This one time… at clinical…

... I had to cath (insert a urinary catheter) a patient. Oh, c'mon, actually, this happens all the time. Simply put, this is what nurses and nurse techs do: we get the pee and when we have it, we are happy, I mean, it's almost like Christmas!

In any case, each cath experience is unique and that is likely because each patient has unique anatomy. That's right, all private areas are a little different, especially on females. Also, FYI real quick, females are difficult to cath in that the urethral opening (the pee hole) is usually difficult to locate visually. So, insertion begins with approximations and guess-work. It's the hard truth, there is not a sign on poot-poots that say, "Insert cath here."

Now males, on the other hand, are easier when it comes to locating the urethral opening. Seriously, it's right there... one-eyed Pete. Boom. However, cathing males poses an entirely new list of potential issues. One, first and foremost (especially on older males) is the prostate. The prostate gland sits between the bladder and the penis with the urethra (pee canal and in male cases, semen canal as well) running through it. It is common for older men to experience swelling of the prostate which compromises the efficiency of bladder drainage. So, imagine the walnut-sized prostate gland swelling... and occluding (blocking) the urethra. Cathing a patient with an enlarged prostate is difficult and requires a specific type of catheter called a Coude catheter (google it if you want to know more about it).

Secondly, males have a much longer urethra than females (hence why men rarely get urinary tract infections (UTI) as opposed to women who have shorter urethral tracts and suffer commonly from UTIs). The cathing kits generally have plenty of cath for instances of cathing males without any worries. Except. *rolls eyes* Except when the male patient has a ridiculously long penis. *sigh*

For real, cathing is intricate and must remain a sterile procedure. The risk of infection is high anytime an invasive procedure is done on a patient, so it is crucial, especially once sterile gloves are donned, that the nurse touches nothing except the sterile materials in the cath kit. Therefore, the penis is considered non-sterile and can only be touched with the designated hand, leaving the other sterile and available to all the work.

So, this one time at clinical, I had to cath a patient. My leading nurse that day was a young male and was happy to have me cath his male patient for him. We had just received the report from the night shift and were beginning our rounds with the gentleman who needed to be catheterized. The nurse remained with me during the procedure, but I will never forget approaching our incoherent patient and flipping the sheets back. Omg. The old man had a ridiculously long penis. Now, this is what is funny. I didn't think about anything else but whether or not the catheter would be long enough to make it into his bladder. The patient did not have any prostate issues, I could tell immediately upon insertion, however, I ran out of catheter and there STILL was not any urine flowing. I literally had to scrunch the poor old man's flaccid penis up to gain more catheter line to continue advancing until I reached his bladder. Anyway, I had to fuss for a while, but I finally got a flash of urine and it began to flow out. I froze and kept my hands exactly where they were when the flash began, only making small adjustments of the penis to keep the urine flow going... I did not want to lose my drain!

After several moments of this, my leading nurse started to laugh. I looked at him with questioning and he blurted out, "Drop the penis. Just... drop the penis. He's gonna end up with a boner!" See? I never thought about the penis and what its instincts and natural responses are. I laughed to myself at how I was so medically focused that I forget what unit of the human body I was handling.

And that's why I am sharing this entire story. I want to point out to anybody reading that that's how it is... nurses do not care what naked parts they have to handle, so's long as they can get what they need from whatever it may be.

So, holy shit! I dropped the penis! Consider it, if it were you, would you want to be standing around with stranger-boner in your non-sterile hand? More importantly, how about losing that urine flow? If the penis grows, the scrunch, catheter length, and tragically, THE PEE DRAIN would have been compromised.

In any case, dropping the penis did not interfere. Thank gawds I continued to get a flow of urine.


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