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I tip I got from a preceptor: If your hospital uses the kits with the tube of lubricant instead of the little packet, you can put a little on the catheter, and then use the rest to aim at the area the urethra is in. It will dilate the opening and make it easy. I got my first foley with no problem with this method!
I am proud to say that I am the nurse everyone goes to when they can't get a foley in. (someone's gotta toot my horn for something here!!!). I think the key is visibility, visibility, visibility! If you can't see where you're putting it, you shouldn't be taking blind stabs at it. Here is a little trick that I use, if I can't see well for whatever reason (pt. is heavy, sinks into the matress, whatever) I put a bedpan upside down underneath to lift that bottom up. It does help. Or if need be, I get a second person to help hold folds, or legs, or whatever else is in the way and also a flashlight sometimes helps too.
bedpan under the bottom, someone to help hold legs apart, excellent light, take an extra cath or 2 with you - they can almost always be put back if not used but are there if you need them, and if you do wind up in the lady parts, leave the cath in so you know where not to go again, then remove it after you succeed.
don't give up. Practice makes perfect. Just take your time.
Have the bed at a comfortable height for yourself. Nothing irks me more than seeing staff in all kinds of contortions because they neglect to get comfortable to do caths, start iv's, etc.
Elderly women may not autotomicly correct after numerous Children 50 or more years ago…. So visibility, flash light, help (some one to hold legs hands etc.). And have the bed up as high as you can. I was a night nurse at one time and would do up to 4 a night. Never thought of the Bed pan, that is an excellent tip.
This may sound weird, but since I'm a new nurse in L&D, I now put a lot of foley's in and I recently discovered I wasn't getting my hand "deep" enough in the labia. I was really trying to be too gentle. I found the best way for me (and this is visibility again) is to put two fingers between the labia and pull up and apart, then use my betadine and watch for the "wink"!
But I like the lubricant tip too! I guess I'll have to try that!
Fancy Face
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For some reason I have a difficult time putting a Foley in female patients. It seems like I miss the urethra alltogether and end up asking another nurse to do it. Anyone else have this problem?