Catheters

Had a prac today on how to place a urinary catheter.  For those unfamiliar with such devices, it's basically a tube which is inserted into the urethra and up to the bladder to help empty the bladder if the person can't empty it reliably themselves or if urinary output needs to be carefully monitored, for example if urine futures are booming on Wall St.

It seems heaps easier than I had envisaged, which no doubt means that it will be the bane of my life when I am an intern and can't get it right.  Of course, we were practising on models, and I don't mean clothes-horses.  I mean plastic and rubber simulacra of people's urinary bits.  In a way that actually made it harder since the models were fairly rigid and unyielding, whereas apparently real people are soft to the touch and altogether more squishy.

It's a strange experience, poking a rubber tube up someone's wazoo and feeding in more and more.  Especially on men.  Men have really long urethras.  I was starting to worry that I was going to run out of catheter, but I got there in the end.  I was also concerned when the urine did not start to flow, but apparently siphoning by mouth is right out.  They have little syringes for that.

The (disturbingly young looking) RMO who was instructing me in the fine art of catheter placement on the male station (I had already perfected the art of placing a catheter in females) almost made me laugh out loud.  I was waiting to take my turn so I got to watch the guy before me do it and figure out some dos and don'ts.  The RMO looked at me and said, "You're going to smash this aren't you?"  I'm pretty sure that he was being encouraging, but all I could think of was the idea of smashing the catheter in, which is not a good mental image at all.

Back in old days I suppose med students learned this stuff either by practising on each other, or by being unleashed on a ward full of demented old people.  Either way, I'm glad that we've moved on.