Catheter Care
Questions Received:
Responses:
Is it normal procedure for a nurse to catheterize a male patient?
11th February 1999
In my experience there should be no reason why a female nurse should not perform male catheterisation. Providing she is appropriately qualified and, in view of the fact that she is accountable for her actions, considers herself to be competent. A nurse is under a "duty of care" and must always act in the best interest of the patients whom she is responsible for. In this sense if it has been established that a male patient requires catheterisation, and providing the female nurse responsible is qualified and achieved competency, she would be expected to carry the procedure out. Having done so she would then record the details in the nursing record.
I can only think of two sets of circumstances whereupon a female nurse might be prevented from performing male catheterisation: Where an employing authority has made a statement which forbids female nurses to perform male catheterisation. Where the patient in question, or, nearest relative acting on behalf of the patient, has made an express wish not to have the procedure carried out by a female nurse.
Aside from these two criteria it is difficult to imagine the grounds upon which a female nurse might refuse to carry out such a procedure. Clearly though if a suitably qualified and competent male nurse where available it would not be unreasonable to assume that he would be willing deputise for her.
According to Easton (1997) and cited by Pomfret (1999): "Female nurses performing male catheterisation has promoted improved patient care. It means that male patients can receive the same prompt attention as a female patient when urinary catheterisation is required".
References
Easton, S. (1997) A Quick Reference to Male Catheterisation. London: RCN Publishing.
Pomfret, I. (1999) Female nurses and male catheterisation. Nursing Times, 95(6), 59-60 (Feb 10th).
See also:
RCN Continence Care Forum (1997) Male catheterisation: the role of the Nurse. Professional accountability for practice. London: RCN Publishing.
Identify and discuss the interpersonal process of the intervention in relation to catheter care, linking with Roper, Logan & Tierney's nursing model.
28th February 2000
In the context of nursing, "interpersonal process" can be taken to mean those skills or techniques we use in order to produce therapeutic benefit during our professional interactions with others. General interpersonal skills are learnt very early during childhood and become modified and refined through experience.
We receive information about the world through a variety of senses and this influences our developing world-view. We respond to events and situations by the use of a range of effectors that depend on the activity of muscular and glandular tissues. When we interact with others, we are using not only our vocal apparatus, but also a body language involving our facial muscles, arms, hands and posture. People become skilled at recognising even quite subtle cues exhibited during an interaction, particularly doctors and nurses who by nature of their work acquire a wealth of experience in this area. What is important however is to be able to appreciate that individuals vary markedly in their interpersonal skills. For example someone with either a sensory or motor deficit can often, mistakenly, be assumed as someone lacking in interpersonal skills.
Knowledge of interpersonal skills is fundamental to nursing. If we apply the Roper Logan & Tierney model of nursing care to the case of someone requiring catheter care, the aim will be to provide individualised care and to take into account the degree to which the problems of elimination affect other activities of daily living (ADL). From this an appreciation will be obtained of how the person feels towards the need for a urinary catheter and what they perceive as positive benefits or negative effects. An assessment can be made of whether the person is taking responsibility for their own catheter care in the way of maintaining personal hygiene, emptying the drainage bag, and checking for signs of infection.
Empathising with the person who has the catheter and helping them to adjust to its use would be supportive. Being sensitive to the fact that the procedure constitutes an invasion of personal privacy is essential. If the procedure is a long-term measure then account will need to be taken of the implications that this may have on a person's sexual relationships, another ADL.
he specific areas of the Roper Logan & Tierney Model of Nursing that catheter-care skills can be linked to are: communicating, eliminating, expressing sexuality, and maintaining a safe environment. Assessing an individual's needs involves gaining subjective impressions and gathering objective evidence. The skills of communication are relevant to both. It is however not simply a question of the nurse assessing the patient or client. When a nurse is gathering such information (s)he is also creating an opportunity for the patient or client (if conscious and alert) to assess her/him and this is equally important.