Pimples, blackheads and acne

[weirdRN]

While cleaning a patient's face, blackheads were mistaken for ground in dirt. (The individual had had a seizure and had fallen pretty heavily onto his forehead, enough so he was bleeding from a cut on his forehead) The nurse was observed picking the blackheads.

The individual actually looked much better after she was done, and the patient appeared grateful for the cleaning but...

My question is shouldn't she have just left them alone? What about pimples? And cystic acne? And boils? Should we be draining boils and other skin infections after they have opened up? I have noticed that this older nurse does this and the areas appear to heal up remarkably quickly. What is best practice?

[CyndieRN2007]

Not only do they look gross, the large pimples and blackheads are painful. I have expressed the PUS out of some boils and blackheads because the patients have asked me! The pressure is relieved after it is squeezed and it is no longer painful. I know, Im gross.

Good ole carbuncles and furuncles!

[MMARN, BSN, RN]

Ok, that's pretty disgusting...

*rotfl*

[madwife2002, BSN, RN]

You know I can do just about anything to a pt that involves bodily fluid, infections, horrendous wound dressings and on and on. But for some reason I just can pop things on the skin, it turns my stomach just thinking about it LOL. Even when I was young and somebody would ask me to squeeze things YUCK no way.

I once got smacked by my mother because she asked me to squeeze something on her back and I ran away.

So good luck to you who can, but dont call on me

[Cattitude]

Even when I was young and somebody would ask me to squeeze things YUCK no way.

I

Some of us are just natural born poppers. It's an urge, a drive, instinctual.

Some could care less.

And some, like yourself, are sickened by it.

It's all good. There's room for all of us.

I'm a popper, bring it on! Better a popper than a pooper .

[CyndieRN2007]

Im a confessed popper! :rotfl:

[oregonchinamom]

I am, also, a confessed popper. It drives my husband crazy! However, I control myself at work, except on two notable occations. One was a fairly young lady in my ICU for respiratory failure on the vent. She had an art line in her groin and had a big, raised blackhead on her mons. After a few days of checking that site, and seeing that blackhead every two hours, I had had enough. I went and got a pair of hemostats, grabbed that thing and out it popped! What a relief!

The other was far more disgusting. I was taking care of an elderly gentleman and turned him on his side to look at his back and found the hugest, most vile blackhead on the face of the earth. I measured it and it was 4inches by 2 inches. I kid you not! His wife said it had been there for over 10 years. I could just not leave that there, it was just to awfull. I put on full PPE, including a hair covering and pulled. Most of it came out in one huge chunk but then I had to push from the bottom to get the rest that had almost tunnelled. The stench was amazing. After almost 10 years, that reamains as one of the most disgusting moments of my nursing career.

[madwife2002, BSN, RN]

You know I think I may have to refrain from viewing this thread

:barf01::lol_hitti

[leslie :-D]

The other was far more disgusting. I was taking care of an elderly gentleman and turned him on his side to look at his back and found the hugest, most vile blackhead on the face of the earth. I measured it and it was 4inches by 2 inches.

wooooooow.

and who could resist popping that sucker?

wow.

WOW.

i probably would have mistaken it for a cancerous lesion...

leslie

[Elvish, BSN, DNP, RN, NP]

I'm so glad to see there are others out there like me.

[harley007]

Okay, I work in the Cardiac Cath lab and as expected our patients usually arrive with their right groin shaved for the proceedure. Well, many of our patients are a bit older and the number of huge blackheads that I see daily is enought to make me ask "does anybody really wash themselves?" I mean these are VERY obvious - even before the prep. The worst one was an acute MI we were on call for on a weekend at 2 am. You have to prep both groins in an emergency cath. If there is difficulty in getting into the RFA there is no time to waste prepping before attempting the left groin. Soooo, we are attacking this patient like a swam of bees as v/s's are crashing, 8/10 chest pain on Nitro IV and we are under pressure to meet our "door to balloon inflation time limit". The patient is stripped and we are prepping in 20 seconds and I happened to get the groin prep - no big deal do it just about everyday. I start shaving and there is something "pulling" on the disposable razor head. I use clean 4X4's to brush off the cut hair but this was strange. Oh yes ladies and gents this was blackhead city! There were so many that I was having a difficult time prepping. What do you do? The MD is going to stick the femoral in 2 minutes? Well, we roughly brushed the area with 4X4's to remove any loose blackheads and used THREE skin prep sticks for each side of the groin. We were all freaking out and this was a younger type 60+/- year old. I had to show the ICU nurse this when we dropped the patient off post cath/stent and begged for a dermatology consult. All of this in the middle of the night - gotta love this job from gross groins to one of the top technical areas of nursing!

[Indy, LPN, LVN]

"gross groins!" Haha!

I had one patient to prep (on tele floor, mind you not in the cath lab) for AM cath who had chiggers in his pubic hair. NASTY. He smelled bad, refused a bath and enjoyed his shave. I'll bet he did, 'cause I then had to pick through all the pubic hair to make sure they weren't lice.

There was a vent patient recently with pubic area smack full of blackheads. Since he was in for MRSA boils, an I&D, and from sepsis wound up in resp. failure, I didn't touch them. Thanks Angie for the tip about benzoin. I got plenty of that in floor stock and will be making use of it now.

For a person's face, if they can't care for themselves, a little sterile gauze dipped in normal saline and gently rubbed over the area will either prevent or help a tiny blackhead. Plus it helps get rid of the grease. So I might do that but so far I don't pop at work. The guy with the boils was on the unit on a remarkable week when all but one of our patients had MRSA. I didn't want to touch 'em, let alone pop anything.

[Diary/Dairy, RN]

Speaking of gross patients - I had an alert oriented male patient who actually made me gag he smelled so strongly of urine. Bad skin (probably from not bathing in forever) Attempted a bath, but he got really agitated (detoxing) - sometimes there's not a whole lot you can do about lack of self care.