I’m such a dork now that I think about it but I love my job. The evening started off well.. We were full and within 10 minutes of coming into work, we were cardioverting someone. Then we got a medevac for a post arrest… It was a fun night.
One patient sticks out tonight… I felt really bad for this older gentleman I took care of today. He came in 79 year old male with new onset shortness of breath. You could tell he was in CHF. He had edema all over his body, rales, and all that good stuff.
What stuck out though was his hygiene. He looked like he had’nt showered in three weeks.. He had this build up in his hair.. he had pus in both eyes which made them red.. His glasses were filthy… One of my coworkers actually cleaned them and he remarked “I can see now.” He was a stubborn old man, even though he would get really short of breath and desaturate to the 70’s he did’nt want help. He had these urine soaked socks on.
The ambulance gave him Lasix, a loop diuretic that will make you pee. So he wet himself...I went to go help clean him up and like I said he was stubborn. I asked him if he lived at home and he said he did, alone. One could see that he wasn't able to take care of himself. I went to go take his socks off so that we could put new ones on and he said no… I asked him why. I said, "Your socks are soaked with urine. I don’t want you to sit there with them on like that." He said that he was embarassed because his feet looked “horrible”. I reassured him that I’ve seen it all and nothing would bother me. He insisted on not taking them off. So it led me to wonder, man this guy really has a bad case of Self Care Deficit. Ha, there goes nursing process…
Anyway so I told him if he was my family member I would not want him to sit there in his urine soaked socks and that I was going to clean him up and make him feel better. We got him cleaned up and I switched his socks...his feet were bad. There was crusting in between the toes and his nails did not look like they were cut in years. Now yes, it was gross and I’m sure everyone reading it is thinking it. And I’m sure we all as health care providers joke about things like that or the “worst things we’ve seen”. What struck me tonight though was the embarassment of the older gentleman.
I felt bad for him. It must be frustrating to lose your ADL’s and your dignity getting older. We all have weakness and something so simple like not wanting to show his feet meant so much more. No patient should ever feel embarassed. Like I said, I’m someone in healthcare that I’ve been doing for so long and have joked about the sometimes dirty patients or the silly stuff that comes in. But in another perspective these people have other stories. That man was losing his ability to deal with everyday things. I felt bad for him and it truly gave me a new perspective to bring to my practice. In nursing school they taught us to be non judgemental when it comes to our patients. I hope the patients know that. I want my patients to know that they can ask me anything because if I were in their shoes, I’d want the same care. His feet and the want to cover them represented his vulnerability.
I hope that man gets better and finds the appropriate care for him. I asked him if he had family and he told me his daughter was a LPN at another local hospital… I was appauled. And I was kinda upset… but then again, just like my patient who had a reason why he did’nt want to take his socks off, I’m sure the daughter had a reason not to take care of her father.
Last edit by Elvish on Jun 5, '08
: Reason: split into paragraphs