betadine.
  5. by   Daytonite
    A trick I learned from many years of working in a nursing home is to have the patient turn on their side. Have an assistant hold the upper leg in the air and forward, supporting it. By looking at the vaginal area from the back, and spreading the labia, you can often see that little elusive urinary meatus. It helps if another assistant uses a flashlight as a spotlight for you, as well.
  6. by   ortess1971
    I'll share a few tips that several people have given me...
    -you may need someone to put on sterile gloves and help retract, especially on the bigger patients
    - You probably do this but I use the OR light to help me see better.
    -A GYN surgeon told me to "aim high". You can usually find the urethra fairly easily if you start high up.
    - I also have seen the prep stick idea used, but I usually reserve that for the difficult ones
    - I never use the gloves in the kit-I open up a pair of gloves in my size, plus I think the ones in the kit are chintzy
  7. by   leslie :-D
    i've done hundreds of female caths and if anything, i have learned is many are not anatomically correct.
    i usually bring 2 catheters in w/me.
    if i don't get an immediate return (of urine), then i 'feel' for the cath tip pressing against the bladder wall.
    the catheter will keep on advancing if you're in the vagina.
    if you're not sure, keep one catheter in and use the other for the remaining meatus.

    and yes, side lying position gives a more distinct view.

    leslie
  8. by   weetziebat
    I had to insert a foley cath. today and, yes, it was embarrassing. Had to have another nurse help me with anatomical landmarks and I still aimed too high. It was were I would have thought to find the vagina.
    Dear Lord, how can I be a nurse for this long and still not be able to find something I've got?!?! Guess I should have spent more time in gynecology!
    I like the tip about the Betadine to mark the vagina but we use cotton balls with Betadine poured over them, and there are plenty of 'dimples' but darned if I can figure out the right one.
    Next time I'll try the sidelying position, if I happen to be with someone who can assist.
    No help to you, but plenty of empathy!
  9. by   NurseCard
    If it's a patient that's awake and laying in bed, if they can stand it, I have them lay flat. It seems to "stretch" that area down there a bit and makes it easier to work with. I had an instructor one time tell us that it helps, again if the patient can stand it, to sit their rear end on a bedpan. Again, seems to help stretch all of that area out and make that urinary meatus kinda stand out a little better. A flashlight or other bright light helps. Also, if all else fails, aim high, thought some people, like mentioned before, are not anatomically correct.

    I never was good at starting IV's, but I did get pretty good at putting foleys in females. I sometimes volunteered to do them for other nurses' patients.
  10. by   CoffeeRTC
    Wow...I just had to cath a 97 yr old pt and let me tell you...I'm normally the pro at my facility. My biggest life saver is to have help with the positioning, bring a second cath and when they are older....remember it aint always the highest spot.
  11. by   AngelsRN
    If I miss and get the cath into the vagina, I leave it there -- look a little above and go in with the second. Usually this works for me -- plus I always have an extra person iwth me who holds a flashlight!!
  12. by   nursebuxom
    here are my tricks - get the hips up up up! put an upside down bedpan or a couple of pillows under the hips, just like going to the gyn, and let those butt cheeks hang down.

    hold the girl open with one hand, wipe front to back and look for the wink.

    put a sterile q-tip in the vagina to mark it

    if you still don't see it, put your longest finger into the vagina while holding the catheter tipalong the front wall of the vagina, it will probably find the meatus all by itself

    and if you can't get it in, go UP in cather size, not down, and 18 is less flexible than a 16 and will go in easier - promise!
  13. by   babynurselsa
    Sometimes (IF the pt can tolerate it) Dropping the hob down. Kind of like trendelenberg helps also.
    Our instructor in nursing school always said "aim for the rosebud". If you look quickly after you swipe with the cottonball down the center you will see that elusive "wink"
    Good luck.
    Practice, practice,practice. Do every one you can. This also increases your comfort level.
  14. by   leslie :-D
    Quote from nursebuxom

    if you still don't see it, put your longest finger into the vagina while holding the catheter tipalong the front wall of the vagina, it will probably find the meatus all by itself
    i would NOT advise inserting ones' finger into the vagina.
    that is totally inappropriate.

    leslie

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