In an interview with Helen Greenham, Continence Care Specialist Nurse at Birmingham Community Trust in England, we get to share her vast knowledge of women practicing intermittent catheterization (IC) and how important it is for them to feel good about themselves.
With more than 30 years’ experience of continence care for both women and men in the IC community, Helen Greenham affirms that there is indeed a big difference between the way women and men look upon and handle their continence care. The difference in anatomy and the difficulty in finding the exact location of the urethra is the main reason why catheterization is so much more of a challenge to women compared to men.
Use your creativity
As a nurse, there’s no magic formula for teaching self-catheterization. You just have to be patient – and teach patience – while realizing that every individual has individual issues and needs. Immobility and obesity are examples of bodily challenges that put demands on a nurse to be creative and propose unusual, sometimes even bizarre, positions, says Helen. In fact, catheterization over the toilet would be the natural – but is in fact the most difficult – place to do it.
“There’s no magic formula”
Find the best solution
As a clinician, you need to know the choices available today as well as all extra aid and appliances on the market, and be able to assess a patient’s need and recommend the solution best suited to the individual in front of you. You need to help them think about what you can do, rather than what you can’t, and what is possible rather than what is impossible, Helen adds and continues: Learning is one thing, sticking to the technique is quite another.
Focus on the benefits
Dignity is a big issue, especially to women – we simply like to feel good about ourselves, says Helen. Which is why you must start by trying to understand the patient’s life and how catheterization can fit into the daily routine of, for instance, a working Mum with four children. Maybe she needs to get up 10 minutes earlier every day? By helping women understanding the benefits and that there will be no harm, that it’s all about giving them control and keeping them safe, you can help women build catheterization into their lifestyle.
Helping women remain independent
Some patients with a chronic condition such as Spinal cord injury, Multiple sclerosis, Spina bifida or Parkinson's disease may not have experienced the negative effects of their disorder. The emergence of bladder symptoms may be the first time when some women have to assume and live up to their condition. Consequently, your role as a nurse is to help them understand the journey that is lying ahead of them before you can talk about – and teach – self-catheterization. Trying to help them regain their confidence, their dignity and independence will be the most valuable contribution you can offer for their own self-esteem and their future.