I can't cath to save my life!

[espritjolieRN]

What am I doing wrong??

I have the hardest time finding the right location on women. I suppose nothing's going to help me there but practice. But this is really puzzling me:

I've done 2 males now without any urine return. I would swear I'd have to be in the bladder because I'm pretty far in with no resistance. Any ideas??

Also, in the clinic where I work they use KY for the lube on the cath. Do you think that's okay? In the hospitals where I've been we always used individually packaged sterile lube. One of the other RNs thinks I could be using too much and "clogging" the holes at the end of the cath...

I'll take any suggestions/comments. Thanks.

[suzanne4, RN]

The catheters should be coming with a sterile set-up that contains some type of lubricant. Are you inserting foleys or just straight cathing and then supposed to remove after you get urine?

I would recommend that you follow another nurse there and observe what they are doing. Definitely observe another nurse there.

For the male patients, the catheter needs to be inserted almost to the hub and then pulled back, this way you know that you are in the bladder and not in the urethra.

[espritjolieRN]

The catheters should be coming with a sterile set-up that contains some type of lubricant. Are you inserting foleys or just straight cathing and then supposed to remove after you get urine?

I would recommend that you follow another nurse there and observe what they are doing. Definitely observe another nurse there.

For the male patients, the catheter needs to be inserted almost to the hub and then pulled back, this way you know that you are in the bladder and not in the urethra.

I'm doing both. The straight caths aren't in a kit, so they're using the KY.

I haven't been inserting almost to the hub though... there's part of the problem I guess...

[Tash4nvyblues, RN]

In regard to the female catheter, unfortunately no woman is the same, and you will find that the meatus is further down in the lady partsl canal. Make sure you have plenty of light and assistance from other staff and don't be afraid to delve a little further then usual.

[nurseby07]

Sometimes those caths start to curl up below an enlarged prostate..not fun.

I had the same problem as you did until I went into home health and HAD to do it, on my own. One time I got no urine return on a male, called my manager and (duh) she had me flush it, and like magic! I got urine return. The hardest are with the women..Leave it in the one opening (if it isn't working) and go for the next. It is the very top one..Right where you think there couldn't possibly be an opening.

You'll get it!

[espritjolieRN]

Sometimes those caths start to curl up below an enlarged prostate..not fun.

I had the same problem as you did until I went into home health and HAD to do it, on my own. One time I got no urine return on a male, called my manager and (duh) she had me flush it, and like magic! I got urine return. The hardest are with the women..Leave it in the one opening (if it isn't working) and go for the next. It is the very top one..Right where you think there couldn't possibly be an opening.

You'll get it!

Alright, I feel stupid. It's a brand new cath, why did you get return when u flushed it?

[rnmomtobe2010]

My best friend said this video helped her and hopefully it can help you as well...Good luck...

[WVStarFish]

I thought cath-ing was a sterile procedure, no? We used packets of sterile lube and were taught that UTI's were the most common problem in the hospital d/t cathing. In school, it was beat into our heads but I don't know how it works in the "real world" yet....

In school, it seemed there were some of us who got lucky every time, some of us who never seemed to hit the right spot, and what made me feel much better...

I learned that even the most experienced nurses have trouble sometimes. I saw two older nurses who couldn't cath this one female at all, then my instructor (who only does this a couple times a year on "real" people) came and got it.

The ones who had to sometimes go get another sterile cath kit, it was suggested that they put some of the betadine on the cotton balls and barely place in the opening of the lady parts.

The reason for this was, when some of the students tried to cath some females, the tube would "slip" into the wrong area. That way, the cath was contacting the betadine cotton balls, not the germy areas.

I thought it was a good idea after seeing a student practically cath a womans uterus!

I hope knowing that even the pros don't always get it will help you in your confidence.

[nurseby07]

Alright, I feel stupid. It's a brand new cath, why did you get return when u flushed it?

Now I feel stupid! Hmm, why did I? I guess, now that I think about it, that the pt was prone to dehydration and perhaps there wasn't much in the bladder to get, so when I flushed it, I was able to get some yellow return. I'm sure there will be more logical answers to follow...!

[nurseby07]

And another question to put out there to the more experienced nurses..when using lidocaine on a male the package clearly states for external use only, yet I was told to mix it with the lube then dip the foley tip in it. What have you guys done?

[ilstu99]

And another question to put out there to the more experienced nurses..when using lidocaine on a male the package clearly states for external use only, yet I was told to mix it with the lube then dip the foley tip in it. What have you guys done?

My husband gets a cath often, and they lidocaine through a syringe as well as dip the tip of the cath in it. He says it doesn't really make any difference, though, since they cath as soon as they dip.

[nurseby07]

My husband gets a cath often, and they lidocaine through a syringe as well as dip the tip of the cath in it. He says it doesn't really make any difference, though, since they cath as soon as they dip.

Sorry about your hub...

So if you lidocained with a syringe first how long before it starts to work to help with the pain?