I work at a clinic and we had a patient 2 days ago with a huge ulcer on his left lower extremity (possible elephantiasis?). It seems that his ulcer was oozing, because the stench was coming out from his lower extremity and spreading out towards the lobby. I'm usually ok with wounds, with the exception of this patient. Everytime that I was close to him I had to excuse myself, because I felt like gagging. As a matter of fact, I gagged four times whenever I was in close proximity
. I was the RN in charge and my staff asked me if we can have him sit out on the patio while he waited for a room to become available. I told them that I couldn't do that (I felt like it was obvious discrimination), unless the other patients complained. The patients did complain, some going outside because they couldn't tolerate the stench. I ended up having his MA screen him so the doctor could see him first even though there were other patients waiting before him. I felt that this was a way that the patient can leave the clinic faster without being way too obvious. However, the staff had all the doors open, fans ventilating around the hallway and a HEPA filter machine circulating inside his room making it seem that it was all geared towards him.
My question is, how would you have managed it differently without offending the patient? I don't know how I would have handled it if I had to care for that patient (or anybody with an offensive body odor) without the need to wear a mask. Should I be honest and say, "I'm sorry Mr. Smith, I need to wear a mask because my nose is very sensitive to unusual smells?" :imbar By the way, the doctor was wearing a mask.