As a 3rd year medical student I was learning how to properly insert Foley catheters. I was green and really didn't pay close attention during the teaching labs because we used fake penis's and vaginas.One of my first rotations as a 3rd year was in psychiatry, and a patient developed urinary retention from her psychiatric medications and needed a Foley. I was very excited because this was my first "live patient." I entered the room and saw a 40 something patient holding a stuffed rabbit, petting it, and talking to it. So I stepped up to the patient, and the nurse handed me the kit. I placed the lube on the end of the Foley and spread the vaginal lips and pushed the foley into the "proper hole." I continued pressing and then used my fingers to get a better look. As I continued using my fingers, I noticed the patient moaning....so thought I was hurting her. I continued trying to insert the foley but kept finding resistance. As I pressed, the patient moaned to her rabbit. The nurses started laughing. I continued to struggle but finally asked the nurses, "Okay, this is my first Foley... why is this not going in?" The nurse said, "Student Doctor Sensitive, you are rubbing her clitoris and she seems to be enjoying it." The nurse then grabbed maneuvered hand to the urethra, and it went in without a problem. It was embarrassing for inadvertentlystroking her rabbit....but at least I made a patient happy for once!
-Doc Sensitive
14 comments:
I would have thought one would pay close attention to the class on how to locate the clitoris.
I can't believe someone could make it to their 3rd year of medical school and not know the difference between a clitoris and a urethra.
Each person's anatomy is a bit different. On larger women, finding the urethra is like going on a scavenger hunt. More importantly -- why did you have to insert the catheter? The only time I've had a doctor insert one is when it requires a urology consult.
I thought what you described was the difference between the forty dollar pelvic and the three hundered dollar pelvic!!!
Pattie, RN
Hee...oh, dear this reminds me of the "Tales from the Tuna Pit" on another doctor blog....
He was a student they always make students and interns do scut work like that
muahah lol
Apparently all work and no play makes Jack a stupid boy!
Maybe you have put Rocket Lube on the foley.
And we pay our doctors how much money???? and think they are so intelligent???? What a moron...
OMG...I laughed so hard I almost wet my pants! Hilarious in a warped sort of way, actually. This blog never fails to either make me laugh or gross me out...sometimes both, LOL!
They pay med students nothing for that reason! To make mistakes before they are docs
The urethra can sometimes be found just inside the vagina, sometimes above the vaginal opening, and occasionally it seems to be found in/at/around the clitoris!
When you can't find it at all, have the woman cough. The urethral opening will "wink" at you.
Having said that... does the resident in question have a girlfriend or wife? She might appreciate it if he could identify the clitoris and knew what to do with it.
Did the nurse use the same foley that was in the vagina (not sterile) and then inserted it into the urethral meatus? Also, if finding the meatus is difficult, and since you need a new STERILE foley, you can leave the first one in the vagina to "mark" it, so that you know that you are aiming for a different opening.
I can believe someone could not recognize the landmarks in a specific individual. However, I would have flunked out of my 1st semester of nursing school if I couldn't demonstrate competence in putting in a foley into a manequin independently with my professor scrutinizing. Not paying close attention was not an option. Neither was ignorance of sterile procedure.
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