APPENDIX 2

APPENDIX 1

During my placement in Edgecombe 1, I had the opportunity to participate in two sessions led by the pre-registration team at Croydon University Hospital. The first session focused on male catheterization and the second covered nasogastric (NG) tube insertion.

In the catheterization session, I was taught the procedure for catheterizing a male patient, the indications for catheter use, various catheter types, and appropriate catheter care. Initially, a demonstration of male catheterization was provided, which I then practiced on a mannequin under the supervision of the pre-registration nurse. I approached the mannequin as if it were a patient, introduced myself, and obtained consent for the procedure. After sanitizing my hands, I opened the catheterization pack while maintaining sterility. I donned an apron, placed a protective sheet beneath the patient’s genital area, and wore sterile gloves. Following this, I cleansed the penis with the sterile water from the pack, ensuring the foreskin was retracted during cleaning, a crucial step for male patients. I then applied lubricant from the catheter pack to facilitate insertion, changed my gloves, and opened the catheter without direct contact. With the penis held upright, I carefully inserted the catheter and inflated its balloon with the provided solution, pulling gently until resistance indicated proper placement. Finally, I secured the catheter to the patient’s thigh and verified it was draining correctly.

This session helped me gain a comprehensive understanding of different catheter types, including Foley, indwelling, intermittent, suprapubic catheters, and urosheaths.

The second session covered NG tube insertion, which was particularly useful, as I encountered several patients in my ward requiring NG tube care. I practiced the insertion on a mannequin, following the same process as I would with a patient. I began by introducing myself, obtaining the patient’s consent, and positioning the patient upright with the bed elevated to 30 degrees. I measured the required tube length from the tip of the nose to the earlobe and down to the xiphisternum. During insertion, I encouraged the patient to sip water slowly through a straw, which helped ease the tube’s passage. I advanced the tube through the nasal passage up to the marked length, checking for resistance and verifying placement by aspirating gastric contents and assessing their pH, which should fall between 1.5 and 5.5. Additionally, I recommended an X-ray, as pH testing alone is not always reliable. The tube was then secured to the patient’s nose. The nurse emphasized the importance of having two staff members verify the pH test. This session also provided insight into the reasons for NG tube use, especially for patients who are nil by mouth (NBM) but require medication. I was able to apply this knowledge in my ward, checking the pH level before administering medications to patients with NG tubes to ensure correct placement. These sessions were very valuable, as they equipped me with the skills and confidence to provide better patient care in my ward.