I had been on the Ortho service for only a few days when I got paged by 2E, and was told I needed to come cath a woman with a fractured femur. I started up to 2E, wondering why they called me (male intern)- most female caths were done by nurses. In fact, I could not recall EVER doing one, except during the delivery of a baby when we worried that a full bladder was interfering with the delivery (it was).
When I got to 2E, the nurse showed me to a private room and the patient, a beautiful blonde 19y/o girl who had been hit by a car in the cross-walk that morning. Her femur was broken high up, and I could see her lower abdomen distended- she was a thin girl but her full bladder made her look pregnant. And her broken femur had caused swelling so that the leg extended over her vulva. Apparently several nurses had "tried" to find the urethra, and now they had ME (who had done one simple cath before).
I couldn't think of any way to bail out, so I began. I introduced myself to the patient and explained what I proposed to do (she already knew). She was heavily sedated with morphine, so she was sort of feeling good, but hurting, and a little "out of it".
I took some betadine and rubbed it between her legs, but could not see what I was rubbing. I tried "pushing" the swollen leg tissue out of the way, but that caused her pain. Eventually I just took one finger (covered with KY lubricant) and poked it in between her legs. I rubbed it up, then down, trying to find "the anatomy". I sort of could feel where her vagina was, and after the third pass I could feel her clitoris (getting stiff).
"What are you going to do that the nurses couldn't do?" she asked. "And is what you are doing now part of it?"
I explained that her leg was so swollen that we could not SEE her vulva, nor her urethra, which is why nobody had been able to pass the catheter- I was just trying to determine "about where it might be" and told her I thought I had a pretty good idea so I would gently "try"- and she should tell me if it hurt because I would stop.