9/11 This week as a PreRN I learned....

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This week I learned....

-That the male anatomy is more complex than I thought! :eek:

Seriously, there is a lot of gizmos and gadgets going on down there.

-I really need to invest in a food processor. I have been researching healthy food options, I found out that you can make banana ice cream with just one banana in a food processor.

I am going to bug my hubby until he says yes :laugh: !

-I have never been so afraid of catching HCV as I was this week. We had a patient come into clinic to be seen for sleep apnea. She had all these bumps, hives and open sores covering her legs. She kept scratching and picking at the open sores. When I offered her a band aide she stated that she was fine, and then proceeded to tell me that she forgot to tell doctor about her HCV :barf02:. Needless to say we all washed our hands and sanitized the mess out of that exam room. We also had to use a large amount of air fresher because of the terrible cat urine smell she left behind. Yuck!

-I am taking my ACT tomorrow (Wish me luck!) and I am nowhere near prepared for it. Hoping to get ad least a 20!

-I am applying to nursing school this month and it is really starting to hit me that I am going to be training to become an RN. I wonder if I am really ready for this.

What have you learned this week?

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Whoops!

This was meant for the PreNursing section....but feel free to share here if you wish!

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Specializes in Telemetry.

I'm sorry but the fact that your #1 involved male anatomy and then #2 was about bananas and chopping them up totally brought out my immature side. :D Thanks for the mental image!

(Also, be aware that you may encounter some interesting variations in that anatomy - a guy in my class attempted inserting urinary catheters on TWO different male patients and neither had the urethral opening where it should have been. ;))

Now back to your regularly scheduled programming! :)

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Specializes in critical care.

(Also, be aware that you may encounter some interesting variations in that anatomy - a guy in my class attempted inserting urinary catheters on TWO different male patients and neither had the urethral opening where it should have been. ;))

Oh my goodness isn't that the truth! I've never needed help with female cath insertion. Males on the other hand.... Boy are there some strange anatomical deviations!

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Thread moved

:)

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Specializes in Hospice.
Oh my goodness isn't that the truth! I've never needed help with female cath insertion. Males on the other hand.... Boy are there some strange anatomical deviations!

Women can be pretty weird down there, too.

Way back when I was working MedSurg, a co-worker got an order for Foley placement.

Seemed pretty straightforward. Except no one could find her urethral meatus. privy parts, check. lady parts, check. Meatus...nada.

Fortunately, she was alert, co-operative and relatively young. I had a reputation for being good at difficult Foley insertions, so eventually, it was my turn.

I got a bed pan (regulation size, not a fracture pan), turned it upside down and positioned it under her butt so she was elevated and at an angle. Had her bend her legs, get her feet as close to the pan as she could and relax her legs open (like I said, she was relatively young and had full ROM).

Took a good look...yep, there it was. A tiny slit, off to one side. After that, it was an easy-peasy piece of cake insertion.

After that, my reputation was solidified and I was the official Catheter Queen lol.

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Specializes in Gastroenterology, PACU.
Oh my goodness isn't that the truth! I've never needed help with female cath insertion. Males on the other hand.... Boy are there some strange anatomical deviations!

Really?! I'm the opposite. So, two fun stories, both in the same shift of my capstone ED rotation, last rotation of nursing school (hours 240-252/300; I will never forget)

1: Preceptor: We still need pee from bed 7.

Me: She says she can't pee though. Straight cath?

Preceptor: Yep. You got it?

Me: No problem. (She says naively.)

Ten minutes later, asking her if she can pee, she still can't pee, explain the procedure, she says okay, get kit, blah blah blah.

Now, I've never been a big fan of the straight cath. I like the flexibility of a Foley, even though it's bigger. I've always thought the straight cath was just like sticking a straw up someone's business, and something about the imagery makes me uncomfortable. But whatever. Do what you have to do, right?

So I go in, follow my steps, stay sterile, and obstacle 1, this lady has big ol' honkin' labia. Like, had to have been five inches externally per lip, and as I'm trying to spread them, they keep sticking together like glue, and my fingers are small. You see those long-fingered hand models on TV? That's not me. So I'm getting hand cramps here trying to get in there and spread. BUT I DID It. And I see it. I see the urethra, and I see the lady partsl canal. I got it. I'm tired, but I got it.

And so go I go. And then stop.

Patient: Ow!

Never a good sign.

Me: Sorry. Almost got it.

Try advancing again. Nope.

Patient: You sure you know what you're doing?

There's the phrase that every already insecure nursing student hates to here. Yes, I do know what I'm doing. Kind of. I think. But maybe not? Why isn't it working?

Try a couple more times.

Patient: Ow, ow, ow.

Me, sweating profusely, nervous as heck, feeling incompetent: WIIIIIIIILLLLLLLLLLLLLLLLLLLL?

Preceptor: Need a hand?

Me, wondering where the heck he was a minute ago: Yes please.

He tries, can't get it, another tries, they can't get it. Tell doc. He orders imaging. Tumor, completely obstructing the urethra.

And there's me, wondering whether to cheer that it wasn't my fault or feel like a total loser because I tried so many times, or because that's how this shift started.

Story 2:

Preceptor, teasing: You ready to redeem yourself? Trauma 2 needs a Foley.

Me: Okay, I got it.

Preceptor: And she's intubated, right? So no screams of agony.

He thinks he's funny. I remind him to this day on FB that I disagree.

So I'm a bit shaky, but staying sterile on someone not moving is easier than on someone who is. God bless propofol. I go in, do my thing, but can't visualize fully where I'm going. I can see the opening, but... I'm not convinced. So I go in, and aim upwards. No dice. I'm in the lady parts.

Okay, it happens. Grab another kit. Go in again. Still lady parts.

Family member peeks in: How many of 'em damn tubes up 'er heehaw she gonn' get?

Me, bright red, feeling like a complete failure: WIIIIIILLLLLLLLLLLLLLLL?

Preceptor, giggling, thinks this is hilarious. We'd had such a good week. I'd gotten every IV, did a bunch of head to toes, helped with multiple codes, was feeling like a seasoned veteran. Until today.

He gloves up and checks. "Hmm," he says. Walks out, walks back in, medical records from other facility just came in, and she's had surgery. Opening is in a different place than where you'd normally expects. We take a look, and it's kind of off to the side.

Freakin' women. Freakin' women and their freakin' urethras.

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I'm sorry but the fact that your #1 involved male anatomy and then #2 was about bananas and chopping them up totally brought out my immature side. :D Thanks for the mental image!

Oh my goodness, I didn't even notice! That is great. I have always known that I have a dirty mind, but I think I have an unintentional dirty mind as well.:lol2:

haha

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Out of all the procedures (that I can imagine) I think that I am going to be the most nervous about inserting caths in nursing school. And now that you guys are telling me that not every patient's goodies look like and Bob's and Sue's from the anatomy practice lab....:confused:

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Specializes in Telemetry.
Out of all the procedures (that I can imagine) I think that I am going to be the most nervous about inserting caths in nursing school. And now that you guys are telling me that not every patient's goodies look like and Bob's and Sue's from the anatomy practice lab....:confused:

Full disclosure - I never inserted a urinary catheter while in school clinicals until I was completing my preceptorship. I was on an oncology unit, and I placed a coude catheter on a gentleman there. I was nervous but managed to complete the task.

After doing a couple foley catheters as a new grad hired onto a tele unit, I decided it was actually a lot less awkward working with an actual person than practicing on our lab mannequin. It also seems easier when you aren't describing aloud each step to your instructor.

So, I guess just give it your best and things will fall into place. Once you've done a few, you'll find your "flow" and you will learn to weather the strange anatomical issues and inflexible patients. ;)

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I am super excited!!! At work learned about chvostek's sign and trousseau's sign how it is a way to test due to the nerves via through the facial nerve or a BP cuff on the upper arm. Hypocalcemia is low calcium serum in the blood that effects cell production.

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Full disclosure - I never inserted a urinary catheter while in school clinicals until I was completing my preceptorship. I was on an oncology unit, and I placed a coude catheter on a gentleman there. I was nervous but managed to complete the task.

After doing a couple foley catheters as a new grad hired onto a tele unit, I decided it was actually a lot less awkward working with an actual person than practicing on our lab mannequin. It also seems easier when you aren't describing aloud each step to your instructor.

So, I guess just give it your best and things will fall into place. Once you've done a few, you'll find your "flow" and you will learn to weather the strange anatomical issues and inflexible patients. ;)

I thank the heavens that I found AN before I start nursing school! I feel like you get advice from folks who have real experience, and also keep it real with you lol.

Thanks :shy:

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