First CATH

I am a CNA/PCT in LTC. We are called PCT's 1, 2 or 3 (depending on our skills) Like a PCT 1 can only do ADL's, PCT 2 can do blood sugars, caths, computer work and has to have anatomy and medical terminology. A PCT 3 draws blood and does IV therapy. Well today I did my first CATH, well i tried! I was wondering if anyone had trouble on their first one? I did good until I had to insert the tip in because I could not find it! Not to mention it was a 98 year old woman.

[kmrmom42]

Relax, it was only your first time! Here is what I suggest: 1.)Try to take every opportunity to catheterize a patient that you can. 2.)Bring an experienced CNA or nurse along with you until you can perform this skill comfortably. Practice makes perfect. I missed more often than not when I first started. I used to always bring two catheters with me so I could leave one in the vagina after I had accidently put it there in order to avoid putting the second one there as well!! Now I can find the urethra on a woman who has just pushed for three hours and had a peri-urethral repair!!! You will get there too, just be patient and practice, practice, practice.

[Noney]

Not everyone's the same down there. Relax aand try again as soon as the opportunity comes up.

Noney

[kimmicoobug]

I have done several caths as a new nurse. I haven't missed and actually like to do them. But recently, I had this one 60ish female patient that I had to cath. I looked at her anatomy and thought that it was a bit off. Her urethra appeared to be just a little high and I thought I saw "the wink". Well, it wasn't until I was swabbing it that I realized what it was. It was her clitoris. Her urethra was more interior. When I inserted the tip, I thought for sure I was going to miss, but I got the urine return. She was probably my hardest.

[Sarah, RNBScN]

Check this site for tips re: foley's.

Hope this helps.

http://www.ena.org/tips&tricks

[jenac]

It can be very difficult to hit the right spot-even after doing it a million times! There is always one that's not "normal" and you have to basicly shoot in the dark, so to speak. I seem to do better with the abnormal anatomies than I do the normals for some reason-atleast I've had alot more that weren't where they should be....but I work in LTC, so I'm not surprised. Always keep in mind that each person really is dfferent.

The best advise is to just keep doing them. The more practice you get, the better you'll be. And always get help if you need it- I've helped frequently and have had to get help too. Sometimes- it boils down to pure luck...

[Disablednurse]

GAstudent, the older they are, the harder they are to hit. Don't worry. You will soon be able to get it in every time. Also make sure that you have extra good lighting when trying to insert the cath.

[GAstudent]

Well the light was not good at all..I know that was one problem. Also I was so nervous and scared of hurting the lady.

[jenac]

Look at it this way-now that you've done it for the first time, next time will be easier. :) (Atleast you won't be as nervous...)

[LPNJenn]

My first cathetrization was a lady that weighed almost 500lbs. It took two other staff to hold things apart for me!

The more you do.. the more confident you will get!

Jenn

[Jay-Jay, RN]

I do home health, and you haven't lived 'til you've had to cath a patient in dimly lit bedroom. Believe me, a flashlight is your best friend under circumstances like that. Another real hard one is if they're sitting in a recliner chair...got the lady's husband to shove some pillows under her behind, so the pelvis was better positioned. Still, I was stabbing in the dark, and at last, in desperation, inserted a couple of fingers into the vagina, found the meatus with my finger, then sort of guided the catheter along it. Not exactly sterile technique, but the lady had a chronic UTI anyway, was on Cipro, it was late evening, and I was down to my very last catheter.

I once had an elderly Chinese lady that I had to do an in and out on, and for the life of me, I couldn't find the meatus. The family didn't speak English, but fortunatley, they had watched the nurses do this many times before. They pointed out the meatus to me...It was on the inside of the inner right labia minora!!

Talk about weird anatomy!