Oh Lord, do I ever feel stupid. It was my first try at it today. SHE was definately not easy to get at. I was really focusing on the sterile technigue rather then just using 1 catheter tube. BUT, is there anyone else that did this in Nursing School, I feel like an idiot. My instructor was there and she was soooooooooooooooooooooooooooooo sweet about it and very supportive. I could not get it in, I had 3 tubes in her sitting there, all were in the lady parts and finally she said, here let me try, I felt so bad, but the lady was so miserable from other pain, she felt nothing and was so thankful when we got it, because within 5 minutes she had drained 1000CC's of urine. Poor thing.
Do you always get it the first try? After it was over, I kept thinking, I want to do this again and do it right and get it myself, but dang, how much can one person take before enough is enough.
While it may not be "normal" there are extraordinary patients that are very difficult to cath, so don't feel bad. I've had patients were we've tried and tried and practice had to have the patient stand on her head while we were doing back bends. :)
We went through 7 catheters the other day and finally said enough is enough. The student tried 3 times and then the instructor tried twice. We finally went and got the nurse and she tried. It was not going to happen. The woman was contracted and her urethra looked like it might actually be inside the lady parts. That poor woman. I hope she gets better.
Lisa did you have my patient? Becuae I swear I was just about to post about this woman I assisted with during my training - she had seven catheters in (some going in one hole and out another), but none draining urine - and she, too, have a urethral outlet into her lady partsl wall. Weirdest damn thing...
After almost sixteen years, I'm still chuffed if I get a female IDC in in only one go :)
PS And we always leave the non-successful catheter in, as a guide. Plus you might want to check that it real is int he wrong spot - last week I had a woman with a litre in her bladder (per bladder scan), popped in the IDC and nothing. Just in case, I infladed it and withdrew, and felt resistance. It took a couple of minutes, but it was in the bladder after all.
Oh, Nursinginthemaking, does that bring back horrible nightmares! My first time I had to cath a female pt (over 20 years ago) as a student, the pt was to go to surgery. The cart was waiting for her, my instructor was in the room, the physician was in the room, and...the director of the nursing program at the school showed up to do a surprise monitoring of my instructor! Luckily, I got it on the first time.
Since then, I have had many difficult times doing female caths, some almost standing on my head! But, there are many good ideas given, many of them I use. First off, always have a second person and a really good flashlight. If the floor doesn't have one, get a small pocket one. The finger in the lady parts trick is very good to use as it makes a very good guide.
Sometimes, these little old ladies can't open the legs too wide due to hip surgeries and frailty. Same with cancer pts some times. Then, it's a blind stick and a lot of luck. Just keep practicing, you'll get there.
Oh Lord, do I ever feel stupid. It was my first try at it today. SHE was definately not easy to get at. I was really focusing on the sterile technigue rather then just using 1 catheter tube. BUT, is there anyone else that did this in Nursing School, I feel like an idiot. My instructor was there and she was soooooooooooooooooooooooooooooo sweet about it and very supportive. I could not get it in, I had 3 tubes in her sitting there, all were in the lady parts and finally she said, here let me try, I felt so bad, but the lady was so miserable from other pain, she felt nothing and was so thankful when we got it, because within 5 minutes she had drained 1000CC's of urine. Poor thing.
Do you always get it the first try? After it was over, I kept thinking, I want to do this again and do it right and get it myself, but dang, how much can one person take before enough is enough.
It seems like it should be easy right? A lot of nurses often don't get it on the first try so please don't be too hard on yourself! Plus, you're just learning!
Tell your instructor you want to do another so you'll feel more comfortable.
I was so scared of cathing during clinicals that my instructor gave me a lady that need to be straight cathed q 2 hours - by the 2nd day I felt like "an old pro"
When I worked at a urology practice they suggested that if you get the cath in the lady parts first leave that cath in until you find the urethra. Hope this helps! Good luck :)
If the pt can tolerate it place them on a fracture bedpan upside down. it works really well for larger ladies,etc. Places everything exactly where you need it
...getting a really strange visual here, but we'll try anything once.....
:lol2:
Just Kidding!!! :rotfl:
I meant the bedpan is upside down, not the patient :) It is kind of a funny visual...but it does work..a gyn nurse told me to do this.Haven't had a bit of trouble since
My first cath was on a woman who was a few pounds shy of 500 lbs. (really). It took 2 other people to hold skin folds back, and even then, there was so much hair it was like trying to find a needle in a haystack, so i had my penlight between my teeth to put a spotlight on it. To this day i still have no idea HOW i got it on the first try, i couldn't even see where i was putting it, but at least i could see where NOT to put it.
It's a breeze for me to cath women now, since by the time we're ready to put in a Foley, their legs are in the Allen stirrups and one of the O.R. spotlights are aimed in that direction.
Don't feel bad. The thing about Foleys is that it isn't a skill that takes forever to learn. I felt pretty comfortable after doing five or so. I haven't done one in a while since I work in a medical ICU and our patients get cathed in ER or the outlying hospital, usually. Next time I have one I'll feel fine, as they say, "it's like riding a bike!"
In my old unit we would refer to large ladies as "flashlight caths" as in "I have to go do a flashlight cath." I've assisted in many of those, and they are frustrating. Also in large men the member virtually disappears in fold of flesh, so they aren't easy either.
Plus, you're just learning!
.thumb.jpg.6eeb2c01c27cfd151d706238b7f6d6b7.jpg){kind=small}
:lol2:
Tweety, BSN, RN
36,333 Posts
While it may not be "normal" there are extraordinary patients that are very difficult to cath, so don't feel bad. I've had patients were we've tried and tried and practice had to have the patient stand on her head while we were doing back bends. :)