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Catheterization? Do you remember your 1st time?

Hi, I just got back from lab, and we learned about how to do a catheter for both male and female. Even practiced a straight cath on some dummy mannequins, as a foley cath wouldnt work on them...but we "talked" through as if we were doing a foley (indwelling) also.

We have clinical next week on monday and tuesday and are expected to perform at least one catheter on a patient. I am so really nervous about this. I did ok on the practicing in lab today, though once I did accidently touch my sterile gloved hand to the labia (of the mannequin), but my instructor corrected me. I knew it as soon as it happened...but also we were trying to stick in the rubber straight cath, into a rubber mannequin, only pretending to use lubricant...and it was hard! :uhoh3:

So I am nervous about doing it for real. Does anyone remember the 1st time they performed this in clinical or once you got your first nursing job? If so, wanna share your experience on how it went? Also any suggestions would be awesome!

thanks, twinbee

when i had to do my first one, i had the RN i was assigned to right there with me, guiding me. Teacher was nowhere in sight (GOD that would have made it much more nerve-wracking!). Luckily, I got it in!

I would review the procedure step-by-step a couple times the morning of clinical just to refresh your memory. Try and relax and remember its not the end of the world if you make a mistake, BUT it is the end of the world if you notice you have broken sterile technique and pretend it didn't happen. Then your teacher will be pretty upset! Just relax and try not to make such a big deal out of it, you will be nervous, but just focus on the procedure.

good luck!

I remember the first time I placed a Foley. It was in my OB rotation and I think the lady had an epidural in, so she didn't feel a thing. The nurse was there and guided me. My first couple jobs were in LTC and for the longest time, I could NOT get a Foley in a woman, any woman, it seemed. I just couldn't find the right hole!!! But eventually, I got the hang of it and it's been a long time since I've been unsuccessful. Men are much easier.:rolleyes:

Hi, thanks for your input! It is really appreciated! I will review over the step by step procedures. Also I would never think about trying to hide a mistake!

thanks again!

MamaTheNurse, BSN, RN

Specializes in M/S, OB, Ortho, ICU, Diabetes, QA/PI.

my first was a female who had the longest urethra ever - I swear it was the entire length of the rubber catheter - and she insisted on talking on the phone to her son while I was doing it!!! my first male was an elderly gentleman in the ER who was circumcised and I forgot to retract the foreskin before I grabbed him with my sterile hand - I had to do a modified jerking motion (if you know what I mean) to retract the foreskin - the ER nurse in there with me turned his back on me but I could see his shoulders shaking from laughter!! boy, those were the days...... :rotfl: :rotfl: :rotfl: :rotfl:

good luck to you !!!

KRVRN, BSN, RN

Specializes in NICU.

My classmate put her first one into a med-surg female pt that had her TV on to a soap opera... there was a woman on the show having a baby and was wailing and screaming while my classmate was putting the foley in. The woman wasn't making any noise so only the wailing woman on TV could be heard. My classmate AND the instructor had a hard time not laughing.

My first ones were in my practicum in the operating room. Perfect learning situation, the patients were out cold.

Ms.Hobbes

Has 15 years experience.

I had to think about this one it has been twelve years since I placed my first foldy catheter. It was a woman who had bilateral knee replacements, definitely wouldn't recommend a patient like that being your first person to catheterize. I remember my instructor standing by, my jaw was clenched so tight and after two tries I was able to place it. Of course now catheterizing someone is much easier. I encourage you as a student though, to grab any opportunity you have to do procedures. Trust me things that seem so difficult will soon become second hand with practice :)

The first time I placed a foley was in postpartum care. The poor woman had so many tears from labor that my preceptor and I couldn't tell which was the urethra...we had to keep poking and trying. Luckily, it wasn't painful for the patient. Not suprisingly, I got really dizzy and had to sit down. :chuckle

DutchgirlRN, ASN, RN

Has 33 years experience. Specializes in OB, M/S, HH, Medical Imaging RN.

My first foley.............. I certainly remember, it was in 1975. It was on the GYN floor and the patient was a post-op hysterectomy. Her foley had been pulled that morning and she was unable to void and needed the foley reinserted. I got the catheter in the vagina instead of the urethra and suddenly the tubing started filling with blood. Freaked me out. The patient was herself a nurse and saw the horror on my face. She said its ok honey, pull it out and try again you're just in the wrong place. I thought I had done something so bad that she would bleed to death or die. I was 19 or 20 years old.

I cathed my first male patient when I was around 21. The guy was in his 20's and was circumcised. Being from Europe I had never seen a circumcised penis. I told him I'm sorry but I think you have something missing down here. I still remember the look on his face. Thankfully I didn't hurt him, he was a paraplegic. My nursing instructor had to explain the circumcision deal to me. I felt so dumb after that.

I only ever inserted one, and that was in nursing school. This poor lady weighed 400+ pounds. She was so large that it took 4 of us; one to hold each leg, and my instructor held a flashlight so I could see what the heck I was doing. Got it in one try, surprisingly enough.

Marie_LPN, RN, LPN, RN

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

I remember cathing the male mannequin. I also remember his, uh, part popping off of his body (he was one of those interchangeable private parts models).

I never cathed anyone in school, my first was on the job. I had only been working a few weeks in LDRP and was still orienting to mother-baby care, but they liked to get us newbies any opportunity to practice skills. So my first fley was on a laboring woman about to go over to the OR for a C-section. My preceptor talked me through each step, and told the patient "oh don't worry, she's done this before, but she's new here and isn't familiar with our equipment so I'm just talking her through it"

I had never believed in lying to patients but it did make the experience much easier for the patient :)

Lucky you - you had a dummy to practice on! My first foley was in nursing school. Instructor by my side - I don't recall what went wrong but my instructor had to leave for a moment - left me bent over and holding this poor woman's labia open. She was gone a good ten minutes and I was sweating, my back was broken from holding that position that long. Got it in though.

Helpful hints

1. Put the bed up

2. Always bring a second pair of sterile gloves and a second foley. If the first one goes into the vagina - leave it there as it helps direct you.

3. Have someone with you...help with flashlight, legs, distraction (especially with men - they tense up much more than woman - have them deep breath as you are going in - don't worry if the cath practically disappears).

Like some of the others posted, my first foley was not in school but on the job. Being a recent grad from Dec and only being on the job a few weeks now. I am in Labor and once an epidural is placed then the foley goes in. My preceptor was awesome. She gave me all kinds of tips and talked me through the whole thing. One thing she said that helped alot was to watch for the little "winking" as I was washing with the cotton balls..that would be my "spot" to aim for. Sure enough it worked and I got it on the first try. I don't think I could do it on my own yet, but a few more times and I will have it down no problem. Course if I ever move to a different area I will have to learn all over again since there "ain't" no chance on doing a male in L & D!

Helpful hints

1. Put the bed up

2. Always bring a second pair of sterile gloves and a second foley. If the first one goes into the vagina - leave it there as it helps direct you.

3. Have someone with you...help with flashlight, legs, distraction (especially with men - they tense up much more than woman - have them deep breath as you are going in - don't worry if the cath practically disappears).

Thank you all for sharing your stories and advice!!! :) One thing I also wondered about is if you should take an extra cath w/you or not, but it makes sense to me now that you should for just incase you miss the first time! :chuckle

Will keep you posted on how my first time goes! :rolleyes:

thanks again! twinbee

It was friday, 2 weeks ago. The end of my clinical day, I was waiting until 12:45P to give report to my primary nurse, and our team leader asked if I wanted to do one. Being 12:30, I thought"I've got 15 min. and my people are fine, sure." Well, I didn't know the woman was in CHF, on isolation and we couldn't lie her less than 60 degrees! So, my instructor stood at the foot of the bed, 2 classmates grabbed a leg a piece, and I set up my sterile field. I cleansed the area, looked and said "I'm gonna need help." So the girls told me where the urethra was, I inserted the cather and decided that wasn't it. Try #2, the girls told me to go low, I went low, -> Vagina, leave that theremy instructor says. Try #3 I finally got it. When we left the room we all laughed, and I said, "well, that's not where it says it is in the book!" I called my g/f later, she laughed and said they only get easier from there.

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