Posted by My OB said WHAT?!?.
Jan
15
Posted by My OB said WHAT?!?.
“…The Problem Is That Your Holes Are Too Close Together.”
“There is nothing wrong with my aim, the problem is that your holes are too close together.” – L&D Nurse to mother, while the nurse needed repeated attempts to insert a foley (urinary) catheter, and consistently inserted it in the vagina, while trying
There are 33 comments to this post.
writing as a nurse. it can be quite difficult to place a catheter in a pregnant/laboring woman. no reason to blame her body though. get another pair of hands to assist and be kind and respectful.
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Aron Reply:
January 16th, 2012 at 6:22 am (Quote)
Yep, this. Everyone’s anatomy is a little different (some people’s “holes”, thanks for that term, are truly this close, ><, together), and sometimes it can be tough to place that foley right where you want it. Oh well. That's why you bring an extra kit, just in case.
It's not the patient's fault (unless she's hula dancing on the bed, in which case you might want to revisit the question of whether or not she truly consents to this procedure). This nurse apparently needs a refresher in respect for human dignity.
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Amanda Reply:
January 18th, 2012 at 6:47 am (Quote)
Seriously, not like the woman can control how close together her holes are.
To the nurse that said this… I bet your the same one that bruised my urethra after the birth of my first child by continually trying to force the tube into my body. It hurt. And when you FINALLY gave up and got someone else to come look, the two L&D nurses that came in were so much more compassionate. Were surprised at the bruising you had created, and yet had ABSOLUTELY NO PROBLEM cathing me the first try. Amazing. Perhaps you should have been watching…..
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Heather had this to say,
Jan 15, 2012 @ 10:44 pm (Quote)
You don’t blame the dart board for having stripes too close together. But even darts is easy point blank.
Even if inserting a cath is difficult, it’s not so hard to admit you’re having a hard time instead of just being a d*ck about it.
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Even if close together there are three holes down there and she should have knownitis definitely not the one in the middle. Use your eyes!!!!
(Can say my hubby never tried to insert his penis in the peeing hole and he does it without looking.)
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Aww, my son says things like this. “I’m BRILLIANT at catching, you just didn’t throw it properly!” (when the ball bounces out of his hands) Or “I’m the bestest reader in the world, but that word is too long.”
I expect he’ll grow out of it, though.
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Jenny Islander Reply:
January 16th, 2012 at 8:47 am (Quote)
Yeah, when my daughter couldn’t read a word she insisted that it wasn’t really a word and the publisher had deliberately printed gibberish in the book. She’s matured past that stage. She’s seven now.
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DaynawithaY had this to say,
Jan 16, 2012 @ 4:05 am (Quote)
owning my ignorance here, but doesn’t the urethra vent out of the anterior vaginal wall? When my frend recently had her bladder and uterus removed after cancer, the surgeon remodeled her vagina since she didn’t need the urethra anymore either.
If i’m right, then this nurse is totally full of it!
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Selia Reply:
January 16th, 2012 at 6:03 am (Quote)
No, they are 100% separated in women, running fairly parallel the whole way (get a little farther apart the farther in, but never meet). There could be an anomally causing an opening of the urethra into the vagina, but that is not normal and certainly not common. I am suspecting your friend’s doc was just correcting problems/changes of her vagina associated with the cancer if it was bad enough to require the removal of her bladder and uterus.
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Selia Reply:
January 16th, 2012 at 6:12 am (Quote)
Vaginal reconstruction can be damaging or complicated to do with a urethra intact since they are close together, so not having one anymore would make the procedure simpler and removes some of the complication risks.
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Jespren Reply:
January 16th, 2012 at 6:38 am (Quote)
Ok, that’s just weird, cuz I was going to say the same thing, the opening of the urethra is *inside* the vagina and *then* the urethra slips behind the vaginal wall…but I guess my anatomy is other-than-textbook. Cuz the opening of my urethra is most distinctly at the very top of my vaginal opening (TMI it sometimes gets bent and caught during intercourse, which is uncomfortable but not really painful, but makes me feel like I have to pee for the next couple of hours, due to irritation I expect).
I’ve been cathed as a child, and had 2 vaginal births (no cath however) and no doc or nurse has ever said anything. Which seems odd if it actually is rare since the cath as a child was to check for problems with my bladder.
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Selia Reply:
January 16th, 2012 at 6:44 am (Quote)
Yeah, normally they stay separated, but there are variations! Mine are very close together too, and when I had some extra tissue removed from my anterior vaginal wall and the urologist was concerned about nicking the urethra because they were close so together for me, and no other urologist or OB/GYN had ever mentioned it. But, they should be separated by at least the vaginal wall muscles. Anything else is an atypical occurrence. Not necessarily bad or needing fixing, just not “standard”.
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Knitted in the Womb Reply:
January 16th, 2012 at 8:09 am (Quote)
Is it possible that you are mixing up the terms “vagina” and “vulva?” Many people refer to the whole area where the clitoris, labial lips, urethra, and vaginal entrance are located as the vagina, but that is really the vulva.
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Jespren Reply:
January 16th, 2012 at 9:05 am (Quote)
Nope, that’s why I said ‘vaginal opening’ not ‘vagina’ since I figured someone would assume I meant vulva. The exiting tip of my urethra is just inside the very top of my vaginal opening. Of course, my anatomy down there isn’t typical anyway, so no big surprise. My pubic arch is so low and narrow you can feel bone on 3 sides on my vaginal wall, the pubic syntesis sits right behind my urethra and you can feel the joint on a VE if you press around a bit. You can also feel my tailbone and lowest 2 verterba on a VE too, my midwife had never felt that before she said ‘is that your spine??’ And then asked if her student could feel it. Still can successfully vaginal birth though, loose enough everything moves out of the way.
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I’ve never had a catheter inserted, but I’m still very glad that my hospital has a two strikes policy. Anyone trying to place an IV or catheter or take blood gets two strikes and then they have to call in the “experts.” I have used this with the blood drawing thing. I have “difficult arms.” It’s so nice to have the option of calling in someone who gets it right on the first try. You can even request to just skip to the experts, too.
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Vy Reply:
January 16th, 2012 at 8:27 am (Quote)
Yes, at my hospital they don’t have an IV team or anything (it’s all nurses) but I told them I was a hard stick and I needed an expert, so they called someone from a different floor. Now, she was an interesting person who made a MOBSW worthy comment… but she got it in on the first try!
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This one is me. I wasn’t actually laboring just yet, the pit had just been started. I am crazy high risk, so I had to stay in bed attached to the monitors. So I was holding completely still. Eventually the attending nurse to do it. I asked my gyn about it a few months ago during my annual, and without even looking up he told me “that’s the dumbest thing I have ever heard.” The weird thing is that she wasn’t a new nurse, and in every other way she was kind and good at her job.
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Rebecca Reply:
January 16th, 2012 at 6:28 am (Quote)
Also, she wasn’t mean about it. It was just such a bizarre comment to make. When she left the room my husband said “everything looks normal when I’m the one down there!”
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Knitted in the Womb Reply:
January 16th, 2012 at 8:10 am (Quote)
LOL at your hubby! He sounds great.
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Lore Reply:
January 16th, 2012 at 10:14 am (Quote)
I was a nurses assistant at a nursing home for a long time, I would assist nurses placing catheters at times. Even the experienced nurses, inserting a catheter into people who they had put them in before still occasionally ended up in the wrong ‘hole’. It happens but it is never the clients fault!
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Actually, it is fairly easy to misplace a catheter during labor- especially if there is a lot of bloody show. The part I’m confused about is that I was taught to leave the catheter in place if I put it in the vagina- that way I can’t make the same mistake a second time.
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Susan Peterson had this to say,
Jan 16, 2012 @ 2:08 pm (Quote)
When I worked as a nurse I put in catheters. Most patients were older folks. There was a great variation in anatomy from one woman to another. Some actually did have a urethral opening a short way inside the vagina. Some openings one could see easily, and others were quite hard to find. The betadine one uses to clean makes the whole area slippery, and you are not supposed to move the fingers of the hand you are using to spread the labia, which keep trying to slip back closed. One trick more experienced nurses taught me was that if the first catheter goes into the vagina, leave it there while you try with the second one; you know then not to follow that path, which is at least partially blocked by the first catheter. But anyway, I know what that nurse meant. I don’t think this was a “blame the patient” sort of thing, as no one is responsible for her own anatomical variation.
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Rebecca Reply:
January 16th, 2012 at 5:20 pm (Quote)
All I know is that my gyn seemed to think that things were pretty standard down there. And the other nurse slipped it in immediately. I did make sure to point out to my husband that they would have an easier time with his anatomy! I was trying to push a baby out of my vagina, I thought he deserved to wince a little.
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No… the PROBLEM is that you need more practice, which in itself is quite fine – I’m a nurse in training myself – but if you can’t be bothered to adhere to the basic standards of care that they teach in nursing school and treat your patient with dignity and respect, I’m afraid I don’t trust you to follow basic catheter procedures. Please get someone with a heart and better aim.
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