On the other end of the cath

Trauma Columnist · Nov 11, 2017

Unsure what your point is? That your use of a catheter improves your skillset?

MrFoley · Nov 12, 2017

Thats right!

Catheter wearing changed my opinion about whole procedure. Insertion is the mayor part, that had to be done very carefully.

Ive read many topics about it here. Sad, that is not common to use lubricants in the urethra. But without it the insertion is very painful. So just lube the cath is not enough!!! I think when its done under anesthesia is much worse, because I'm not sure they use lube. Than you wake up with a hell-burning urethra! It hurts!

One more thing. Secure the cath to your lower abdomen. Fixing to the thigh is uncomfortable beacuse it tugs on the cath.

If everythings done right ,catheter wearing can be realy comfortable.

aprilmoss · Nov 12, 2017

Can't say I wore one while placing one in a patient, but I've experienced them a few times back in the day.

SouthpawRN · Nov 13, 2017

I warn patients that after removing the catheter, the first urination may sting, burn and be painful but after the first one only minor discomfort or back to normal by second or third urination. At least this is my experience when I had to have them for past surgeries.

allnurses Guide · Nov 13, 2017

I think it adds understanding when a nurse has some personal experience with any procedure, but I don't think it's necessary if you practice to he highest standard of care and are observant for potential objective and subjective signs of pain or other unexpected reactions a patient may experience.

Guest219794 · Nov 13, 2017

Thats right!
Catheter wearing changed my opinion about whole procedure. Insertion is the mayor part, that had to be done very carefully.
Ive read many topics about it here. Sad, that is not common to use lubricants in the urethra. But without it the insertion is very painful. So just lube the cath is not enough!!! I think when its done under anesthesia is much worse, because I'm not sure they use lube. Than you wake up with a hell-burning urethra! It hurts!
One more thing. Secure the cath to your lower abdomen. Fixing to the thigh is uncomfortable beacuse it tugs on the cath.
If everythings done right ,catheter wearing can be realy comfortable.

What do you mean by no lubricant?

MunoRN, RN · Nov 13, 2017

What do you mean by no lubricant?

I have actually come across a couple of nurses that saw no problem with a 'dry' foley insertion, one didn't do it completely without lubricant but used a single small drop on the tip of the catheter, which is essentially dry, the other put no lube on at all.

aprilmoss · Nov 13, 2017

Ouch. I've always been liberal with the lubricant. Our instructions say the first two inches or so, but I often use more.

I was reading something in another forum that suggests that rather than the normal lubricant jelly that seems to be the standard, that lidocaine ointment (cream) works better for patient comfort. I may see if I can obtain some and ask the kids who regularly get them if they'd like to try and report.

MrFoley · Nov 13, 2017

Catheter insertion without lube is a nightmare. Its also uncomfortable to wear it after a dry insertion. Feels like your urethra is burning. Hurts so much!!!

For those ,who do it dry.. I wish they have it the same way!

KatieMI, BSN, MSN, RN · Nov 14, 2017

Please, no Lido.

It doesn't work immediately on contact in gel form, so the insertion with it is as unpleasant as it supposed to be. Later on, it feels less sitting there for a couple of hours as the best but if the cath was removed during this short period of time, patient feels literally nothing and can experience full-blown incontinence, overflow type (in plain English, urine just flows out with no sensation wahtsoever). It is temporary thing, of course, but can be quite scary for someone who never experienced it before, not speaking about that feeling being absolutely repulsive and possibly delaying discharge (if the talk is about ER), and also increasing risk of urethral trauma because patient is less likely to notice, for example, pain. Since the usual mantra for very short-term/straight cath is 'it just will go in and out momentarily and nothing changes after that", having urine leaking freely for a couple of hours kills a good deal of trust between patient and nurse.

Plus, if the reason for Foley had something to do with acute neuro (cauda equina syndrome, spinal fracture, etc), lido will kill any chance for adequate neuro assessment in perineal area for good few hours, which can be detrimental in case of true emergency.

And, yeah, "dry Foley" is a torture even for females. Only one thing worse is probably taking it out after perineal restoration plastic surgery, and especially peeing the first time after that.