What is the grossest thing you have encountered in clinicals?

finally · Jun 10, 2004

I took care of an elderly client with cancer of the face...It started out as a stye on the eye and progressed to the whole side of face...You could see through the face...like feeding this person you were litarelly dropping the food (ensure) into the back of the throat...if standing on side of client you could see bone of nose..no eye...inside of mouth like far back towards throat...so sad...:imbar :crying2:

maire, ASN, RN · Jun 11, 2004

Okay here is something to think about, I have too many stories but here are a few of them. As an ADN student I saw a pt with a stage 4+++ decub that was lower back maybe lumbar to member midway down femur, while working with the wound care nurse that day the head of his femur fell off, I did not get sick but it made me cringe. The second story comes from the days when I was a paramedic in a small community that also did p/u for the medical examiners, he looked like a short fat african-american that turned out to be a skinny white guy, it was summer time w/o ac, he had died about 9 days prior and had liquified but his skin stayed intact, when we moved him his arm pulled off and his content spilled unto the floor. I was the only one that kept from vomiting, I had to put flexall 454 under my nose which only helped a little. By the way, one of the people helping us move him fainted and fell on the floor, you guessed it right into to gross stuff.:imbar

Oh gawd I am gagging just thinking about it.

Sailorboy · Jun 11, 2004

I have to second that C-diff is the foulest thing I have ever encountered. Before, I could handle the whole poop thing but ever since I got a whiff of C-diff poop, I am fighting dry heaves all the time.

What is C-diff??

twarlik · Jun 11, 2004

What is C-diff??

Clostridium difficile. It's a nasty opportunistic infection that people get in their bowel. A lot of times people who are receiving antibiotics get it. It causes horrible diarrhea that smells just plain awful.

mamabear · Jun 12, 2004

I'm not positive, but I think breathing throught your mouth instead of through your nose should help get rid of yucky smells. Bypasses a lot of the olfactory receptors.
Edited to add: Last week I saw something that topped my grossest thing seen so far. I was helping out with a dressing change on a gentleman who had both Necrotizing Fascitis and Gangrene all along his back and buttocks and spread to his front all around his member. The wound was infected with a lot of different bugs including pseudomonas. It was about 1/2 inch deep all along and was undermined by about a full inch all the way along the perimeter of the wound. The poor man was in so much pain throughout, even though he was on a morphine drip. It was just awful.

One of the first nursing skills I learned was how to effectively mouth breathe without the patient catching on. In my first year of med-surg clinical I helped debrede an infected skin graft on the back of a beautiful young woman with advanced malignant melinoma. The open area was about 5 inches square, with bits of grafted skin in various stages of decompensation. Bleccch! :uhoh21:

HyperRNRachel · Jun 12, 2004

I will take a Clostridium difficile, poop, smell any day over a non-treated, out of control, yeast infection. The poor elderly lady could not speak, was semi-conscious, and was contractured and on my very first clinical day three of my fellow students and I were given the task to bathe this poor woman. We all walk in and nothing taught in class or from a book could have prepared us for this poor lady. We got water, face cloths, and soap, two students on each side, and we started bathing her starting at the top. Well everything was not going o.k. ,because every time we moved her she would yell "NINE NINE NINE NINE " which we interrupted as 'DIE' , something she wanted for herself or for the four of us students. I guess the yelling would not have been bad but she had tears rolling down her face. We were being as gentle as we could, BUT being gentle does not move contractured muscles. So we start working our way down, as we lift the sheet, a smell so intense it made most of my body hair fall out came up from the area we dreaded cleaning. All four of us had our necks stretched out trying to get a fresh air pocket, but the smell had taken over every square inch of the room. Two of the students were actually in tears. One said she did not know if she could be a nurse and the other said she had made the wrong decision about being a nurse. To make matters worse, the only way to get a descent smell in our nostrils and to keep for vomiting on our shoes was to try and smell each others hair. Being students we prepped her for peri-care, making the nice drape the best way possible for a client whose legs were practically welded together. I volunteered my friend in crime to do the honors of cleaning the area from where this odor was still rising. As she pulls the cloth out from under the drape,.......it is covered with thick, yellow-whitish, yeast. It was out of control. The next day we found out she was returned to the nursing home and most likely the yeast infection will go un-treated. It was a sad day. I am now in the second week of my second clinical and that episode was the most horrific thing I have witnessed out of all the poops, vomit, snot, or blood.

NewEnglandRN, RN · Jun 12, 2004

Okay, all this talk about maggots is really grossing me out. Can someone tell me why/ how this happens? I can handle most things, but I really HATE creepy crawly things:crying2:

Michelle

nursecompassion · Jun 13, 2004

I have been a nurse for almost 10 years and not too long ago had a nasty experience. I took off a foot dressing on a new admit who came from home. He said he just wrapped his foot cuz it was sore. Well, I take off the dressing and about 1000 skittering nasty little maggots took off!! EWWWWW those little buggers can run, or slither or whatever it is they do! They were everywhere, looked like some one spilled a bag of cooked rice in that dressing!!!

I work in a nursing home and am used to bm, uti smells, c-dif, drainage, colostomy bag odors and wound smells,and generally just the sight of gross things.... HOWEVER................I LOATHE creeepy crawlies.................you poor person,,,,,,i feel so bad for you!! I think I would have barffed right there on the spot!

(I guess they were eating the dead skin away though! :chuckle ) sorry could'nt resist............

Julee

nursecompassion · Jun 13, 2004

I will take a Clostridium difficile, poop, smell any day over a non-treated, out of control, yeast infection. The poor elderly lady could not speak, was semi-conscious, and was contractured and on my very first clinical day three of my fellow students and I were given the task to bathe this poor woman. We all walk in and nothing taught in class or from a book could have prepared us for this poor lady. We got water, face cloths, and soap, two students on each side, and we started bathing her starting at the top. Well everything was not going o.k. ,because every time we moved her she would yell "NINE NINE NINE NINE " which we interrupted as 'DIE' , something she wanted for herself or for the four of us students. I guess the yelling would not have been bad but she had tears rolling down her face. We were being as gentle as we could, BUT being gentle does not move contractured muscles. So we start working our way down, as we lift the sheet, a smell so intense it made most of my body hair fall out came up from the area we dreaded cleaning. All four of us had our necks stretched out trying to get a fresh air pocket, but the smell had taken over every square inch of the room. Two of the students were actually in tears. One said she did not know if she could be a nurse and the other said she had made the wrong decision about being a nurse. To make matters worse, the only way to get a descent smell in our nostrils and to keep for vomiting on our shoes was to try and smell each others hair. Being students we prepped her for peri-care, making the nice drape the best way possible for a client whose legs were practically welded together. I volunteered my friend in crime to do the honors of cleaning the area from where this odor was still rising. As she pulls the cloth out from under the drape,.......it is covered with thick, yellow-whitish, yeast. It was out of control. The next day we found out she was returned to the nursing home and most likely the yeast infection will go un-treated. It was a sad day. I am now in the second week of my second clinical and that episode was the most horrific thing I have witnessed out of all the poops, vomit, snot, or blood.

Are you suggesting that because she was returning to a nursing home the ppl at the LTC facility would'nt treat her????????? :stone

I'm sorry, but not all facilities are like that. In fact, it should have been treated while she was in the hospital. We had a trach pt who was sent out to the hospital and came back with an ulcer on his rear. He did not have this when he was sent out. Obviously he was not being turned, just left to lay there like a vegetable.

If I read your post wrong I am sorry. :uhoh21:

Julee

HyperRNRachel · Jun 13, 2004

Are you suggesting that because she was returning to a nursing home the ppl at the LTC facility would'nt treat her?????????

Yes I am. She was admitted with the infection, and returned to the nursing home, will not be cared for properly, and the infection, will in fact, become worse. I blame the nursing home and the family of the lady. I am not being rude, I am going on facts. At our hospital she was being turned q2hours, place on an air bed with all types of skin breakdown prevention devices, and given medications for her various illness' and above all else she received attention to her medical care needs. Even if her infection began as an antibiotic reaction, the extent of the infection was from lack of proper care, care that was not given while in the nursing home. Do not flame me for my remarks. Unless you live under a rock, are visiting from another planet, or are in serious state of denial, it is a well known fact that most (not all, but I have not seen that to be true) do not provide the care to patients that they are being paid for. I blame it on greedy doctors, lazy staff, or selfish family members. The facts are a sad result of how this country chooses to honor its elderly. I am not being naive. The condition of this client is only one out of dozen that come in from the nursing homes. Even if they cannot speak their bodies show all the evidence anyone needs. The quality of care being provided is appalling. It is sad but very true.

IamRN · Jun 13, 2004

Even if they cannot speak their bodies show all the evidence anyone needs. The quality of care being provided is appalling. It is sad but very true.

I am curious...why didn't she get any care for it at the hospital? Was this not reported to the RN under her care that day or the MD?

Chad_KY_SRNA · Jun 13, 2004

Was this persons yeast infection being treated in the hospital? That part of your post was unclear to me.