Foley Catheter Lubrication

[Twinmom06]

Can someone please assist me? I'm a new grad and in my orientation class are 2 of my friends that graduated with me. The foley insertion we were taught in school and clinical (as well as how I inserted as a STNA in a magnet facility) had us dip the end of the foley in sterile lubricant that we squeezed into the sterile catheter tray.

Yesterday 2 of my friends were assigned to the floor we will eventually be working on with a completely horrible instructor that really got in their face and and one of the things she was lecturing on was that the nursing literature now states that we should be instilling the sterile lubricant into the meatus? I've done numerous searches via PubMed, Google (using sites such as mayo clinic and NJM - NOT Wiki) and have found nothing of the sort except for 1 article from 2005 that indicated instilling lidocaine gel when introducing a Coude catheter into men with BPH that were a difficult insertion. I wouldn't consider 2005 to be "the latest literature" - not sure if she was just being a witch or if there is something I'm not finding. Have any of you heard of this, or can you tell me where else I can look?

both of these normally unflappable classmates of mine are ready to bail because of this instructor.

[Twinmom06, ASN, APN]

apparently the facility I'm working at doesn't write their own procedures, they use Lippincott - the 5th edition says to do it either way, but the 6th edition (just released for 2013) indicates to instill in the meatus - however again, we didn't use Lippincott in school, and the 2 hospitals we do clinical at write their own procedures - ergo we always just dipped the tip...

and to the poster that asked if the instructor got in their face away from the patient care area - no she didn't - she felt the need to do it in front of the patient and staff....

[K+MgSO4, BSN]

Amazing the difference in practice I started my studies in 2002 in Ireland and always saw lidocaine gel being instilled into the meatus of a male for catheter insertion. Still do it here in Australia 11 years later!

[dishes, BSN, RN]

K=MgS04, I was aware that UK and European nurses have been instilling into the meatus for many years, I find with some procedures it can take us North American nurses a long time to adopt best practices.

Twinmom, Maybe the problem is the two new grads and the clinical instructor have opposite communication style . If the new grads have feeler/emotional communication styles and the instructor has an analytical/logic communication style, it is easy for a communication breakdown to occur. People with feeler communication styles, sometimes misinterpret people with analytical communication style as being mean, harsh, rude when it is actually just factual information. People who are analytical communicators see no reason to communicate facts about patient procedures in privacy, as they would not respond to this information emotionally.

[edmia, BSN, RN]

thanks for the information guys - the clinical we've done and the hospital I've worked in as an aide have never done that - and if that is the standard thats fine - the reason I brought up the research aspect was because this instructor was chastising my classmates that they should have been "up on the literature" - since no one taught us any differently (and none of the hospitals have lidocaine gel anyway) I was looking for specific literature explaining that.

also it wasn't a man she was catheterizing - it was a woman. I guess my greater point was there is a way of teaching new grads without embarrassing them in front of regular staff, making them go home at lunch and cry and wonder if they're in the right profession considering we just graduated 2 months ago and for them its their first job in a hospital. I was looking to see if there were specific studies that I could find and if not could suggest to our education coordinator that perhaps a refresher for either us or the instructor was necessary.

Someone already posted the links for you from urological sources.

I've always insisted on using urojel if the patient is awake. I do confess that I've never used it on a female though, so I will look into that. It makes sense but the male urethra is so much longer and there's that often inflamed prostate in the way... It's cruel not to prep with lidocaine!

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[nrsang97, BSN, RN]

I have only used lidocaine jelly a few times. Only on males. I have never thought to use it on a female. I just dip the tip in the lube and insert like I was taught in nursing school.