Can I do this to help me insert a Foley?

[allthesmallthings]

I have some trouble inserting Foley's in women by accidentally inserting it into the lady parts. I expect I'll get better with experience, but to help me, is it okay to put an empty 10-mL syringe in the lady parts at the start to mark "not here" (insert the barrel of the syringe, with the broader edge and pump sticking out so that I can see it -- I'm not talking about shoving the whole thing in there right up to the cervix)? Things get kind of all mushed together in the vulva, especially if the Pt can't move her legs into frog-legs position (we have little old ladies who fall and break a hip and need FOley's before surgery), and it seems like I need more than my one free non-sterile hand to spread all the folds, and still try to keep the procedure sterile.

I know the rule about temporarily leaving the Foley in the lady parts if you insert it incorrectly so that you can get a second kit and do it right; but it seems simpler and cheaper to use a 10-mL rather than have to use 2 FOley trays. Why risk having to charge the Pt for 2 Foley trays if I could just use a cheap 10-mL?

Obviously, I would make sure to take the syringe out right after the Foley insertion. Women aren't really looking "down there" when I'm inserting Foley's, so hopefully they wouldn't feel the 10-mL and ask questions, but if they did, what would I say? Is this okay?

[caliotter3]

As many women who lose and forget tampons, not a good idea to use the syringe this way. While it may not get lost, there could be other problems and you could forget it. The things I say I won't do, are usually the things I do.

[casi, ASN, RN]

Do a clean glove search first. If you don't find it search deeper. I've done a lot of caths on lil old ladies lately where the urethra is somewhere in the lady parts.

[Forever Sunshine, ASN, RN]

A nursing supervisor once guided me through inserting a foley. One of the many things I took from her lesson is before you start try to look for the urethra and see what you are working with. Bring help. Use flashlights too.

[Purple_Scrubs, BSN, RN]

I knew a nurse who would leave a betadine soaked cotton ball just at the entrance to the lady parts (NOT pushed into it, it just kinda sticks there, lol), as her note to self to not aim there. Seems to be a much better idea than a syringe...I would be very angry if that was done to myself or a family member.

[NurseInTexas12]

Hello! I agree with the other posters that sticking a syringe in the lady parts would not be acceptable practice. You would have no medical indication for penetrating the woman with any object, which means it needs to be avoided. Think about how you'd feel if someone was going to do a non-lady partsl procedure to you but then said they were going to stick something in the lady parts so they'd have more success.

Female foley hints:

-Look under the privy parts and above the lady parts. Some urethras (i.e. the elderly lady ones that appear to be inside the lady partsl opening) are a little trickier to locate, but it's a good starting place.

-Watch for the wink! When you rub a cotton ball over the urethra, it will briefly open and then close again.

-Labial traction is your friend. If you spread the labia open enough prior to cleaning, you can't miss the wink, and you're keeping stuff cleaner than if you were losing your grip, re-opening labia, continuing to dig around, etc.

-Ask for a friend's extra pair of hands if you need help.

You'll get it with practice!

[NRSKarenRN, BSN, RN]

All the above tricks are tried first.

For those patients with unusal anatomy and multiple lady partsl openings due to fistula's, sterile qtips can be used as anatomical markers where not to enter and immediately removed upon urinary catheter insertion and drainage.

[deeDawntee, RN]

Another tip: I have numerous times been able to insert a foley by "feel" alone. The meatus of the urethra is easily felt, it is an indentation, very distinct. Some women's urethras are away from the privy parts and tucked up practically inside the lady parts, (I have heard that childbirth can distort the anantomy). Of course, if you do it that way, you have to have things well cleansed and as sterile as possible. Give it a try, it works. I have a great track record with foleys and have not had any incedents of UTIs with my foley insertion.

[bjaeram]

Make sure they are flat or even trendelenburg. Have a friend help hold legs and pull up on the belly apron if there is a large one. Use a light.

Spread the labia as far as you can with one hand. Use the other hand with the betadine to push things around and find the opening. Aim up and you will almost always hit it!

Our betadine comes on three Q tip like things instead of cotton balls and I have on occasion put one at the lady partsl opening as a marker.

[Sparrowhawk]

Use the privy parts as a marking point...less then half an inch down is the meatus....5 to 1.0 inches...always works for me. Any further then .5inch you have the lady parts...

Don't go poking things in people that don't belong..you open yourself up for alot of bad things...up to sexual harrasment.

[Rose_Queen, BSN, MSN, RN]

The only time I can see this not being a high potential legal/infection issue is the patient in the OR for an abdominal hyster (and still not 100% ok). Most of us will do the foley at the same time as the lady partsl prep, and a few will leave the counted sponge stick in the lady parts while they insert the foley. Not something I would personally do, and there was an incident when we were using disposable prep sticks where a patient found it still there once on the floor. Your best bet would be to get a friend to hold a light or help retract if necessary.

[Batman25]

To echo the others...NO. Don't do it. You will get better in time. Lots of good advice in this thread. Try ones you haven't been utilizing and see what works.

[rnmi2004]

Ouch.