Published Aug 15, 2002
I was looking through my Fundamentals of Nursing last night and I came across the section that teachs you how to do cathedars (not sure if spelled correctly). As I was looking at this section, I thought to myself, "will I be able to do this"
Was it hard to perform cathedars or other tests on males or even females? How do you become comfortable so that you can do it properly?
Sometimes we scare ourself by looking too far ahead. You'll do fine! I worked in a group home with a client that had to be cathed TID. It took a couple times of doing it before I was comfortable, but you'll do fine. Two things I learned is the value of knowing when to breathe and not to, and how to hold your breath without anyone knowing it. Good luck, and you'll do fine!
practise, practise, practise.
Take advantage of every opportunity to do these procedures during clinicals. Never shy away from a clinical experience because of fear of failure or lack of confidence...proficiency comes from experience.
Male caths are easy unless they have some wierd anatomy. Females are a challenge. A trick to use is to put one catheter in the patient's vagina before you catheterize so you won't mistake it for the urethra.
That said, I truly believe that female catheterization, like IV skills, are a skill for which certain people have "a knack". I was always really good at IVs but sucked at catheterization.
How do you practice this in school?
Rena RN 2003, RN
this is gonna sound a little uncaring, but for the most of my lab group, the first time we actually did a catheter on a real person, we were too concerned with the mechanics of doing it that you don't really think about the person. you focus so hard on making sure that your technique is sterile and that the cath is going into the right place that you don't concentrate on the actual person. i think herein lies the real skill. getting to the point of comfort that you remember the human being. jmo.
Ahh, don't worry. Learn the steps carefully and follow them. Talk to your patient. I remember my first cath like it was yesterday! It wasn't so bad. She was a heavy set woman and I did just fine. I told her she might feel a little pressure for a minute while I inserted it and I let her know to take a nice deep breath then exhale slowly while I placed the cath. It worked great and she complemented me on a job well done....I didn't tell her she was my first until AFTERWARD! I have been the victim (yes, VICTIM) of a couple of caths when I was pregnant. The first time the nurse was so rough! I could tell she did not care about me as a person...she was technical and that was it. Awful!
Here's my cath horror story. I have urinary retention due to MS related paraplegia. The last time I was hospitalized I was to have q3hour straight caths. A UAP came bouncing into my room with the straight cath supplies and laughing said that she only needed 4 more attempts in order to test out of this procedure. There was a total of 5 (five) people for this cath. (made me wonder where they all came from after hearing how bad the staffing was that day) One held my right leg, one held my left leg, one seperated the labia, one stood at the end of the bed with a flash light and the fifth "attempted" to insert the cath. I have no sensation so it at least it wasn't painful extremely degrading, but not painful. Lots of giggling and talking, of course not to me, in fact no one really noticed that I was there. They took a total of 12!!! attempts, running out of catheters and leaving for more until the supply room on the floor ran out of the latex fee variety. I was getting angry, asking them to stop and not getting their attention at all. I had suggested that the next time they were in the wrong place that they leave it so they would know where not to go again, they totally ignored that suggestion. The RN in the group was also unsuccessful. I had been cathed before without difficulty. They said (to each other) that I wasn't "anatomically correct". Of course, when you can't do something, blame the patient. While they were deciding what to do next, the resident came in and notice all the wrappers and used caths in the bed and while he was picking them up and tossing them into the wastebasket by the bed (he was someone that I knew from working with him and I made him clean up after himself in the past) asked what was going on. He asked for a foley and inserted it in one try without any difficulty, instructing them on female anatomy and cath insertion while he was doing it and while they all stood there and rolled their eyes. The foley was left in for the rest of my stay (5 days). Before I could be discharged I had to "be instructed on straight cath technique" and prove that I could handle it at home myself. I had done this techinique often both as a bedside RN and as a clinical nursing instructor. The thing that worried me was that I had no sensation in my fingers/hands or anywhere from the waist down and of course couldn't see where I was going. But I knew that if I didn't cath successfully I would have another foley inserted and need to be seen in the urology clinic once a week to have it changed. (wearing a leg bag for the rest of my life) I did it on the first try without a problem and have been straight cathing TID ever since.
If I can do it "blind", being unable to see the urethra as well as unable to feel what I'm doing, I know you will have no problem. Just please remember that there is a PERSON involved. Everybody has days when thing just don't work the way you want them to. Stand back, take a deep breath and let someone else try. This was a particularly bad day on this floor. They had lots of staff turnover problems and they were getting to the end of the shift before they even were able to get to the first straight cath of the day for me. I did have a total over 1200 cc out by the time the foley was in. One of the benefits of loss of sensation is that I no longer had those feelings of frequency and urgency so waiting for them to have time wasn't really all that uncomfortable and the retention did keep me from peeing in the bed :).
Good luck, you'll do fine.
there really is nothing to it once you practice. females are not as hard as you think just look for the wink reflex. after a while you can do them blind ,which comes in handy for pt who just gave birth and are swollen
I was also concerned about putting in my first cath, but when theopportunity came up at clinicals one day ,I just jumped at the chance! My patient was a frail older women with all of her cognitive abilities. My instructor was very helpful and I scored well on the procedure...(yea!!!) Anyways, stop reading about it until you have to.. the procedures always look harder in the books than they really are!
Thanks everyone. I know I am jumping the gun. I need to just read the chapter that we have to read for Monday and not worry about the rest.
i believe keeping a sterile field will be more dys than doing the actual procedure. you will do fine.
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