I hate that I'm like this, I've had no other big fears thus far in nursing school. All the other 'gross stuff' hasn't made me flinch even a small amount. But foleys.
Oh god, foleys. I've never seen one inserted before, but just thinking about it makes me cringe and get sick at my stomach. Have any of you had this same fear but then overcame it? Just the thought of inserting something like that into...ugh even now I'm nauseous. It's just so strange that I'm so ok with basically everything else.
Any help or encouragement would really, really be appreciated.
Specializes in Triage, MedSurg, MomBaby, Peds, HH.
I felt the exact same way! The perianal area is not my favorite part of the body, male or female.
That said, when it came time for me to do my first one I was in postpartum. As you may or may not know, a full bladder compresses a post-delivery uterus and makes it more likely to hemorrhage. And sometimes a postpartum mom can't void. You can actually see the bladder if it's really full.
Anyhow, the revulsion and fear disappeared. I saw the potential complications and this wave of compassion took over and without thinking twice I DID IT! I never looked back. You will too.
Suctioning is another area I feared, as mucus makes me gag. However, I had a 90 year old man with aspiration pneumonia who lacked the ability to swallow. Every time he coughed up something from his lungs, his airway became blocked. The first time it happened, I grabbed that Yankeur and suctioned away. I just felt the urgency to help and it overcomes the fear and revulsion. For me it did anyway!
Make sure not to forget the Urojet! That 2% lidocaine/xylocaine lubricate makes all of the difference to both patient and caregiver. Where I've worked (Europe & Australia), using it was standard operating procedure because all of the students trained with it from day one . In the past few years I can count on one hand the number of times I have cathed without using it. We even used it in the ER, obviously unless we are very pressed on time. There are only a few things to remember about Urojet (or equivalent):
- It actually causes the urethra to dilate. This can make insertion easier and reduce the chance of injury, especially if PT has a narrow meatus and/or urethral opening.
- The patient is much more relaxed, because before the procedure, you tell them you will apply a "special painkilling gel" that will numb them "inside". Make sure you clearly say the word "gel". Otherwise they might suspect a very scary needle being inserted on to their intimates!
- Once Urojet is inserted in the urethra, allow a few minutes before foley insertion. Too many clinicians insert the foley immediately after urojet insertion. Very bad! Not only will it not work properly, but now the patient will think you lied to them about numbing.
- Since you showed such concern about the PTs comfort/pain you will find them to be very appreciative, cooperative and calm. Especially if they are a male who has had bad foley insertion experiences in the past. BTW we used the gel on females as well.
Go to www.youtube.com and watch the insertion videos. It can help make you more comfortable procedure wise and possibly help to desensitize you.
Good luck.
This is what I was going to suggest. I watched some of those videos before I even got into nursing school, because I was intimidated by the thought of doing one, too. Here in a couple of weeks I am going to get to learn how to insert a Foley, and I feel more comfortable with the idea than some of my classmates because I have watched the videos and read about the procedure several times.
Visualize yourself doing it, over and over. That has helped me with all of the skills I have learned so far.
Did my first one in the ER the other day and to be honest, it's really easy. I mean you read your book/watched a video and practiced how to do it, AND someone will be there watching you do it - guiding you through it. Hell i'd put in a central line if I was guided through it :) it makes it that much easier.
Specializes in Getting my LVN first, the onto my RN!!!!.
I totally understand what you are talking about. I used to be so scared of the prospect of inserting a foley that I even decided not to go on pursuing nursing. However, at my current job as a PCT, I help the RN insert them on a regular basis and can take them out so I have gotten over that fear and am starting LVN school in June!
I think that its so intimidating but nothing impossible to do. Just remember to breathe before beginning and have your patient take a deep breath!
graceomalleyRN, RN
249 Posts
I felt the exact same way! The perianal area is not my favorite part of the body, male or female.
That said, when it came time for me to do my first one I was in postpartum. As you may or may not know, a full bladder compresses a post-delivery uterus and makes it more likely to hemorrhage. And sometimes a postpartum mom can't void. You can actually see the bladder if it's really full.
Anyhow, the revulsion and fear disappeared. I saw the potential complications and this wave of compassion took over and without thinking twice I DID IT! I never looked back. You will too.
Suctioning is another area I feared, as mucus makes me gag. However, I had a 90 year old man with aspiration pneumonia who lacked the ability to swallow. Every time he coughed up something from his lungs, his airway became blocked. The first time it happened, I grabbed that Yankeur and suctioned away. I just felt the urgency to help and it overcomes the fear and revulsion. For me it did anyway!