Ah, the Foley

Yesterday I got into a discussion with one of our residents about Foleys. As she talked about her experience as a med student learning to put a Foley in, it made me think back to when I learned. I remember in nursing school practicing on the rubber crotch and thinking, "Will I really have to do this?" My friends and I joked about it, and of course there was no missing the right spot on the rubber model. And then when it came to attempting on a real patient, I realized this was no rubber model with "X marks the spot." While trying to still get the hang of sterile technique, I fumbled around there for a while trying to get that catheter in. Eventually, I did, but it was no simple feat. The resident related that she's only put in less than a handful and commented about it being harder in larger women. That's the truth. When I worked in the ER, I put Foleys in many times a day. Far from the days of figuring out where to aim, I put so many in it became like old hat. But I had a very large lady one day, and I absolutely couldn't see anything down there. Ultimately it required two people holding each leg and person with a flashlight behind me. It was still a blind shot. I don't remember if I actually got it in or not, I think eventually I did after multiple attempts. But really that isn't what mattered. The memorable part was that to date that was the most difficult Foley placement (barring traumatic cases).

You'll find through your career, that certain things start out hard to do but eventually become easy, or easy enough. Really that's the case with starting anything new and you just don't exactly know what to do. But with time, you learn how to do it better, you gain more experience from your attempts, even if they are initially failed attempts, until you feel you might have a handle on it. But then there will still be those cases that are out of the ordinary, that challenge your skills. And it will be those that you remember.