Tuesday, September 18, 2007

I need to put a catheter in your bladder.

With every epidural comes a catheter, due to the new inability to feel the urge to pee. Those of us who are nice (and I am) wait a little while for you to start to go numb before inserting the catheter. Sometimes, a full bladder can keep the epidural from taking full effect and the only way to ensure you a wonderful epidural is to go ahead and get that catheter in in a timely manner.

If this happens to you, it will be OK. Having a baby isn't a cake walk, something I assume most people know from before the time they realize they are expecting their bundle of joy. Having a catheter placed is going to be the least of your problems. To ensure that we don't have to use 2-3 catheters, and to keep the procedure time down to less than an hour it would help if:

1) You do not jump 3 feet every time I touch you. I will tell you what I am about to do. Coming off the bed doesn't help.

2) Please don't scream that I am stabbing you. I'm not, I promise.

3) Please don't have a panic attack. Breaking sterility to get you an inhaler will only delay the inevitable and leave me seriously questioning your ability to get through the rest of your labor.

With these handy tips in mind, you catheter insertion should be smooth, quick and easy.

25 comments:

Courtney said...

You sound like the nurse from hell.

Ashley said...

I'm really late on this but, wow, ditto Courtney. Try having a little sympathy (or, if you're as bitter as you come across in some of your blogs, maybe you should think about pursuing a different career). All I can say is that if my nurse had that kind of attitude with me and didn't at least wait until the numbness starting kicking in, I'd probably punch them in the face.

a.k. said...

Ok, seriously? Courtney and Ashley need to CHILL OUT. This is the author's commentary on what's going through her mind during these situations. NOT a commentary of what was actually said to the patient.

I'm sure if you had to deal with this crap on a daily basis, you'd be snarky too.

Now get off your high horses.

Ashley said...

a.k.-

I really don't care if the nurses see this crap on a daily basis. It's still a new experience for their patients so they have to show at least some patience and sympathy.

My mother has told me stories about the awful nurses she had while she was in labor (she had 2 unmedicated births). They were horrible. In my opinion, if a nurse can't muster up enough compassion and can't give their patients the respect they deserve, it's time to think about a different line of work. If a person chooses to study nursing, then they should know what they're getting into. If they can't take the heat, then they need to get the hell out of the kitchen.

People don't pay thousands of dollars to give birth in a hospital only to be treated like sh*t. Just another reason why I'm considering a homebirth and will definitely use a midwife.

bigtodd said...

I am with you here. I am NOT a nurse, but I have huge respect for nurses. It's bad enough that you all have to see the worst side of us, patients. The least we can do is be cooperative :). After all, it's in our best interest, no?

Rachel said...

Wow ladies chill out...obviously you are not nurses.....we are compassionate people, but compassion only stretches so far when people are being idiots...or drama queens etc etc etc. Please keep in mind that if something truly horrible is happening, you will get all the compassion in the world from us. I put in catheters all the time in the ER..and we don't numb anyone! Really, its not that bad, be thankful you're not a man..its worse for them.

Lee said...

reason #346 to not have an epidural.

Annie said...

Hi, I'm a nurse assistant and nursing student, and I agree with what rachel said. A patient who does what l&d.rn said in her post is a drama queen. I have to assist with foley catheters on a nearly daily basis in the ER (we don't numb anyone either, not even men), and they are not nearly that dramatic. Caths are unpleasant, yes, but there's no need to make a huge case out of it.

Seriously, a blog is the nurse's inner thoughts, NOT what is actually said to patients.

Ashley said...

Annie,

It is a big deal to some people. It isn't a big deal to you because it's something that you see and do every single day. For most patients who have to endure it for the first time though, it can be a frightening and painful experience. It isn't fair to belittle them or minimize their feelings just because YOU don't think it's a traumatic event (sorry, that's my psych degree talking but it's true). For some people, just the very act of walking into a hospital can be enough to induce a panic attack. I can obviously see that they don't teach compassion or empathy in nursing school.

p.s. This is just one of the many reasons why I've decided to have a homebirth.

ldrnurse said...

Wow! you guys are seriously getting too emotional over this. The fact is that some people tend to overreact to things. I take huge offense to Ashley saying that nurses do not have compassion and empathy. Give me a break. You obviously have not idea what we have to do everyday and the number of idiotic people that walk through our doors. Good for you and your choice to have a home birth. I hope it goes well for you. At least you won't have us horrible nurses there to torture you (oh, by the way, midwives ARE nurses!!!)

Ashley said...

Um, no, you happen to be misinformed on that point. Not all midwives are nurses! For example, the midwives at my local birth center are CPMs and don't have nursing degrees. There's a difference between CPMs and CNMs (at least there is in my state). The CPMs are just as qualified though, having delivered thousands of babies.

I understand that some patients may overreact, but that still doesn't give you the right to treat them like they're defective and talk crap behind their backs. Some people (like myself) are perfectly normal and rational when outside of a hospital. It's when we step into a hospital that it sometimes triggers a panic attack (and if you find it difficult to understand that concept then you really need to go back to school and study psychology; it would be an asset to you!). And I'm sorry, but most nurses I've encountered have been jerks. I'm not sure why that is, but it's just an observation and I know many of my family and friends have had the same problem which is why so many of them are going the homebirth/birthing center route instead. Oh well.

ldrnurse said...

Great to hear you are going to someone with a lesser degree than a master's degree. Good luck with your home birth. You sound like a person who has never thought a mean thing about anyone. Get off your high horse. If you had ANY clue about the crap we deal with EVERY day then you would keep your mouth shut. If you don't like this blog, quit looking at it! Obviously you have no sense of humor. I could tell you a dozen stories about CPMs but hey, you know it all already.

Ashley said...

Um, yeah, because we all know that doctors and nurses are perfect, and babies NEVER die in hospitals *sarcasm*... lol. FWIW, I've known women who were as dumb as door knobs and were still able to graduate from nursing school somehow so a degree doesn't mean squat as far as I'm concerned. You should come to Florida sometime. Many of the nurses that work in hospitals here can't even speak English, yet they're charged with managing a patient's care. scary. But I digress...

If this is how you actually come across in real life, I just feel bad for your patients. I'd probably tense up around you too. Have you ever heard of the theory of attraction? Maybe if were more positive and demonstrated more compassion toward your patients, they would show you the same in return and you wouldn't have to deal with so much crap from them. Just a thought.

Also, I think nurses need to get off their high horses. Seriously. If there's one thing I've noticed, it's that nurses always seem to act as if they have the hardest job in the world. Here's a newsflash for you: everyone has crap to deal with at work! Whether it's demanding bosses, annoying clients... whatever. But that doesn't give them an excuse to disrespect their customers. Most people would get fired from their jobs for acting that way. Yes, there have been occasions when I've gotten p*ssed off at people, but I've learned to be tactful and keep it to myself. That's what professionals do!

Ashley said...

Oh, and another thing... I know a few people who are nurses including my cousin, and they don't complain about their jobs nearly as much as you do even though they have to deal with difficult patients on a regular basis too (like drug addicts and such). I'm being completely sincere when I say that maybe you need to re-evaluate why you chose nursing as a career in the first place. You had to have known what you were getting into, right? What did you expect it to be like?

ldrnurse said...

wow ashley, how dare you tell me that I am a bad nurse. I was just replying to your comment. Too bad we can't all be as perfect as you. You obviously did not notice that this blog is supposed to be about funny stories about labor and delivery. This nurse never said this is all patients and neither did I. Luckily these kinds of patients are few and far between but they are memorable. How dare you insinuate that nurses are dumb and can't speak English. Talk about labeling people and being mean. Take a look in the mirror.

hrw102779 said...

LDRNurse completely hit the nail on the head...I've had 3 Catheters during 3 different pregnancies, and seen it done in 2 other people. I can admit it's not fun, but nothing compared to what Labor and delivery offer. If someone is screaming in pain from a catheter, not contractions they have issues...they need to relax....

I am guilty of jumping of the bed when I had to have my last catheter...yup I'm an idiot LDRNurse...I couldn't help it...that entire delivery had me jumpy...turned out to be justified, but none the less. But come on...it has to happen.

P.S. I'm loving this blog...you have to keep your sanity somehow ;)

SEvans said...

Well at least you catheter your patients (whether numb or not). When I delivered my son the nurses forgot to catheterize me at all so for a good hour or so I was pushing against a full bladder - needless to say the baby wasnt coming out. Eventually one nurse asked "hey... did anyone drain your bladder?" When I said "um...no" (how was I to know, never even crossed my mind) she immediately inserted the catheter and 15 minutes later out came my son... of course 20 minutes after after that I began to hemmorage due to the massive strain of pushing against a full bladder. After goping into shock and almost requiring a transfusion the bleeding was eventually taken care of by the oh-so-wonderful use of the doc up to her elbows inside me and me climbing the wall crab like and screaming in agony.

I'll take the slight discomfort of being un-numb when catheterized over the near death experience of hemmoraging any day. I cannot tell you the horrible feeling it is to finally see your baby after 9 months only to be faced with the heart breaking realization that there is a distinct possibility that it may be the first and last time you see him.

zoomdog! said...

I'm so glad this blogger is tough enough to ignore crazy comments and blog on, baby! This is one of the best blogs I've ever read. Hilarious and hits the nail on the head.
I had my son a year ago, three weeks early, and the nurses were totally freaking out of control awesome! I had the best experience ever, catheter and all!! No epidural, in the long run (blood pressure already too low) but we were laughing and listening to music and breathing together all night long. And when the shit hit the fan suddenly at the tail end, and the baby's heart stopped, and I had to have emergency vaginal surgery, the nurses were totally on top of everything (the resident had only been in my room all of five minutes so far that night). I credit their quick efficient work and ability to work with me and listen to me, to saving my son's life.
When he fell ill and was hospitalized at two weeks old, the nurses in the peds ward came through and made our ordeal as tolerable and painless as possible. They went above and beyond the call of duty to show me support and kindness at an awful time.
So did the nurses at Children's Memorial where he was transferred for surgery a week later.
He survived, and is now healthy and huge and wonderful -- and then I got sick this fall from my plethora of gallbladder stones, including a huge one that lodged in my common bile duct, causing a massive internal organ infection. Again -- awesome nurses, who did their best to help me out in an overcrowded ER, and when I was hospitalized for days, who loved to see my son when he came to visit me. And awesome lactation consultants (nurses) who helped us too. And awesome support staff (more nurses) when I returned for surgery six weeks later.
I'm sorry this blogger Ashley has so much anger at nurses. Wow! Really scare when she talks about her psych major! Can you imagine if she was counseling you and you happened to be a nurse LOL!!! She actually puts it best when she says "If you can't stand the heat..."
Ashley -- here's a tip. Stop reading this blog! Stay the hell out of this kitchen!! It is obviously WAY too distressing for you to acknowledge that nurses are only human, and have no issue with most of their patients, but who need an outlet to vent occasionally about the ones that really tested them.

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ldrnurse said...

Ashley may be interested in knowing that sinse this blog was posted I was catheterize without anesthesia or medication and guess what? I managed to stay still. And yes, babies do die, at hospitals and at home. The reason more babies die in hospitals than at home is that most midwives are smart enough to not care for high risk patients and refer them to a physician. The higher risk patients are much more likely to have a loss than the mothers with no risk factors. Also, if a midwife is caring for a mother and she discovers an IUFD (intrauterine fetal demise) the midwife refers them to the hospitals for delivery. Seriously, use your brain.

Beverly said...

Nurses are trained professionals and specialize in saving our butts in emergencies. As patients, we have a responsibility to not be a bunch of horse's behinds, to be educated, to ask questions, and to have behavior that is reasonable to the situation.

BlueNostalgia@etsy.com said...

On catheters:

When I was 25 weeks pregnant with my first son I suffered from kidney stones and was admitted into labor and delivery and given a catheter. I was in so much pain at the time, I could have cared less about the catheter and while it was uncomfortable it was bearable.

Fast forward to 39w 1d, the day of my scheduled c section. That morning I went into labor and delivery and was admitted. My husband and family were asked to wait in the waiting room while my nurse prepped me for surgery. First thing I had to do was get changed into the dreaded hospital gown. Next was the IV.

For some reason (maybe the fact I hadn't had any fluid for 10 hours) the nurse couldn't get the IV started. She had to stick me 4 times and she ended up blowing a vein in my left hand. I was starting to get a little anxious at this point.

Next she tells me she is going to shave me. She lifts my gown with no warning and freaking DRY shaves my crotch with a single blade razor. Not only was it pretty killer, but I started bleeding from the cuts and it started to soak through the gown. (I wish my OB would have told me to shave myself)

Then it was time for the catheter. I wasn't scared, and I didn't have any preconceived notions about how painful it was going to be. After all, my first cath was simple and painless for the most part....

But let me tell you, it was the worst part of my day. She couldn't get the catheter in, and it felt like she WAS stabbing me. She had to call for backup and a couple of nurses came in to help and help hold me down. Once it was placed, I couldn't move, I couldn't sit up, I couldn't do anything but cry. It was severe pain.

I walked to the OR with the cath inside me and had to endure the spinal, but the cath was what was hurting me the most.

I talked with my OB about it after all was said and done, and she had a pretty logical reason why I had such a bad experience. You see, my vagina pretty much swelled to the point of being shut by the time I was 30 weeks. I am short, and I had a big baby and a ton of swelling in my hands and feet as well. My OB thinks my urethra was really swollen which made the pain incredible for me.

So there are logical reasons why the catheter can be bad for some people. The pain for me was worse than the pain from the section.

ChrissyRBV1984 said...

I just have to say that most of the comments on here are so catty and obnoxious. I'm not a nurse (I want to be but being a single mom has put those plans on hold) but I am pregnant with baby #2. With my son I drove myself to the hospital after having my water break at home and while contracting every 2 minutes. Not once did I yell at my nurses. I made everything as easy on them as possible and they were absolutely amazing. I think the only time I screamed in pain was when another nurse tried to start my IV with a needle that was too large and ended up blowing my vain. Point being, quit acting like these women are just helpless to their pain and can't help but scream and all that. Yes, they can help it. They can learn to do breathing exercises and manage their pain better than acting like howling morons!

justlaugh said...
This comment has been removed by the author.
Lex said...

I'm not a nurse but I've been considering becoming a mom. I recently discovered your blog and absolutely love it. I appreciate the blunt, honest way you describe childbirth and what you see on a daily basis. THIS is the stuff I want to know BEFORE I get pregnant! I wish you would start writing again. With that said, I object to number 3 on your list. Panic disorder and anxiety in general are very real, potentially debilitating conditions that deserve recognition from medical professionals, particularly during a terrifying experience like childbirth. Your minimization of the disorder is insulting and demeaning to the people who actually suffer from panic. Even if you were just using the words "panic attack" to describe someone who was not having an attack and was just being unreasonable, you've lumped people who actually have panic in with the crazies. Your comments just perpetuate the social stereotypes we have about people with these very real disorders. It's the equivalent of saying that the terrible movie you saw last night was "gay". Maybe you'd have fewer people who clearly don't have anything wrong with them showing up to your ER complaining of heart trouble if the public and medical professionals like yourself knew more about panic and accepted it for the very serious and widespread health issue it is. I'd recommend you visit ADAA.org. You need some educating. Otherwise, I love the blog and wish you would start updating again. :)