Old Military Nurses

Back in my early days of medicine, there was almost always an old military nurse who would likely be the head nurse for that area of the hospital or perhaps even of the hospital.  Bay View Hospital had one, and I’m so sorry I forget her name.  Well, I was senior resident and on-call on this particular night.  I was sleeping in the intern quarters when I got a call about 3 a.m., and she said a patient needed a Foley catheter.  Now this is not an uncommon experience.  It happens mostly in older men who have enlarged prostates and circumstances like swelling or maybe tumor causes them to compress the urethra all the way shut and prevents urinating normally.  It doesn’t take too long for the bladder to swell full of urine and cause a lot of pain.  So, I went down to the floor he was on and the nurse was at the bedside with all the nesessary equipment.  One has to scrub the area (back then it was betadine) and the place towels around to prevent contamination.  Inserting a catheter is a sterile proceedure.  Putting bad bacteria into the urethra or bladder would be bad.  Now, when the urethra is touched with a cathter it is painful.  We put in a gel that is an anesthetic, but it doesn’t prevent pain caused by the stretching of the urethra.  Normally the procedure is so quick that there is only a little pain and much relief by allowing the urine to flow.  So, with my sterile gloved hands, I start to pass the catheter.  The patient (whom I knew nothing about) barely stirred, either asleep or unconscious, but when I got to the level of the prostate, he started to moan.  This particular prostate was quite large obviously and it took a Lot of pressure (and time) to push the catheter thru the urethra into the bladder.  I pushed and pushed, and the patient started moaning loudly “I gotta go!  It was a slippery catheter of latex rubber and quite flexible.  I kept holding the pressure of the foley into the prostate and he moaned even louder “I gotta go!”.  Almost everybody does this because their bladder is so full….and I knew that once the urine started to flow, the feeling would stop, so after the third scream, knowing as soon as it went thru the prostate, the urine would flow and he would be pain free, I said, Well, Go ahead!  and he Shit all over the bed!  Of course I didn’t have to clean up the mess, but every time the old nurse (whom I really respected) passed me in the hall, she would drop her head and snicker heh heh heh.!