Catheterization Expiriences

fiveofpeep · Dec 12, 2011

Another post reminded me...

We had a young guy catheterize someone's rectum and no one knew for multiple shifts despite the catheter somehow "leaking." They found it during an abdominal CT for patient's rectal related complaints.

That guy never heard the end of how he must not know much about female anatomy.

teeniebert, LPN · Dec 12, 2011

if you want to avoid the lady parts reliably and prevent contaminating the cath there, tuck the last betadine-soaked cotton ball into the introitus just enough to occlude it on the last swipe. i learned this 40 years ago and it still works, never had it fail me. don't forget to remove it :) .

thanks for this! i've been lucky enough to get the urethra the first time so far, but then i've only been at it for 2 years. i did have a pt. who was scanned for >999 ml after 6 hrs w/ no void; got about 10 ml return on insertion, then nothing. that was weird. we ended up sending her to the hospital and she didn't come back to the same facility so i don't know what happened.

Cuddleswithpuddles · Dec 12, 2011

Another random thought:

It amazes me how many of my former professors would treat breaking sterility or missing the urethra as the end of the world. Game over. No license for you.

It took me a while to realize that HEY! If I miss, I can get another kit and try again.

Seems so incredibly basic but it is so sad that some teachers choose to cultivate a culture where there is no room for error.

I hope someone out there reads this thread and feels better about a missed insertion. I know I do.

Cuddleswithpuddles · Dec 12, 2011

Another post reminded me...
We had a young guy catheterize someone's rectum and no one knew for multiple shifts despite the catheter somehow "leaking." They found it during an abdominal CT for patient's rectal related complaints.
That guy never heard the end of how he must not know much about female anatomy.

I really, really would like to know how that guy managed to stick a skinny squishy Foley through the orifice. I mean that guy must have really focused intently to get that sucker in. That's like putting cooked spaghetti through a keyhole. :lol2:

FootballGirl · Dec 12, 2011

Another post reminded me...
We had a young guy catheterize someone's rectum and no one knew for multiple shifts despite the catheter somehow "leaking." They found it during an abdominal CT for patient's rectal related complaints.
That guy never heard the end of how he must not know much about female anatomy.

..... is that for real....??

:lol2:

Rob72, ASN, RN · Dec 12, 2011

I really, really would like to know how that guy managed to stick a skinny squishy Foley through the orifice. I mean that guy must have really focused intently to get that sucker in. That's like putting cooked spaghetti through a keyhole.

I'm not sure if that's more revealing of the patient, the student, or both... but, disturbing, in any event.:sofahider

I'd done quite a few caths, and so was asked to help some of the ladies in class, at times. Gross, buried, foreign material, what-have-you, I still think its hard to beat a 6'4", 287# transgender male, loudly proclaiming in a raspy falsetto,while being cathed, "I have a very small member!" My cohort almost lost sterile field, trying to "ease" a laugh out her nose...

blondy2061h, MSN, RN · Dec 12, 2011

Some moron ED nurse inflating the balloon on my sphincter, and walking out even though I was wincing and saying "ouch" (SAYING- not yelling, or acting stupid). I had to get it positioned myself- she never did come back to check it. orificewipe.

I can't tel you how often CT calls us to tell us to move someone's foley because of this. And how few patients notice. A foley really is initially uncomfortable no matter what, though.

I must say I thought this thread was about cardiac caths.

Esme12, ASN, BSN, RN · Dec 12, 2011

I'm not sure if that's more revealing of the patient, the student, or both... but, disturbing, in any event.:sofahider
I'd done quite a few caths, and so was asked to help some of the ladies in class, at times. Gross, buried, foreign material, what-have-you, I still think its hard to beat a 6'4", 287# transgender male, loudly proclaiming in a raspy falsetto,while being cathed, "I have a very small member!" My cohort almost lost sterile field, trying to "ease" a laugh out her nose...

I gotta tell ya.....(even though I''ve experienced this myself) it's quite the visual! :lol2: :lol2:

sbostonRN · Dec 12, 2011

I was very flustered the first time I found a prolapsed uterus. If you do find one, stay calm!

Definitely don't be afraid to ask for help from a nurse or CNA to help hold legs, run out and get more supplies if needed, or for general support!

Jenni811, RN · Dec 12, 2011

i've been dubbed "Catheter queen" it's a very odd talent, but i can get a catheter in the most difficult people. Not something i like to brag about to my non nursey friends, they wouldn't understand. :)

Once i did get it into the lady parts rather than the urethra. Best advice i can give you, is when doing a lady bring an extra tubing with you. We have extra sterile catheters rather than a whole catheter kit so we don't have to charge them for 2 kits. So if you get it in the lady parts, leave it in while you insert the new one. This will prevent you from going into the wrong hole. Kind of like a landmark "Do not enter this hole!!"

One lady, we bladder scanned her it said >999cc urine. YIKES! She is only going little bits at a time (25-50cc). Paged doc, got an order for a foley. inserted foley, but i had alot of trouble advancing it. did what i could, and it drained about 100-150cc. Not what i was expecting. I irrigated it, and got a little more, about 250cc (Plus the irrigation solution, so like 300 came out). Anyway, still wasn't what i was expecting. Doc came and checked it out....he was just as stumped as i was. Bladder scanned again to check for accuracy it said like 800cc. We were stumped....

We talked outside the room about possibilities (not wanting to scare her since she was a very nervous lady). She didn't have ascites but we thought of a peritoneal bleed and bladder scan is picking up that, or an obstruction. We were certain it wasn't all urine. And she was comfortable.

Anyway, next AM doctor ordered some tests. Turned out she had a tumor in her bladder.

Apprently bladder scans can pick up tumor as urine, so she really didn't have that much urine, but it was causing some obstruction to completley let her empty. Not sure what came of that later because once we found that out, she transferred to another unit. I'm in cardiac unit and she originally came to us as an observation patient for syncope. Things started making more sense (weight loss, syncope). Never told doctors about her difficulty in urinating. Her urine was not bloody, very concentrated but not bloody.

That is my fun catheter story :)