Everyone's laughing except me.

nrsang97, BSN, RN · Sep 17, 2008

Hello everyone...
Recently at work, I had a really tough pt that needed a foley. Myself and a very seasoned PCT (they are allowed to place them where I work, and do so very frequently) tried to get it in MANY times and the doc was unwilling to try themselves.... (pt had a hx of urinary procedures, etc)..
The doc looked at the placement of the caths I tried to get in and said they looked correct and the pt was prob. "spasming"..
Long story short, they were in the wrong spot, and another nurse got it in for me.
My shift ended with the doc saying in front of all of the staff (who were standing around the desk) "Wow, I guess you really need an anatomy lesson down there, huh?!"
:imbar
Sooo... am I being overly sensitive (usually true) or was that kind of mean?
My confidence is really shot and it sort of tainted the way I feel toward this doc. They are great at their job, one of my favorites to work with, and now I feel almost .... degraded?
Help.
Need to deal with this in an adult manner.
thank you!

I would take this doc aside and tell him that his comments are uncalled for. Women can be very difficult to cath. Don't feel bad for not getting it.

girlr6RN · Sep 17, 2008

That wasn't very nice to say. I'd feel the same way if it happened to me.

I'd pull that person aside and tell them " I'd prefer if you don't criticize me in front of other coworkers," and they should get the point. I wouldn't stand for that nonsense. They may not have realized how rude that was.

((Hugs))

icyounurse, BSN, RN · Sep 17, 2008

First off, I may be wrong here as I do not work in ER, but I have not seen many docs (maybe med students but not docs) ever place a foley catheter unless its a urologist who is putting one in for a complicated case. So it could just be that the doctor doesnt have the experience to know that some women (especially those who are older or obese, ect) DO NOT HAVE TEXTBOOK ANATOMY. Period.

I would have replied that I didnt see him rushing in to try for himself or he might have seen that an anatomy class doesnt really help often in the real world, :rolleyes:

I wouldnt sweat it, but it would have made me mad too.

Tweety, BSN, RN · Sep 17, 2008

What was the tone of the doc's voice. Was it a mean spirited tone or light-hearted. If it was mean-spirited, stand up for yourself next time you see him and very nicely but assertively ask him if he meant to come off across the way he did and that you'd appreciate that he not do that again and would like an apology.

Also, everyone is not laughing out you. For most of them it's yesterday's news and they aren't thinking of you at all never mind laughing at you so don't blow that out of proportion.

Every nurse has had their confidence shot at one time or another. Heck I've been a nurse for 17 years now and still fubb up every now and then and embarrass myself. Hang in there. You're a great nurse!

HappyPediRN · Sep 17, 2008

I would have shot back "I guess I should sign you up for the course too then since you verified the placement was correct." It's just a doctor. Don't ever let yourself feel degraded for one millisecond. It takes so many little mistakes like that along the line to be able to get the experience to be seasoned. In the end there are so many worse things you could have done....down the line you will be able to laugh about it. :)

RNcDreams · Sep 17, 2008

What was the tone of the doc's voice. Was it a mean spirited tone or light-hearted. If it was mean-spirited, stand up for yourself next time you see him and very nicely but assertively ask him if he meant to come off across the way he did and that you'd appreciate that he not do that again and would like an apology.

Their tone was kind of a mix of snide & "just joking around"......... but every single person standing there laughed.

Thanks to you and all other posters for the support! I suppose I just have to forget about it and move on.

skittlebear · Sep 17, 2008

I would have felt the same way you did, especially if you are a less experienced nurse. Women can be very hard to cath at times and like another poster stated, not everyones anatomy is the same. I wouldn't let this get to you. That doc was just being an insensitive jerk. This doesn't make you any less of a nurse and don't let it make you feel as though. :nurse:

BlueRidgeHomeRN · Sep 17, 2008

sounds like doc's a jerk, but for future reference, if you make a perfect lady partsl landing, leave it there while you look for the urinary meatus. i've found them in all sorts of odd places, including an intralady partsl urethra! :eek:

RNcDreams · Sep 17, 2008

sounds like doc's a jerk, but for future reference, if you make a perfect lady partsl landing, leave it there while you look for the urinary meatus. i've found them in all sorts of odd places, including an intralady partsl urethra!

that's exactly what i did... and i placed a second in what i thought was the urethral orifice.... as it appeared to be a separate hole.....

aaaaaaaand they were both in the wrong spot.

romantic, BSN, RN · Sep 17, 2008

During my L&D preceptorship, I experienced the same problem with insertion of Foley. It wasn't always easy. Urinary meatus sometimes was difficult to find-- for example, 2 times I saw a strange growth and a small opening of urinary meatus was hidden within. I performed about 12 insertions and considered myself "knowing it all" -- what a silly attitude-- my last attempt was total failure. Twice I inserted catheter into lady partsl orifice.

There is a tip I received from my preceptor. You might find this technique to be not very sterile, but in difficult cases, as I was told, it should work. Though, I didn't try it yet.

Find privy parts (hopefully, the woman has one and it's above urinary meatus :)). With the tip of catheter start to slide down from the privy parts toward urinary meatus. I was told that before reaching lady partsl orifice, I should successfully find urinary meatus.

What do you think? Does someone use this method in difficult cases?

BlueRidgeHomeRN · Sep 17, 2008

it happens...but it's also hard to be laughed at, not laughed with. only you know if the doc was being cutsie or nasty, but either way, shake it off (unless it happens again). and from an old ob nurse--female anatomy can be a real bear, especially in the older population! :cool: