Tuesday, April 27, 2010

Blog Feed: That's Just Unsanitary!


Hey guys! So here is a post made by one of my bloggy friends @ Crash-Course In Nursing that I love to read who is currently a nursing student. We thought it would be great to get feedback of how some of you in the field or headed into the field of Nursing would react or care for the man who needed treatment in the post? For those of us who are newbies entering the field, we need to be aware of all aspects of the field and hopefully be ready to bring forth the effort it takes to be an awesome Nurse... It is hard-work, takes perseverance, dedication and a will to carry out quality work. Some won't cut it, some will go above and beyond. Which one are you?

Share your feedback, thoughts, critiques. We as (hopefully future) nurses need to be prepared...

That's Just Unsanitary!

Friday was another 12 hour shift in Midsize Non-Trauma Center's ED, and while there were only two people I would actually be able to label "True Emergencies" all shift, there were some VERY interesting cases in other ways, which was impressive given that when I walked in at 645, there were NO PATIENTS IN THE DEPARTMENT. I curled up on one of the swivelly chairs and DIDNT SAY ANYTHING for fear of jinxing it, but as predicted, the "quiet" (oh no! i typed it!) only lasted about half an hour.

The first truly bizarre/awful case of the day was a 500 some-odd pound man, brought in for, ironically "failure to thrive". This MUST only be a social designation, since in neonates "failure to thrive" means they're LITTLE...not this particular gentleman's problem. His problem was bilateral cellulitis of the lower legs. REALLY GROSS cellulitis of the lower legs. They were wrapped in biohazard bags by the medics, who promptly ran outside and started shaking their clothes off on arrival...which is NEVER a good sign. Apparently this gentleman had ROACHES LIVING IN HIS SKIN FOLDS.

The truly odd thing about this large man was that he was COMPLETELY LUCID, and convinced that we were "making a big deal out of nothing!". He was caked in dirt, apparently from "pulling himself across the floor" which he didn't seem to think was a problem in and of itself, and was FURIOUS that he'd been taken out of his house. It took us (me, my partner and three Real Nurses) almost an hour to get him all cleaned up. He was really quite polite, and seemed lucid, albiet with a HUGE blind spot about how bad his house and hygeine really were. He was admitted to med-surg, for placement in assisted living, and may lose both his legs to gangrene.

I learned that the smell of gangrene actually does not upset me nearly as much as I had originally thought. Good to know! On the other hand, I have also learned that I will be itching for the rest of any day when a patient has bugs.

Its tough to know how to feel about a patient like this- on one hand, you KNOW they cannot take care of themselves, because...well...he was dragging himself across the FLOOR in a filthy house! But on the other hand, now we're taking away all his perceived independence. Tough call.


Posted by little d, S.N. at 12:44 PM

Be sure to leave your comments where credit is due as well please!! @ Crash-Course In Nursing

Thanks ~ Missy Prissy

7 comments:

  1. Oh...My....Gawd! THats really truly the worst Ive heard..

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  2. I think the worst part was that he was, in all other respects, completely lucid. Thus, it was really much tougher to have to tell HIM that it had been decided that he could no longer care for himself. It was sort of like taking the car keys from my grandmother.

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  3. Wow--I wonder how long it'd been since he'd been out of the house. I've actually heard "failure to thrive" used to describe adult patients post-bariatric surgery. I believe it had something to do with the micronutrient deficiencies some people develop after surgery d/t malabsorption, less stomach capacity, etc. Whereas in peds it usually references low weight, in adults it's more nonspecific and seems to just generally mean they're not doing well.

    And thanks for stopping over at my blog!

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  4. @Little d. S.N.: That had to have been so traumatizing in all aspects. Did he know he had the bugs living in his legs? How did he react at that point?

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  5. @thedogatemycareplan: He most definitely wasn't doing well at all. How heartbreaking. I think I would have over compensated his care, just because. I hope I can find the balance.

    You're welcome!!! :-)

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  6. The bugs weren't actually living IN his legs, they were in his skin folds, and we're unsure if they were LIVING there, or "just passing through". He actually had pretty good hygiene, considering what I was lead to expect. Most of the dirt on him was actually DIRT, and not human-waste related. It's the little things that you have to appreciate.

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