I can't cath to save my life!

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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.

Specializes in Operating Room.
I know there's no absolute with women, but "usually" it's right above the lady partsl opening isn't it?

Some womens anatomy is wacky though, I've seen it right on top of the lady partsl opening, to the point where it's very hard to see.

I'm usually very good at finding the urethra-my issue was unruly labia, especially on very big women. Some are so big that my unsterile hand would start to cramp up and I'd lose my grip. We treat foleys as very sterile in the OR-many sugeons will watch you like hawks to make sure you're staying sterile. We would not be allowed to use a nonsterile tube of KY. One surgeon would never let you cath her patients again if you didn't use the tongs in the kit to prep..I was trained to use them and I still do. UTI's are nothing to sneeze at, especially since Medicare considers them a nosocomial infection and will stop reimbursing for them.

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Specializes in ED, ICU, PACU.

For the elderly or obese woman it works real well putting them on their sides with at least one leg bent and go in from the rear aiming for the top of the lady partsl opening. The angle is just right and I have only missed once doing it this way, even though I can not visualize the meatus.

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Specializes in ICU, ER (ED), CCU, PCU, CVICU, CCL.
I know there's no absolute with women, but "usually" it's right above the lady partsl opening isn't it?

Yes... but this way I don't have to digg around to find it! The cath with hit the next hole (or come back out at you). I have to place foleys while patients are on the cath lab table.... drapped and without lifting and externally rotationing both legs (and with little light). It works for me and I don't need to be spending time pulling back the labia to visualize the meatus.... I hit gold (urine) and I know that I'm in.

Still the side position worked best when other nurses asked me to help them. I don't know if we teach this or how I learned it. I think it was when I did a lot of home health.

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Specializes in CCRN-CMC-CSC: CTICU, MICU, SICU, TRAUMA.
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...!

If you used a copious amount of lubricant it will clog until the water soluble lubricant dissolves... this could take a little time... but will open up the fenestrations at the catheter tip in a short while... However, if you flush it... you will open it up immediately... that's probably why you got return after a flush from a new cath... make sense?

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Specializes in Med-Surg, Peds.
If you used a copious amount of lubricant it will clog until the water soluble lubricant dissolves... this could take a little time... but will open up the fenestrations at the catheter tip in a short while... However, if you flush it... you will open it up immediately... that's probably why you got return after a flush from a new cath... make sense?

Makes sense. This is what one of the other RNs thinks is my problem. She's seen me cath and she says I use a lot of lube. Can I flush a straight cath from the opening?

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Specializes in Oncology, radiology, ICU.

I have only seen lidocaine used once and it was by a urologist who had to insert the catheter on this one particular patient. Of course the urologist proceeded to tell me how stupid I was because I couldn't insert the catheter and he couldn't believe how I had actually graduated from nursing school, all in front of the patient:nono:. Nevermind the fact that I had just come on shift and the order was written 10 hours prior after several attempts were made including using a coude catheter and the patient hadn't urinated in over 24 hours.

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