Second guessing myself after watching foley catheter insertion video

[Elizabeth K.]

I'm going back to school after working in the real estate industry for about 18-19 years. I have KNOWN-- since high school -- that I wanted to be in a career where I would make a difference in people's lives. I'm looking into nursing for several reasons (in no order of importance):

1) Don't need to have a four -yr degree to work as an RN. This is important for me as I am single Mom who needs to work. A 2-yr degree will already take me longer than 2 years -- probably 4 to 5 years with prerequisites.

2) job diversity : working in different units or even outside of hospital settings

3) good, stable income once I get a job: I currently work on 100% commission and, in some months, I make ZERO. I'm just tired of worrying how much money I will make from one month to the next.

4) greater possibility for me to move and find a job elsewhere ...something that is very difficult to do when you work as a commission loan officer

5) I like the idea of possibly working 3 12-hr shifts and having time during the week to do something else p/t

6) greater sense of making a difference in this career ... I think about being there for a pt who doesn't have any family visiting him/her, assisting with the delivery of a baby and seeing parents cry when they meet their child for the first time, helping to save someone's life in the ER, playing with a sick child and making him/her laugh, etc...I do realize that these are all nice thoughts and that there are many moments with patients that aren't happy, but when I think about these things, I get EXCITED and feel a sense of gratification that I do not get in my current career.

7) fast-paced job : I get bored VERY easily, so I LOVE working in a fast-paced environment. My gf is a nurse and says she hates working in the ER because it's too chaotic. I, on the other hand, get absolutely giddy at the thought of being in the middle of all that action.

So, I took the plunge and enrolled in a CNA course today for 2 reasons: 1) It will give me a good feel as for whether or not I really do like working with patients. 2) I can also get a p/t job and that income will come in handy right now since the real estate market is so slow.

When enrolling, I was told there is a CNA II class and one of the things they teach is foley catheter insertions. I looked up a video on youtube and now I am second-guessing myself. I had an idea of what it was because I had one when I gave birth to my daughter, but I looked up the video to be sure I was thinking of the right procedure. I watched it and freaked out!!!

When the procedure was done on me, it wasn't painful because I already had the epidural. It was either that or the contractions were so painful anyway that I didn't really notice the pain from the catheter insertion (if there was any pain at all). Well, now I am freaking out about the thought of having to perform the procedure with a pt and me causing them pain!!!! I don't like that part. It makes me cringe.

I've come to terms with the idea of dealing with the gross stuff like blood, urine, poop, vomit, etc ... I just really don't like the idea of me being the person to cause a pt pain. I don't mind anything to do with needles because the pain is over so quickly. I'm not so sure about inserting foley catheters, though!!! I want to help make people feel better -- not hurt them!!!

Can anyone tell me their experiences with how they handled this procedure when it was new to them? Don't you feel bad when it hurts the patient ??? Do most RN's end up having to do this procedure or do CNA's end up doing them most of the time? Are there some units where the procedure is never done on pts???

This one thing is making me wonder if I'm just not suited for nursing!!!

[Elizabeth K.]

Thanks to all for the replies. I feel SO MUCH better about it now! :nuke:

[UM Review RN, ASN, RN]

Wait'll you have your first patient that hasn't peed in 15 hours, or who's been awake for days dribbling milliliters of urine past an enlarged prostate.

You check with the bladder scanner and see over 800 ml of urine in the bladder.

A Foley can actually be a relief!

[sandywinter]

i am not a nurse, i am a optician, but have been on the side of needing a foley, as i still have it. three months now. its been awfull, i have had them in the past, they always made you flinch. but sept. i went to er, thought i had flu, had obstruction, in my bladder they said, the biggest bladder they ever saw. i went in to renal failure. the dr said, picture one two liter bottle of soda, plus almost a seconde. almost died they said. lucky my kidneys etc.. all came back to normal, i was in renal failure, sepsis, etc.. but the nurses tried and tried with the foley. i screamed , never did in the past...they called a urologist in, he dilated and then put it in, i felt like he cut me in half. if was horrible. becuase it was so rough, had blood for two weeks in my urin... now between a new primary dr. and new urologist, no one gives me pain meds, its been awfull, i cant even sit up without having pain, and the tests they have done in office, completely made me break down, scream and cry..and i think most of the nurses have been awesome. one made me feel worse, and said , it doesnt hurt. four foleys in one day.i am raw, have had three infections in three months. feel lilke broken glass inside me, i think its the obstruciton issues, asprin does not help. went to er three times, they gave me pain meds, i could at least function...they without even talking to me, pretty much decided to put the cath. in my stomache, its put above the hair line,.still have to deal with the foley. i just couldnt empty my bladder in the past. but they only had it out one day. and i was so raw ,,i couldnt try to self cath...and still no pain meds. i keep thinking how barbaric, i cry all the time, lost my job, cant walk around ,cant do much, going to be homless more than likely...they will not help me with pain meds, first they said, because of the tests they were doing no false readings,,so i did all the tests, falling apart, and now they are done, but will not give me any relief...because they said they dont want me dependent, IT kills me. they are all going home enjoy their evenings, and holidays, and i cant sit up, without feeling like i am being cut, and for them to say finally, ooh they dont know whats going on. but still no help managing pain...i have had a awfull time. but i understand that typically, its not suppost to hurt, i admire the nurses. the ones in the er, have helped me alot. they tell me when they are doing it what they are doing, and while i am listening, they try to help me control my breathing, and try to warm me with blankets because i shake so bad during and after they get the foley in.i have always apolgized to them for crying and screaming, but its to much for me...the two percottes they gave me in the hospital calmed me down, and helped the pain, i was able to walk and function. went home did a few dishes, sat up and ate,etc.. any way, bless the nurses, i think talking to the pt. calms me down, saying when to breathe etc.... i just wish i had some relief by now, like i said been three awfull months. good luck to you......like i said 99% of the nurses they have been great.

[Virgo_RN, BSN, RN]

Sometimes you have to hurt in order to help. Try holding down a kid getting an IV stick, or giving an IM to an infant. Hurting adults doesn't bother me so much, because, with the exception of those with dementia, they understand what is happening and the need for it. Little kids and babies don't. But even so, the discomfort/pain is necessary in order to help them.

[Otessa, BSN, RN]

Pain is having a bladder full of 700 cc or more of urine and you can't urinate or worse.

The discomfort of insertion is normally forgotten once the relief of urination.

otessa

[Do-over, ASN, RN]

I'm not a nurse, but I've been a patient; and I've been through urinary catheterization. I had an operation that left me sore in the midsection, and a nurse offered to put in a catheter so I wouldn't have to face the agony of getting out of bed to go urinate. I was curious about catheters anyway, so I told her to go ahead. As the catheter went in for the first three inches or so, there was a stinging sensation--not bad, but enough to make me wince. After that, there was no pain. There was discomfort when the catheter went through the two sphincters, but the nurse had warned me ahead of time. If she hadn't, I'd have been frightened. She used an intermittent catheter to minimize the risk of an infection; so I actually went through a number of insertions. The only real pain was when a very young nurse came in. She was fine at insertion, but ripped the tube out like someone yanking the cord on a lawn mower. THAT hurt.

Just a question. Do you get a standardized patient to practice on before catheterizing a real patient? Or do you just get one of those dummies?

Curious why you didn't use a urinal? (assuming from your user name that you are male)?

[joanna73, BSN, RN]

Worrying about some of the skills before you perform them is natural. We all do (or did at some point). With practice, it gets easier, and you become more confident. Some things are uncomfortable for the patient, but remember that you are helping them. Also, some nurses are better at certain skills than others. It depends where you work. For example, I've always been better at catheterizing males vs females. I worked in the OR, and most of our population was men. You learn as you go anyway, so it's different for everyone.