Female cathing

[sistrmoon, BSN, RN]

I'm wondering if anyone else has noticed this as a trend. I get called in a lot to help with female catherization, and I've noticed a lot of nurses go right for the clitoral hood! Now there are definitely patients who present a challenge(I had one patient with very unique anatomy who stumped even my floor's most expert cathing people), but I guess I'd expect people to aim low into the lady parts rather than high like they seem to do so often. These are exclusively female nurses too, so I guess I'd expect that even if they somehow missed that class in A&P, maybe their own anatomy would help them along?

[dirtyhippiegirl, BSN, RN]

You remember that scene from Fried Green Tomatoes where Kathy Bates goes to that class where they use mirrors to explore their lady partss?

I've never done that.

So, no, I don't think my own anatomy would help with cathing.

[klone, MSN, RN]

The clitoral hood often has so many folds that look like there could be a hole in there. I can understand why there would be confusion. At least with the clitoral hood, they can still try again when they miss, whereas when they stick it in the lady parts, they theoretically have to get a new kit.

[SquishyRN, BSN, RN]

I used to do that :blush: Aim for the clitoral hood I mean, not examine my lady parts in the mirror . I can only speak for myself, but I realized I did that because the picture in my head would be of the diagram from my nursing textbook that showed where everything was located. The urethral opening and lady partsl opening looked to be much farther apart in the picture than they are in reality, so I would assume the urethral opening would be somewhere under the clitoral hood after I had identified the lady partsl opening. It didn't help how other nurses would describe what I was looking for as "someone winking at you" or "sometimes you have to dig through the folds." The first time I finally did a female cath on my own, I was cursing in my head thinking "Damn, that was some REALLY bad advice/descriptions those other nurses gave me." And like the above poster mentioned, b/c I was looking for something under "folds," as I was wrongly advised as a student, I thought there might be a hole under the clitoral hood. Experience is invaluable and new grads that act like know-it-alls only because they are textbook smart scare me.

[sistrmoon, BSN, RN]

I have about 6 years experience, but I've noticed this in everyone from the new nurses to some really experienced ones. The LPN on our floor is hands down the best at female cathing, though. I find her if I have a problem.

[SquishyRN, BSN, RN]

I have about 6 years experience, but I've noticed this in everyone from the new nurses to some really experienced ones. The LPN on our floor is hands down the best at female cathing, though. I find her if I have a problem.

The really experienced ones who still do that are probably not that experienced in female cathing. I used to always try and dodge the bullet by asking some one to "help" me, but really knowing they would just do it themselves while I helped because it was faster than guiding me and they just want to get back to their work. I was an LVN for a year before I buckled down and decided I was just going to start doing it because I'm only doing myself a disservice by not learning something so basic. And the first time I did it myself? A CNA guided me.

[sistrmoon, BSN, RN]

Yep, I usually just have the other nurse do it and I guide them. But they will often argue with me too! Doing it repeatedly is absolutely the best way to learn. I've had CNAs help me as well with cathing and they are great with positioning and knowledge of the anatomy.

[klone, MSN, RN]

As an L&D nurse for 5+ years, I became quite skilled at female caths. In fact, I don't think I've ever cathed a male patient in my life. I LOVE doing caths, and would offer to do them for the other nurses on the floor. As such, I became quite skilled at difficult anatomy, and cathing obese women (lots and lots of skin folds, you need an extra set of hands to hold back skin).

[Brekka, ADN, RN]

I've cathed a few women with interesting anatomy. One actually had her urethra up about 1/2 inch from the privy parts. While it was interesting to see, it had to have been the easiest cath I've done. At least after I stopped thinking, "that can't be it, can it?" Another one had her urethra up inside of her lady parts and was very difficult to cath.

I've found it easier for me, if she's able to, to have the woman lay on one side and bring her knees up to her chest. The urethra is usually easier to find that way. They say they feel more comfortable and not as exposed as the lithotomy position.

[JBudd, MSN]

I've had to cath "by feel" on some of our elderly ladies, the urethra has actually receded up into the lady parts. Happens more often than expected, especially the tiny thin ones.

[NICUmiiki, DNP, NP]

Hehe...

I was embarrassingly old when I figured out that urine, in fact, did NOT come from the clitoral hood.

[sistrmoon, BSN, RN]

Definitely agree that bariatric and elderly patients present a challenge! My last shift, I helped cath a 500 lb patient.