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?

[LisalaRN99, BSN, RN]

It didn't help how other nurses would describe what I was looking for as "someone winking at you" .

LOL! In my first job out of nursing school the charge nurse kept telling me this same thing! I never, ever saw anything winking at me "down there"!

Thanks for the memories!!

[wooh, BSN, RN]

If so many women are unsure about their own anatomy how are us guys suppose to have any chance?

Here's a life hint, generally outside of catheter placement, women don't want you poking at their urethra!

[tech1000]

Tons of old ladies have their urethra up their lady parts. It's a miracle that we even find those bad boys, but I guess you just get used to it. I don't really go in for many caths unless I do it myself or a tech is in there with me (in critical situations, and generally the techs are more experienced then), although it did happen the other day. The tech asked me to cath my pt cause she couldn't find the urethra and I thought it was a very straightforward cath, but she told me she thought it was "that" (the clitoral hood). I can see why... Most women aren't getting down with mirrors and their urethras.

[Cobweb]

The first lady I cathed in school had many fistulas. I took my best guess and put a catheter in one place and it came out another. I just stood there, petrified with dismay, sure that I had committed some horrible misdeed that had ruined my patient, looked over at my teacher, and she was laughing her butt off.

[chrisrn24]

The first lady I cathed in school had many fistulas. I took my best guess and put a catheter in one place and it came out another. I just stood there petrified with dismay, sure that I had committed some horrible misdeed that had ruined my patient, looked over at my teacher, and she was laughing her butt off.[/quote']

Omg haha! I would've panicked

My mantra is, "anterior and midline."

I was once precepting an LVN student who was trying her first she-cath... and wouldn't you know it but it was one of those old ladies whose urethra had fallen back in. I just kept telling her, it's gotta be in there... anterior and midline... in she went and there was the urine.

She was sooooo proud of herself... and I was feeling pretty damned smug as a preceptor.

[PinkNBlue, BSN, RN]

"Aim high" is what I was always taught and that has helped a lot. Especially the super swollen postpartum patients I usually cath.

[monkeybug]

I truly get that cathing pregnant women can be difficult if you don't do it multiple times on a daily basis. Still, I was ready to murder a couple of postpartum nurses. At the hospital where I used to work, scheduled C-section patients would be prepared for surgery on the postpartum unit. We would then get them, do the section, recover them, and then take them back to their room on PP. First of all, the nurses out their acted like placing Foleys was equivalent to scaling Mt. Everest, and would do anything to avoid it. They acted the same way about IVs. Yes, practice makes perfect, and we got a lot more practice than them, but that could be remedied if they would just do them. I know they were busy, so were we, just doing different things. And nothing thrilled the doctors more than standing there scrubbed and waiting while we scrambled around to do prep that should have already been completed. The absolute worst, though, happened to me twice within a month's span, and I could not figure out how it was happened. I had a patient come back for her section. Foley bag is hanging from the bed, Yay! I'm happy and assume all is well. We get her spinal, get her prepped, docs waltz in and begin the incision. I turn my back to the field so I can start my mound of paperwork, and I hear an exclamation and then my name, loudly called. I turn around and observe what appears to be a huge balloon emerging from the incision. No balloon, it's the patient's bladder, which had miraculously escaped being nicked by the scalpel. "Why does this patient not have a Foley?!" Ob asks. "She does! She did!" I reply. "Well, obviously not in her bladder!" he snarls and gestures toward the distended object waving in the breeze. He and his assistant (the second most impatient, difficult OB--#1 was wielding the scalpel) then raise the drape so I can investigate. Foley is nicely secured to the leg, but one gentle tug reveals that it was placed in the lady parts. I throw another one in while the two OBs tap their feet and sigh. I make a point of telling them that I was NOT the one that did this. OB declares that he will get to the bottom of it. I become hyper-aware of urine in the tube and bag. If the bag is empty on one of my sections, I begin to investigate before the OB hits the OR. I do not want a repeat performance that included the surgeons putting baby formula in the Foley and then pushing methylene blue to double check for nicks. Two weeks later I get a scheduled section with an empty bag. I investigate, and find, ta da! Foley in the lady parts. I remedy the situation before the doctors hit the OR. It is the same two from last time. I tell them about it, and get a "thank you for checking." The results of the OB's questioning about the first incident? He's told that it's a float nurse. SO??? A urethra is a urethra regardless of the location in the hospital. You place it, gently tug, make sure you've got a return of urine, then tape.

[sistrmoon, BSN, RN]

OMG, monkeybug! They didn't get a freaking urine return and just sent the patient on like all was good?! What a nightmare.

[OCNRN63, RN]

Pregnant women usually have terrific veins...what's the big deal about placing an IV? Tell those OB nurses to try sticking a cancer patient who has no veins. And who puts in a cath without checking for urine return?

[sistrmoon, BSN, RN]

Pregnant women usually have terrific veins...what's the big deal about placing an IV? Tell those OB nurses to try sticking a cancer patient who has no veins. And who puts in a cath without checking for urine return?

In nursing school, they always had us do caths and IVs on the pregnant women because it was supposed to be easier.

[IrishErin]

Haha, too funny. I was imagining pouring it over the urethra to make it more visible, or using the can to hold the pannus out of the way.

I just spit out some of my tea while reading that!