Female cathing

[sistrmoon]

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?

[monkeybug]

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).

Ditto. I've never placed a catheter in a male, not even in school, but I've probably done upwards of 10,000 female caths, straight and Foley in 15 years in L&D. And yes, it does help to have a second (or third) set of hands when it comes to the morbidly obese patient.

[nurseprnRN, BSN, 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.

To avoid contaminating the catheter by inadvertent lady partsl placement, try this: When you do your prep, tuck the last betadine-soaked ball into the introitus, just enough to keep it in place. Then if you slide posteriorly, your catheter hits only sterile cotton ball, and you are free to then slide anteriorly until you hit the urethra. Asking your patient to cough a bit might help, as sometimes a bit of urine is expressed from the urethra with increased intraabdominal pressure. Don't forget to retrieve the cotton ball when you're done.

[NICUmiiki, DNP, NP]

To avoid contaminating the catheter by inadvertent lady partsl placement try this: When you do your prep, tuck the last betadine-soaked ball into the introitus, just enough to keep it in place. Then if you slide posteriorly, your catheter hits only sterile cotton ball, and you are free to then slide anteriorly until you hit the urethra. Asking your patient to cough a bit might help, as sometimes a bit of urine is expressed from the urethra with increased intraabdominal pressure. Don't forget to retrieve the cotton ball when you're done.[/quote']

Great tip!

[SubSippi]

I did that with my first female cath (which was only a couple months ago). I was kind of embarrassed, and couldn't figure out what I was doing wrong, a CNA ll came and helped (i.e. did it for) me.

I think it has something to do with the fact that when we practiced in the sim lab, it looked like the opening to the urethra was going to be on top/outside the lady parts, not practically inside it. Those things are useless.

[nurseprnRN, BSN, RN]

I did that with my first female cath (which was only a couple months ago). I was kind of embarrassed, and couldn't figure out what I was doing wrong, a CNA ll came and helped (i.e. did it for) me.

I think it has something to do with the fact that when we practiced in the sim lab, it looked like the opening to the urethra was going to be on top/outside the lady parts, not practically inside it. Those things are useless.

Nah, they're not useless. It's that human anatomy is wildly variable. When you've done enough of them, you'll start to do it better because you'll have more experience in finding it.

[uronurse1]

Practice, practice, practice. When i started in urology over 10 years ago i had probably only placed one female catheter. I was clumsy and clueless. Thousands of catheters later i feel like i could throw it from the doorway and make it in.

[BuckyBadgerRN, ASN, RN]

I will readily admit that I don't think I do female cathing well. Luckily, one of my reliefs is very good at them and enjoys doing them, and I gladly take her IV starts and lab draws =)

[Beautiful Mind RN]

I know the fluffy female patients have extra folds down there that make it even more of a challenge. Most of the patients I had in my care during my clinical that needed a foley have been the fluffy sort. So even if you are good with anatomy (or even know the basics), you can get lost down there easily...

[Anna Flaxis, BSN, RN]

I am the Queen of the Blind Cath. I just seem to know right where to go. It's a gift.

[DoeRN]

I am the Queen of the Blind Cath. I just seem to know right where to go. It's a gift.

Lol me too and I only had trouble with placing one my whole time doing direct patient care. I was a tech at the time and called the nurse because I could not cath this patient. They sent me in because the other tech had missed. It took 6 people, a flashlight, trendelenburg, 4 foley kits, a bunch of coughs, a can of diet sprite, and a prayer to place this particular foley. We were about to call the covering urologist but our prayers were answered and the foley was placed. This happened over 10 years ago and I'll never forget it. I felt terrible for this woman having 6 people poking around in her peri area.

Sent from my iPhone using allnurses.com

[Anna Flaxis, BSN, RN]

Okay, what was the can of Sprite for?

[NICUmiiki, DNP, NP]

Sometimes I'll have the older ladies who can't spread/lift there legs (many times contracted) lay on their side. You can usually get a pretty decent view of the lady parts like that.

I'm interested in the diet Sprite too.