The catheterization that went so very wrong

While working last quarter in the nursing home I had many experiences that helped me grow as a nursing student. One of which was the catheterization that I had to perform. The woman had severe MS and her legs would not open very wide. Because of which, the CNA's did not perform adequate perineal care. When I did peri-care for her, I had to do a lot of "clean up" so to say. The smells were atrocious and almost unbearable. After I cleaned her, I set up my sterile field. I prepped her with betadine to sterilize her, and I thought I was good to go. I tried to insert the catheter, but what I thought was the appropriate spot, apparently was not. I had to have the two other students who were holding her legs open to also hold flashlights. I spent about 10-15 minutes or so with no luck. My instructor came to the rescue and assisted with finding the urethra, which still took some fishing and hunting around for it.

The catheter finally went into the right hole. Unfortunately, the catheter that I used was not like the one I was used to in the practice lab. The caths in the lab already had the collection bag attached. I forgot to attach the catheter to the bag. Soon I had urine coming out onto her bed. I quickly fixed that problem and was able to collect the urine in the bag. I then had to blow up the balloon in the catheter with 10ml of water. The syringe had 30, so I had to stop at 10ml. I pushed in the 10ml of water and had difficulty getting the syringe off with the same hand that was holding the catheter in place. Another student nurse that assisted me helped take it off. Unfortunately, I was still putting pressure on the syringe as to not lose water out of the balloon. I ended up squirting the patient with water all over her legs. This is exactly what not to do when performing a catheterization!!!!

I got her all cleaned up and went to measure her urine from her old bag. As I drained it, I became nauseous from the putrid odor of her urine. My spirits were down and I felt very unqualified to perform another one. Comforting or not my instructor said that was the hardest cath-job she’s ever seen, because her anatomical orifices were not in the correct location, which made it hard to find the urethra. I was finally done 50 minutes later!!!

As luck would have it, I was able to perform another catheterization. This time it went off without a hitch. I performed it from start to finish in 10 minutes and my instructor was very pleased, and boy, my confidence level came back.

I look forward to more fun and interesting events during school.