Learning to Catheterise Is Not Just a Procedure, It's a Life Skill

The gap between being shown how to perform intermittent self-catheterisation in a clinic room and being able to do it confidently in your own bathroom is larger than most people expect. For many catheter users, that gap is exactly where things fall apart. This episode names it directly and offers something more useful than technique tips.

A Procedure Designed for the Wrong Environment

Angie Rantell has been teaching intermittent self-catheterisation for nearly 20 years. The way she does it now looks almost nothing like the way she started.

The first shift was recognising that a bright clinic room with a hard couch bears no resemblance to the environment where someone actually needs to use a catheter. Teaching in that context and then sending someone home to figure out the rest isn't teaching the skill, it's teaching a simulation of the skill.

"Me teaching someone a procedure in a clinic room is very different to you going home and doing it in your own toilet or in your own bedroom. Working out how you're going to do it in your own environment is half the challenge." ~ Angie Rantell

The evidence supports home teaching and Angie now sends patients to be taught in their own space wherever possible, with a specialist community nurse. The difference in outcomes, she says, is significant.

What Angie Actually Does

Her current approach to teaching intermittent self-catheterisation starts not with technique but with understanding: why the catheter is needed, what it is meant to achieve, and what the person's actual life looks like.

She asks where someone works, how they travel, what their daily routine is. She lets people handle different products, try different sizes and coatings, find what feels manageable rather than what looks least intimidating. She once taught a flight attendant standing in a boxed-off corner of the clinic, specifically to approximate the conditions of an aeroplane toilet.

"The skill is not in performing catheterisation. The skill is in adapting it into your everyday life and managing it in social situations in life." ~ Angie Rantell

Keira's Very Different Experience

Keira learned during the COVID pandemic. Over the phone, from a distance, with a pack of six catheters and instructions to pick a favourite. For months, she struggled. Infections were frequent. Her technique was uncertain. The whole process felt like it was making things worse.

"Having to transfer that skill to trying to do it over a toilet was really, really difficult. I made so many mistakes." ~ Keira McGarrity

What eventually changed was not better instruction. It was a shift in how she related to the process from bracing, self-critical, performing, to curious and willing to try without demanding it go perfectly.

"I recognised that my whole body was tense. And if you try and put in a catheter when you're tense, it hurts. So I started to change that. I was like, I'm going to try it and see what happens." ~ Keira McGarrity

That shift from trying to get it right to being willing to find out is one of the most quietly important things in this episode. Continence care and quality of life are genuinely connected to the psychological relationship someone has with the process, not just the physical technique.

What intermittent self-catheterisation eventually made possible for Keira (sleeping through the night, travelling abroad, running) makes the full picture of this conversation worth hearing in its entirety.

Listen to the full episode with Angie Rantell and Keira McGarrity now.

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