How do you handle bad odors in a clinic setting?

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    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.

    BJ
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  3. 21 Comments so far...

  4. 2
    we had a similiar situation last night and wore masks. Hey, you gotta do what you gotta do. Patient care is what matters. :trout:
    tishirajan and Chapis like this.
  5. 2
    in the ER, we would wear masks, sometimes with a little alcohol or peppermint oil in it. Some swear by putting coffee grounds in a bed pan and leaving it in the room. Other times we'd put peppermint oil on some 4x4s and place them around the ER. So no, you can't put them out, but you can still do things to make the environment better for everyone. Oh and when we wear masks, we don't say anything about it. The patient knows anyway.

    One time we had a patient refuse to take a shower even though he smelled HORRIBLE.
    Black Jade and tishirajan like this.
  6. 1
    I'm glad somebody brought this up...I have a super sensitive nose and I'm always wondering how I'll deal with
    'those' smells once I'm a nurse. I always think of that scene in "Silence of the Lambs" where Jodie Foster is doing the autopsy and puts some stuff in her nose to help cover the smell. What is that stuff? Anyone know?

    I've thought I would maybe carry around a little tin of Vicks and discreetly put some under my nose if a smell is really bad...

    Would love to know any 'tricks' of the trade for dealing with overpowering stenches. :spin:
    Black Jade likes this.
  7. 5
    I carry a little vicks vapor rub stick in my pocket. I put on a mask and that usually helps ALOT. I do this sometimes when I'm working with colostomy bag.

    Also, we do this for hospice pt's, put a little box under the bed with kitty litter in it. This helps to neutralize the smell in the room.

    Kelly
  8. 4
    If something stinks... I would wear a mask... and not feel bad about it.
    Black Jade, tishirajan, Chapis, and 1 other like this.
  9. 4
    It's funny how each person is different in their sensitivity to offensive odors and what they do that works for them. I've had some tough colostomy experiences and took the advice of others and went in with the Vicks approach. It didn't work for me at all. We all have incredible recall of certain smells from our past, and I wasn't particularly bothered by the smell of Vick's very much until I got into nursing, and the combo of colostomy vapors surrounding me and the smell of Vicks under the nose. I associate the smell of Vicks with being sick as that was the only times I ever smelled it as a child. Now just the smell of good old Vicks will lurch my stomach. Kind of like a moth ball smell which I associate with not pleasant things either! So.. since we can't exactly blast Febreeze up our noses (but maybe in a mask as a suggestion) I thought about pleasant smells that hopefully would work for me. Went to the store and headed for the candle isle. There you can find little bottles of essential oils. There's so many of them available now. I bought one fresh cotton scent and I think an apple cinnamon. I tell you what, it worked like magic. A little goes a long way and a small dot under the nose or inside your mask works well. During clinicals all my classmates ended up pleading for me to dispense dabs on their fingers or a mask. Some of the nurses got hip to it too. Now that I am a nurse, I still use the oils. No sick smells for me. Yes I know, I will write a book about this someday.
    Mommy0f4, Black Jade, tishirajan, and 1 other like this.
  10. 2
    Vicks Vaporub. Don't leave home without it.

    I have a patient with an unusual form of penile gangrene (Fournier's, if you're curious). The odor is terrible. An air filter machine has helped somewhat, and we open the windows whenever possible. But I can't bring myself to wear a mask into the patient's room because he is acutely aware of how awful the smell is. I know he's overheard staff complaining about it. So I dab some Vicks on my upper lip before I go in. Hadn't heard the kitty litter idea, though -- that's worth checking out.
    Black Jade and tishirajan like this.
  11. 3
    Breathe through your mouth. I do this out of habit, and it works for me.
    Black Jade, tishirajan, and leslie :-D like this.
  12. 3
    My newest favorite is the bottle of orange essential oil I got from the Body Shop. I put a drop in the trashcan of whatever rooms smell bad, and if it's really terrible and up the whole hallway, a drop in the trash at the nurse's station too. It won't kill the entire smell, but it really helps. With people who smell like yeast or something rotten, a drop in the bathwater bucket is really good, the patient smells nice for hours afterwards. Since it's not a spray, it doesn't do anything to make me cough.
    Black Jade, tishirajan, and newtress like this.


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