Clinical Supervision 4
What was the event?
I had developed several objectives for my learning contract during my placement in A&E. One of these apparent objectives was to conduct as many catheterization procedures as necessary. After discussing this object with the mentor, he allowed me in the procedure rooms to watch the procedure. However, I had to gain patient consent as the process is always intimating, and the patient may not be comfortable with the presence of students or many staff. I had earlier performed catheterization on a female patient in the wards. However, things became fierce as the current procedures were on an older woman admitted at the A&E due to acute urinary retention. I gained the courage and confidence to perform the procedure under my mentor’s supervision. I thought of accomplishing the procedure in due time and with no complication, since I had performed observed several catheterization procedures and also did one procedure successfully to one patient. Despite my prior knowledge and carrying out the process earlier, this one proved complicated by the patient’s weight, age and her muscles had very loose tone making it difficult finding the urethra orifice. With the trust that the procedure technique remains the same, I was able to conduct catheterization by the help of my mentor successfully. However, we took much time than earlier anticipated caused by the earlier stated complication. I maintained the patient’s attention, reassured her of the success probabilities of the process through continuous communication throughout the catheterization. She was on provided with painkillers by my mentor as earlier prescribed by the doctor. She was thus transferred to the ward for further investigation and diagnosis immediately she settled.
What did I learn from the event?
I learnt the primary reason why catheterization is performed on patients is to drain urine from the gall bladder. The nurse needs to perform a holistic assessment of the patient as there are several indications to suggest why the procedure is required before the actual process is decided. According to Robinson (2013), immediate action is necessary in emergency cases of acute urinary retentions to prevent complications. It is essential to gain informed patient consent before performing catheterization by building rapport and then explaining the need for the procedure. The procedure is embarrassing and painful for patients. Thus there is a need to minimize instances of pain and organ injury through the use of lubricants such as instillagel and promote measures that ensure patient privacy and dignity. There is a need to assess any signs or history of allergies to latex before commencing the procedure.
Furthermore, maintaining hand hygiene, sterile fields and use of aseptic techniques are significant procedures in the prevention of infections. Factors to consider before deciding on the urinary catheter are catheter length, material, and how long it shall remain in place. Individual patient needs dictates the type of drainage system during insertion of a urinary catheter. Patients must be educated on catheter and drainage system self-management care immediately after the procedure. All the activities carried out during catheterization must be recorded and documented on the nursing notebook after the procedures as guided by the National Institute of Health and Care Excellence (2014).
How can I apply this learning to nursing practice?
I got a full understanding of the human female urinary system and its anatomy to perform the procedure successfully.
I also developed awareness and acquired knowledge of performing the correct female catheterization procedure by using the aseptic technique that prevents infections. I thus shared what I learnt with other peers.
I learnt that, before the procedure is performed, informed patient consent must be gained, and continuous communication with the patient is vital throughout the process; thus, I will ensure I adhere to the practice.
I will practice proper handwashing, assemble all equipment’s, ensure that I work with the right patient in a sterile field and assesses any form of allergies to latex to reduce allergic complications.
I gained more confidence in carrying out the procedure now and in the future, and I have a clear insight of possible complications that may occur in some patients due to their body size and age.
I will work under the supervision of qualified care staff and perform the procedure within my limitations.
I will ensure that the patients gain necessary information concerning catheter procedure and also be aware of risks of infections and complications and how to prevent. I will advise the patient to take more fluids as it’s a prevention measure to urine infection.
After the procedure, I will make a record of all the activities on my nursing notebook and also ensures that the catheter is well-drained.