What's the trick to putting in Foleys in women?!!

SouthernLPN2RN, MSN, RN, APRN, NP · Oct 3, 2005

It helps me (sometimes) to separate the labia and have the pt cough. Sometimes this will cause the urethral opening to open just so you will know approximately know where it is. I have also placed cotton balls at the lady partsl opening to help with knowing where not to go. One other tip is to always keep the tip of the catheter angled slightly upward so that you don't slip in a downward direction so easily. Good luck!

phebee rains · Oct 3, 2005

Hi! I'm a new RN & I would say that the biggest fear I still have is putting in Foleys in women! I always have difficulty getting them in, & end up having to toss out the first Foley & get my preceptor to help. I have only put in one! I've asked my preceptor to let me know when any patient needs to have one put in, so I can get the practice. But I'm hoping all you veteran nurses will help me out here-how do you get it in the right hole?! I'm so embarassed about this. I feel very competent in just about everything else related to my job but this! Any advice for me about how to proceed with putting the catheter in? Thanks a bunch! :)
-Christine

Hi christing, this is phebee from Jonesboro, Arkansas.

I was the foley queen in LPN school. Alot of times I have the pt. bear down and this will help the meatus become visble. I was taught to go into the middle of the grapes and aim upward. Now, sometimes I still miss and have to get another cath but if you miss, leave that cath in place and this will help you not go there the next time. Also too, just for good luck, I take an extra cath with me incase I do miss. This is ususally my good luck and I end up putting it back into the pyxis, but if I am not prepared I will miss everytime. Hope this helps you a little. Dont get discouraged I have been a nurse for 3 years now. You will learn your own technique. Keep up the good work.

pricklypear · Oct 4, 2005

This trick works about 75% of the time. As you take your last swipe with betadine right down the middle, have the cotton really soaked, and watch for the "wink". If you do it right, the urethral opening will appear to wink at you, just keep your eye on it.

daisybaby, LPN · Oct 4, 2005

This trick works about 75% of the time. As you take your last swipe with betadine right down the middle, have the cotton really soaked, and watch for the "wink". If you do it right, the urethral opening will appear to wink at you, just keep your eye on it.

Ahhh, that's my trick, too! Works almost every time

christvs, DNP, RN, NP · Oct 4, 2005

Thank you so much everybody for telling me what works for you. I am going to try them all now! :)

-Christine

babynurselsa, RN · Oct 4, 2005

Our instructor in Nursing school always said to look for the "rosebud". The meatus looks like a small bud of flesh right at teh top of the lady partsl opening. I have also used the last swipe as mentioned above to visualize the opening. Point up with the cath as you go to insert. Practice any chance you get and you will get more comfortable and proficient.

Daytonite, BSN, RN · Oct 4, 2005

Christine, here's a tip I picked up working in nursing homes. For those little old ladies who are crippled with arthritis and cannot separate their legs very well, someone who has contractures that make it difficult to put into a good position for cathing, or who has a meatus that is very high up into the lady partsl canal, try this. Turn the patient on her side. Have another person gently reposition and hold the leg that is uppermost, forward and slightly upward if possible. You approach the meatus from behind. You have to make sure you separate the labia very well so you can see the structures. When you see the meatus you merely have to advance the catheter forward. I usually also have another person holding a flashlight focused directly on the area I'm working as well.

madwife2002, BSN, RN · Oct 4, 2005

A quick question, you use betadine to clean with? We only use sterile saline over here. I have never heard of betadine being used. Can you advise for reference. :wink2:

Nickle · Oct 4, 2005

Our Foley kits come packaged with Betadine; I've never heard of NS being used. How do the infection rates compare? Although the urethra is sterile, the external genitalia are not - that's why we disinfect.

My "lucky charm" is to always have an assistant to hold the labia apart. The way they show you in school (to hold the labia apart with your non-dominant hand and place the cath with the other) often fails because those parts are slippery and you don't want to lose your grasp with your now unsterile hand, since you'll need to reswipe with Betadine again. And you'll have used all the Betadine swabs/cotton balls in your kit already, so you'll have to get a new kit and start over. If you have an assistant, this prevents some of those problems. It's much easier to see the meatus this way. And it's faster.

The other trick with Foleys - if you screw up and need a new kit, just GO GET IT. (We're not allowed to bring a second into the room with us due to infection control reasons.) I have seen too many people use sloppy technique or just use the same cath when they place it in the lady parts, and the patient will end up with a UTI.

pricklypear · Oct 5, 2005

A quick question, you use betadine to clean with? We only use sterile saline over here. I have never heard of betadine being used. Can you advise for reference. :wink2:

That's really interesting! I've never heard of anything but betadine being used to disinfect before a cath.

cardiacRN2006, ADN, RN · Oct 5, 2005

Another thing I do in addition to looking for the betadine wink is if the woman is a big girl, then I put her in a little trendelenburg position, so that her abdomen and its contents will fall back out of the way.