Catheter insertion newbie

[cathmandu]

Hi, first time poster here!

I am in my second year of a 4 year BSN program and have learned how to insert catheters,NG tubes, IVs, etc on models.

In May, we will be entering the first acute care clinical setting where we will have to do these skills on a real person.

Keep in mind we have only practiced on models once, so not a ton of experience before we get a real patient, but my biggest issue going into clinical is the fact that i have to cause someone pain...especially for catheter insertion.

This is obviously a mental issue, not a safety issue or anything.

How can i overcome this fear of hurting people with procedures?

thanks

bonus points to someone who catches onto my username...no i am not nepalese

[OldDude]

How could you possibly think you're going to run a tube up someone's urethra and not cause pain? It's a painful procedure...just do it correctly and get it over with as soon as possible. Apply this to stabbing someone with a needle...it hurts; regardless of your user name:happy:

[KelRN215, BSN, RN]

Depending on the setting you're in, you may not have to do it at all in your clinicals. My med-surg clinicals were both on surgical floors and I never had to straight cath anyone there. The first time I did it, it was on a laboring woman who'd had an epidural. Those are good patients for your first one because they can't feel anything. And the vast majority of the patients I've cathed in my 11 year nursing career were spina bifida patients (or occasionally spinal cord injuries, transverse myelitis or spinal cord tumors) and they also couldn't feel it anyway.

[KelRN215, BSN, RN]

How could you possibly think you're going to run a tube up someone's urethra and not cause pain? It's a painful procedure...just do it correctly and get it over with as soon as possible. Apply this to stabbing someone with a needle...it hurts; regardless of your user name:happy:

Laboring women who've had epidurals or patients with spinal cord injuries who have no sensation down there won't have pain with it.

[OldDude]

Laboring women who've had epidurals or patients with spinal cord injuries who have no sensation down there won't have pain with it.

Well, that's true. So even less to worry about!! Good point, Kel.

[NightNerd, MSN, RN]

It's not a super pleasant procedure, but I look at it like, retaining urine isn't all that fun either, so... Basically it just helps to know that it will bring the patient more relief in the long run, so just be confident in your rationale, whatever that may be. Then just make the process as quick and easy as possible (tall order, I know!) and help them get their mind off it afterward.

[aprilmoss]

Everybody is apprehensive at first I think. I remember trailing along behind the phlebotomy nurse as she asked each patient if they were willing to allow the trainee to try the draw or whatever. I was quite surprised that they almost always said yes. I tried to do a good job. Every evening I'd go home and practice on a spare armboard. There's more things that can go wrong on venous caths. Urinary caths, while equally squeamish at first, are a bit easier. Still I was glad when I moved out of the hospital environment. Then I found out that I'd have a few kids in the elementary school that needed assistance with catheters (to range from me doing it all, to just supervising). I never thought I'd be doing foleys in high school either, but here I am.

[Accolay]

Getting over the fear of causing patients pain will come in time with experience and the accompanying confidence. Be real about it with patients i.e. "this will not be comfortable but will be over quickly." Feed that catheter quickly in a sterile fashion. And don't inflate the balloon in the urethra.