Thursday, November 10, 2005

Foley Catheterization, Genitals, and Social Rules

Before we can dress, administer, or insert anything in the hospital, we must pass a clinical checkoff. Today I had a practical examination in Foley catheterization. (For those of you who don't know what that is, it's where you insert a tube into the bladder. Through the urethra. Yowza.)

The labs are filled with these pathetic looking dummies students can use to practice everything on. I say pathetic because they look worse than many of the vegetative patients I've seen in the hospitals; their plastic bodies have interchangeable parts for just about every ailment possible. You can even swap out genitals, which amuses me to no end, so today I inserted a Foley tube into a somewhat disturbing labia mold. Disturbing because the urethra was very exaggerated for easy learning, which is NOT the case in the real world. (Where the hell is the hole?)

I'm not someone who balks at nudity. (As a 96 year old woman once said to me, "If you have something I've never seen before I WANNA SEE IT.")
But I'm also not someone who thinks you can totally objectify something like this. For example: sometimes when inserting Foleys in males you can first inject this numbing gel inside the urethra. Only problem is this: you have to hold it there for five minutes. My instructor said "I've never done the gel thing, probably because I'm not one for small talk". Honestly, what do you say to someone while you hold on and wait for the stuff to kick in?

It always amazes me how willing people are to get naked for you once you wear a hospital uniform. I've had a good number of patients sofar this semester, and not a one objected to me lifting their shirts to listen to their chest, or helping them put on clean undies and a gown. Of course, they have no reason to worry about me seeing them naked; I am a professional. I'm going to see a million before I'm done. But what is it that makes them trust me with their body more than they would any other stranger? Surely it isn't the purple uniform... though I'm certain they'd be more uneasy if I was there wearing jeans and a tee-shirt.

We build up the most interesting environmental associations. Being in a certain setting, playing a certain role, and wearing a certain costume makes all the social rules change. Sometimes the roles can be de-humanizing (people expect super-human responses to their problems, especially from doctors). When someone fails while playing their role, we are disillusioned and disappointed with the role (profession!) as a whole, and not just the offending individual.

This is why I try very hard not to laugh at the plastic genitals of the practice dummies when I'm in the lab, less I undermine my professionalism. But another part of me sees that professionalism is a function of context. Objective detachment is a function of one's role. And though nursing is arguably something that becomes ingrained in one's very identity... I AM still a student.

So. Between you and me, I am seriously considering turning all the "parts" upside down one day. Just to see if anyone notices. I have the serious suspicion the instructors would find it hilarious. For all the roleplay, nurses aren't as stuffy as people think. So long as no one is watching. ^_~

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