Female Foleys!

Marie_LPN, RN, LPN, RN · May 16, 2006

A couple of times, we've had a second person put on gloves and help. This usually happens on obese pts.

Maybe use the opposite hand that you usually use to insert the foley. Some peopel have better luck retracting with their dominant hand.

indigo girl · May 16, 2006

Are you talking about female cath kits? I hate them!!! Especially for use on obese, limited ROM patients!!!

Babarnurse · May 17, 2006

The best advice I ever got::::: Keep all your fingers straight and together, touch your thumb to your middle and ring finger (hard to describe, easier to show), insert fingers and spread up...then don't let go. It has worked for me every time. Good Luck

bonodonnaonaroll · May 17, 2006

Always look with a good flashlight before putting on sterile gloves. That gives you a baseline. Having someone to retract the mons is also very helpful with larger women. Thay aren't in your field so you still have your clean area.

Last reccomendation-use a pair of sterile gloves that fit! I work with alot of new nurses. When putting on gloves they will use the size provided. If they are too big you just can't work well. Find your size and bring the package of gloves with you.

ortess1971 · May 17, 2006

Excellent tips, everyone. I'm going to try them next time. Thanks...

Long Term Care Columnist / Guide · May 17, 2006

On a large and/or elderly female, it's almost always best to take a second person into the room who can hold the flashlight and help keep the legs open. Also, I'll bring in an extra catheter just in case the first one ends up in the lady parts (happens a lot!) and leave the cath there so I'll know where NOT to go on the second attempt.

In addition, sometimes I'll approach a difficult catheterization from the rear, with the patient lying on her side. This helps in cases where the woman has contractures of the lower extremities or hip pain; it was the only way I could get a catheter in one patient I had with MS.

The biggest challenge I've ever dealt with in this area, however, has to be the 650-pound lady with a chronic indwelling catheter which had to be changed every month. She couldn't lie flat for more than a few minutes; she couldn't get onto her side. Home health wouldn't touch her; nursing homes wouldn't take her.

So she came to the hospital once a month for catheter changes, and over time we developed a system. It took eight staff members to do it quickly and efficiently: one to hold the flashlight and lower the head of the bed, one on each side to keep her labia separated, three to hold up her enormous belly, one to take the old cath out, and one to put the new one in at the same time. We could usually get it done before she panicked and started screaming; we always got it done within five minutes of getting her prepped and lowering the HOB.

Ahhhhh........teamwork at its finest.

Marie_LPN, RN, LPN, RN · May 17, 2006

The small OR directed at that area can help.

Or even better: If you have a Cuda or Luxtec headlight, that can help too.

mitchsmom · May 17, 2006

Here's a previous thread on female foleys... it might have ideas:

https://allnurses.com/forums/f224/whats-trick-putting-foleys-women-123155.html?highlight=foleys+women

sharann, BSN, RN · May 22, 2006

A co-worker taught me a trick. Use a fracture bedpan(the thin flat one) and place the flatter side upside down underneath the patients buttocks. This slightly elevates the hips so you can see more. Otherwise, the above tips are great!

mcmike55 · May 29, 2006

Female catheterization is often a real challenge, especially as we see more and more obese pts.

I'm lucky in the OR, as under anesthesia we can position and retract in ways that you often can't on the floor and ED.

I totally agree with good gloves, most of the time the gloves in the kits are worthless at best. I've found them virtually rolled into a ball, so forget even getting them on !!! Where are your quality control inspectors guys!!!!

Extra person, or more helps, someone retracting towards the head, with hands around 10 and 2 o'clock leaves you to retract farther in with your one hand.

Having an extra cath available is a good tip. If you miss, leave it, at least you've got one oriface marked.

The "back door" method also is very effective in certain situations, so don't forget about it.

I frog leg them. Soles of feet together, bring them back toward body as far as possible. I'm lucky, I feel comfortable using my left or right hand to insert the cath. I'm right handed, so I tend to use my stronger hand to retract, I use my index and middle fingers, palm against the pt, sort of in a hook motion.

You've got some really good advice from the others on this post.

Good luck. Mike