True Tales of Medical School: The Foley

May 28th, 2004

Filed under: Medicine

I was down in the operating suite helping the anesthesiologist prep a patient for surgery. It was the middle of my third year in medical school, and I was halfway through my general surgery rotation in the downtown VA Hospital. Just as we got the patient sedated, intubated, and hooked up the ventilator, two older nurses walked in.

VA nurses are a distinct breed; they are capable nurses who have chosen not to pursue the higher pay and higher acuity at better hospitals, but instead to reign in comfort in the federal system. Almost uniformly, they are old, big, and tough. You learn quickly not to cross a VA nurse.

I’m almost out the door as they walk up to the patient. They look at me, look at each other, then share a wicked smile. The anesthesiologist quickly leaves.

“Hold it there,” the older nurse says. “This patient needs a Foley catheter.” She hands me a Foley catheter kit. Foley catheters are soft rubber tubes that are placed up into the bladder to drain the urine during surgery. To place a Foley in women, it takes a little lube and a deft twist of the wrist. In men on the other hand, it takes a lot more lube, a firm grip, and some honest effort.

“I’ve never put one in before,” I said.

“We’ll tell you how,” she said as she handed me a pair of gloves. As I put them on, some other nurses came in the room to watch. The first nurse handed me the catheter, the tip dripping with lube.

“Hold the Foley in one hand,” she said. “Now, take that other hand and just choke that chicken, son. Just choke that chicken!” All the other nurses joined in, laughing, “Choke that chicken! Choke that chicken!”

I placed the catheter, made sure it was working, and left the OR as quickly as I could, the nurses still cackling behind me. I hoped nobody else been watching; I also prayed that for his sake, the patient was deeply asleep.

From that day on, I made sure I was out of the OR long before the nurses came in.

9 Responses to “ True Tales of Medical School: The Foley ”

  1. Anonymous
    June 27th, 2007 at 4:56 pm

    Gosh this is SCARY. I wonder if I ever go to a surgery after reading this.

  2. PG
    July 21st, 2007 at 12:39 pm

    Almost as embarrassing: when I learned how to place a male Foley, it was at the hands of the cute OR nurse (who we all secretly had a crush on) yelling at me to “c’mon, grab it like you own it!!”

  3. Not a doctor
    October 14th, 2007 at 6:29 pm

    As a guy, I can safely say that getting a Foley cath while wide awake is the single most painful thing I have ever experienced.

  4. alabama
    November 5th, 2007 at 5:15 pm

    As a guy, being absolutly, totally unable to urinate after a hemorrhoid
    operation (nobody warned me about this) let me say the Foley was a God-send.
    And the (male) nurse inserted it quote skillfully and with no pain whatsoever.

  5. Diane
    December 5th, 2007 at 11:52 am

    I am a VA RN (two years out of nursing school) and love my job. I have tried other hospitals but returned to the VA because I missed the veteran population and fast pace of the VA floor. I, too, have been on the receiving end of the behavior you described. Some of of my colleages fit your description. Unfortunately, some older nurses attempt to “eat their young” along with the occassional med student. However, I am not old, big, or tough and I always try to help the doctors in any way that I can. I work with a lot of other young women and several men (many former medics) who are efficient, respectful and excellent nurses. The population of VA nurses is changing.

  6. Daniela
    December 16th, 2007 at 4:46 pm

    I’m a med student and last year, we were in a group, guided by a nurse, and had to take care of one patient. The first thing he needed was a foley. Nobody wanted to do it and I volunteered. I had theoretical knowledge, but it was my first foley. Everything went just as it should be, I got it in and urine started to flow, we had a little cup to keep it so it was no big deal. But then, I had to inflate the little bag that the catheter has on the first two cm that prevents it from sliding out. Meanwhile, everyone in my group was very near, watching every move. I had to loose the grip to inflate the bag, it clashed into the cup, spilled the urine in it and started to act like a hose when you let go, moving upwards and sideways and covering my teammates in urine. They jumped backwards and I announced: “Calm down, urine is sterile” meaning that it can’t make you sick, like poop can

  7. Confused
    May 2nd, 2008 at 9:47 am

    Um….where does it go? please don’t say it goes in the pee hole

  8. Scott
    May 2nd, 2008 at 10:12 am
    Official Comment

    Sorry, that’s just where it goes:

    http://en.wikipedia.org/wiki/Foley_catheter

  9. Becky
    June 22nd, 2008 at 9:15 pm

    Just want to add that Alabama had the luck to have a guy put that Foley in. Guys seem to know all about using lidocaine gel as a lube instead of the KY stuff. A urologist taught me that. Most other female nurses never give a thought to how far the cath has to go and the emotional aspect of having a strange woman grab your penis.
    An old not VA nurse

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