What are some of the strangest situations you have gotten into in home health - page 2
What are some of the strangest wildest kookiest ect. situations you have found yourself in in the home health setting. I would love to hear your stories. I know in nursing school I would have never... Read More
Jun 19, '04My most memorable home health case was "Charles", a hospice patient, with colon ca, back in 1996. I was scheduled to work 7p-7a and it was my first shift there. When I arrived, his brother, who he hadn't seen in 11 years, was there, having been there since the afternoon. About 10pm, his brother went to bed. Charles sat quietly for a few minutes in the living room and then went into the kitchen, coming out with a glass of bourbon. He sat back down in the chair, smoked 2 cigarettes, and drank it down. He then looked at me, across the room and announced, "I think I'll die now." Walking across to the sofa, he laid down and closed his eyes. Needless to say, I didn't take him seriously, but I watched him. Finally, after awhile, I walked over and sat on the sofa next to him. He opened one eye, patted me on the shoulder and smiled. A few minutes later (I don't remember how long), he was gone. I woke up his brother, who wasn't very upset. Being a DNR, there wasn't much I could do but call the on-call nurse at hospice and my agency. Everyone was concerned about me and handling the death emotionally, but I thought it was beautiful. He "bargained" so he could see his brother. What a way to go. My other patient, I remember, was "Herb", a rage disorder along with thyroid ca. He had a bad habit of throwing things at the nurses. It was hard for his family to get nurses to come there. Well, I went for a shift, and, sure enough, I ended up ducking as he would pick something up and throw it at me. Last item was a 60cc syringe. I finally stood up and waved a finger at him, telling him, in as stern a voice as I could, that if he did that again, I had the right to defend myself, and I would put him on the floor. A little unorthodox, I know, and not part of good nursing. Well, he glared at me for a minute, then broke out into a smile and said "ok". From that point on, we got along fine. I never had a problem with him again. He eventually passed away. 2 patients I won't forget.
Jun 26, '04You know just when you think you've seen and done almost everything there's always a surprise waiting. The other day I went to see a patient who lives on a dirt road sort of in the middle of no where. This patient still has an outhouse, which they use, and no running water. Oh and did I mention they have more dogs and cats than I do relatives? I get there and he's outside putting around in his electric wheelchair, I've never seen this patient before so I introduce myself and tell him why I'm there, which happens to be do do wound care on his sacral decub. He's sitting in his wheelchair with nothing on but his button up shirt, which by the way is unbuttoned. I hear all the dogs barking from inside and he doesn't want to take me in the house, wants me to do the wound care out side:uhoh21: . After a few minutes of assessing the situation and careful thought I decided it'd probably be cleaner and safer outside so we pulled up the metal chair, I spread out my chux pad and materials, much to my surprise he was able to stand up and I did his wound care. Needless to say I left shaking my head and chuckling wondering what a Medicare surveyor would think of that situation??
Then my assist director tells me about the patient she went to see when she had to draw blood and he wouldn't hear of going inside, so she drew the blood while he sat at the HOG PEN!
If nothing else our jobs keep us creative and most of the time smiling.
Jul 5, '04One of our nurses told me this story about an elderly farmer. He had a foley, and she was going in to teach catheter care. On the second visit the patient insisted everything was okay, but then his wife eyeballed him, and said, "Well, aren't you going to tell the nurse what you did, George?"
Looking embarrassed, the patient pulled up his pantleg to reveal a large burn. Turns out he'd put the leg bag in the clothes dryer to dry it after he washed it out, and he took it out and tried to put it on without checking to see if it was cool enough.
Flamazine cream was not supposed to be part of his treatment protocol, but it was after that!
Aug 8, '04Hello,
Here is one, made a visit to a trailer home, invited in by patient yelling come in!
Opened door and could see the patient laying on the couch across the living room. Stepped in and there was no flooring, only the carpeting, being a heavy
woman, you can imagine, I had to crawl dragging my bag, it was like being
on a trampolene without the bounce. Oh home health! Social Worker HELP!
Sep 29, '04Quote from lionelizWhile working Home health in Southern California I did a visit on a young man Para Plegegic who had wound care needs from a burn on his thigh.What are some of the strangest wildest kookiest ect. situations you have found yourself in in the home health setting. I would love to hear your stories. I know in nursing school I would have never imagined or belived some of the situations I get into in patient's homes. Two come to my mind...
The first was an elderly diabetic gent we admitted for teaching. Talk about hygiene issues! His feet were in terrible shape and needed attention. He didn't have running water, so we got permission from a neighbor to run a garden hose over to provide him with some water untill other arrangements could be made (luckily it was summer).
The other was very sad. A middle aged lady that had sufferd a massive stroke - was in a persistant vegatative state. Mexican national, no green card, sent home with her daughter who tried her best to care for mom. Mom had a feeding tube, foley,contractres and never responded. Daughter did a good job mom never had decubs. At one visit (also in the summer) I happened to arrive just as the caregivers finished moms bath--- using a garden hose in the back yard. I was flabergasted. I recommended that they not bathe her outside in the yard. At the next visit I found that the whole family had moved lock stock and barrel. I don't have a clue where they went.
While I was changing his dressing his wife was in the bed room watching me do my thing while her husband was on their bed.
Now it is the master bed that was the od thing about his visit.
I noticed right off that the bed was ov an unusual sioze and shape.
What cought my attention immediatly was the large wooden dowle balanced above the bed and across the square frame that attached to the enoures bed post.
During my patient teaching I had to ask about the nature of the bed and its function
His wife from that point never quite smiling for the rest of the visit.
Her husband explained as best he could how it assit him in satisfying his wifes desires in face of his physical limitations.
In my natural inquisitive nature I kept requesting for more detail as to how and what aparatus was nessary for this type of acrobatices to be effective. They were most accommidating. <Grin>
I have always said... I have learned much more from my patients than I have tought them in my professional travels.Last edit by sirI on Oct 17, '07
Oct 25, '04One of my patients was a young 19 year old girl who was recieving Vancomycin infusions via PICC. Her infusions were done and we were just waiting on the doctors orders to pull the PICC. She was needing a dressing change though, and since we didn't know when we would get the order to pull the line, I made a visit to change her dressing. I called the patient to try to set up a time for my visit and she said that she was at work and asked me if I can do my visit there. I told her okay, she gave me directions to her work place, and on my way I was. When I got to her workplace, I had a feeling that this visit might be interesting when the sign on the door read "MUST BE 18 TO ENTER!". When I walked through the door I was welcomed by inflatable sex dolls, Vibrators, Porn, Underwear, and a counter stacked with Bongs, Digital Scales, and various other drug related items. So here I am, performing a sterile dressing change, thinking: We do see the most interesting things in our profession.
Oct 25, '04Walked into a new admit case (COPD). The husband meets me at the door smiling and chatting about the weather. Walk through the house to the living room where the pt is slumped in a recliner, blue around the lips and gasping. Husband is continuing to chat about weather and the vitamins he sells and how healthy they keep him. Pt POx is 84% on O2. I crank up the concentrator as high as it will go and call 911 and ask the husband, since the pt can not talk she is gasping so hard, how long she has been like this. "Oh she has trouble somtimes you know" and (believe it or not) goes into the other room to get samples of these vitamins and brochures. As the ambulance is pulling up, he looks suprised and finally notices that I am running around trying to clear a path for the EMTs to come in and get what I do know about the pt together. As the EMTs are getting the pt onto the gurney, (they had given her more O2 by mask and she was improving) the husband asks if he needs to go with her since he has a sales meeting in an hour. By this time I was completely ticked off at him and told him that it was a matter of priorites and he needed to decide whether his wife or a sales meeting was more important. :angryfire
Don't know if he went to the hospital or not. Really don't want his viatmins either as they seem to produce brain damage, and didn't help his wife either.
Sorry needed to vent this one really got to me.
Oct 25, '04homecare -- the twilight zone of the nursing profession!
13y.o CA patient -- her mother died (of CA) a year prior to child's dx of CA
House a sty -- Dad frequently had "guests" over through out the day -- he worked nights -- heard all sorts of "activity" from his room -- very thin walls!! Had "the talk" with her -- at dad's request "even though she ain't ever gonna need it". Suctioning trach and doing decub care with cats wandering all over the place.
At first, she would vomit her tubefeeding within 5 minutes after the night nurse left the house. Until the day I told her that we were going to work on hand eye coordination and I got her a bucket and a sponge and had her clean it up herself -- amazingly enough... no trouble with the tube feedings after that! We got to be the best of chums! Got the house cleaned up, taught her to help cook simple meals, was able to assist with mainstreaming her into classes at the local school for a few months. Had to leave when I lost our first baby -- too much heavy lifting -but visited 2-3 times a week- she survived to hold my eldest son -- never saw her happier than that day! Huge void when she died!! Still think of her often-- touched and changed my life in SO many ways!
Then there was the 700+ lbs woman who "took out" 4 members of the HH staff when she fell on us - - ambulating from the bathroom to the bed.-- LOOOONG story -- will share another time. Have to go collect the kids from school!
Oct 25, '04[QUOTE=missmercy
Then there was the 700+ lbs woman who "took out" 4 members of the HH staff when she fell on us - - ambulating from the bathroom to the bed.-- LOOOONG story -- will share another time. Have to go collect the kids from school![/QUOTE]
Hey!!!! Don't leave us hanging!!! What happened?!?!?!?!?!?! :chuckle
Oct 26, '04A crazy bible thumper (truly believe paranoid schiz but I couldn't get anyone to intervene) who played '20 questions' biblically with me then demanded I repent before I could see his wife (terminal cancer patient). I heard my patient crying so I actually tried praying with him hoping he'd let me see her...but it wasn't enough; I wasn't in his denomination and couldn't speak in tongues: this would have proven me worthy.
I ran into crazy stuff in the short time I tried HH...went back to the hospital fast.
Oct 26, '04Three of us were assigned to go to "M's" house to get her up to the bathroom, let her smooke and give her a bath and get her back to bed. I was the biggest one of our gang -- and back then I was a size 10 -- my cohorts were tiny -- size 3 type gals.
Day one, we were supposed to walk right in, but when we looked in the front door, we thought there were 2 people in the bed in the living room. Not wanting to interrupt any "activity", we waited in the car for a few minutes -- the patient's dad came around the corner of the house and said something about how he hadn't heard us pull up -- and to "come on in". We went in and met the biggest woman I have ever seen! M was covered with open sores, only ambulated to the BR once a day -- when we took her there. (Her dad had a "newspaper funnel system" for her to use when we were not there (?! Never did figure that one out) She had been discharged from our local community hospital the day before because the nurses couldn't get her into the bathrooms at the hospital and it REQUIRED 3+ people to move her.
We only had an approximate weight of 700+ lbs -- but we were relatively sure it was accurate. Prior to discharge, the EMS squad filled with gas and drove to the truck scale on the edge of town. They came back to the hospital, filled with gas and drove back to the truck scale again -- this time with M inside. She was transferred from vehicle to house on a door (she had destroyed a gurney first round)-- carried by 6-8 hulking volunteer firemen.
So we were to ambulate her to the bathroom, let her smoke while she had a HUGE BM, bathe her, change the bed and get her back in it. An RN came out once a day -- after we had been there to attempt to dress and care for the blistery sores she had all over her body. We drew straws to see who would have to be in the bathroom with her -- that was torture! When we ambulated her across the living room, the whole house shook -- we were sure we would end up in the basement some day -- however, after I saw the piles of stuff in the basement ( floor to ceiling -- literally) I was relieved -- weren't going to fall far!! We were also awaiting the day when the toilet would explode and give her a power enema -- from her literally plopping herself on it -- never did THANK GOODNESS!
One day, as we did her bath, the gal who had short straw 2 was on her knees, washing the poor woman's crotch while the other two of us separated her thighs far enough so the task could actually be accomplished. "A" started laughing -- quietly, but uncontrolably... when we ased what was so funny, she replied "You guys, I'm stuck!" We pried the tighs apart and she got her arm out of the nether regions -- but then started cracking up again -- this time she gasped between giggles " I HAD a washcloth!" (None of us felt brave enough to go hunting for it at that point -- did get it out after we got her to bed)
Anyhoo... one day she was weaker than usual. We called our supervisor and explained that we didn't know if she would be able to ambulate -- and were told that that was why we were there -- so ambulate her! We made it to the bathroom -- stopping to rest about 4 times on the way. In spite of the extra work it was to bathe her in bed, that was our plan -- didn't want to risk having her fall -- our supervisor arrived just as we were coming back from the BR -- had rested 3 times already -- she jumped right in and said that M could do this! to get it done -- "enough lollygagging"... well, "M" fell within 4 feet of her bed (which was a "big boy bed" and the frame was bent!) As she started to fall she yelled "Girls, I'm goin' down!". The supervisor got both knees strained, M's knee landed on my L foot, and the other gals got back strain trying to lower her to the floor gently. No way we could get her up -- called the squad. 9 guys came, carried her out of the house on a door and took her to the hosp. A second squad was sent for us. We waited about an hour -- hoping M would not see us inthe ED when we all came in -- didn't want her to know we had been hurt. When our squad got there -- about 1/2 the staff was popping in and out of ER to see how we had faired.
Doc says I was lucky that whe was as obese as she was -- the huge amounts of fat actually surrounded my foot enough to avoid crushing it completely -- had a couple months of kryotherapy and wore a brace for a bit -- no long term issues though. She was admitted and died a couple of days later -- they say she was too heavy to breathe -- couldn't raise her chest -- and the heart just gave out!!
She was so large that she had to be dismembered to be cremated -- couldn't get her into the "oven -- or whatever you call it". Saddest thing -- she had gained 300 pounds within a year! MAJOR emotional trauma -- mom died of breast Ca, on the way to mom's funeral, M & her boyfriend were in a MVA -- he was decapitated and she was trapped in the vehicle for 3 hours before someone found them and got her out -- she was hoarse from screamming so much. She truly was a delightful person -- tried to be cheerful, told great jokes, was intelligent and engaging, and yet -- so totally alone! Her dad was caring for her as well as he could, but he was poorly educated, illiterate, and traumatized himself.... just kept feeding her whatever she asked for to make her happy!
I am forever greatful for friends who are open enough to tell me to quit eating, who are there for me when I need to talk, cry or vent! M has changed my life!! I will never again take family and friends for granted and will never judge another heavy person -- you NEVER know what lies beneath it all.
Oct 26, '04undefinedQuote from vitalnursemomyou gotta love home care! I have ducked a bullet, been bitten, interupted drug deals, sat on a sofa soaked in urine(I never sit unless I HAVE TO now). Let's see, I was told that diabeties is contracted from blood transfusions(too much suger in the doners blood....duh we medical folks need to get a clue). A patient saved a stool sample for me by taping it to her bedrail, the drunk son of a patient practially attacked me in the front yard-I slamed my car door on his hand and got him pretty good in the eyes with pepper spray-he was not even mildly subdued. I almost ran over him when I left. A patient was picking her nose while I was preparing a wound dressing, when I approched her she smeared a massive booger on my hand. A man was attempting to pee in a urinal, missed & peed in my shoe. I had a midget I was caring for that needed to go to the bathroom & wanted to walk to the toilet, so as I held her from behind, she droped a massive turd on my foot(new shoes, naturally). I could go on for days, mostly because I type slow!............ozoneranger
Boy have I been waiting on this thread! Would you guys like the whole list or the top five?
1.) I had to remove maggots from a diabetic man's foot wound/amputation site. He had been home from the hospital less than 24 hours.
2.) I was chased from a patient's front porch by their family pet. A HOG! Not a pot bellied pig! A true HOG! Turns out the porch was his domain and he didn't like me standing on it. I could be in the house or in the yard, but NOT on the porch!
3.) I was met at the front door of a sweet elderly lady by two sheriff's deputies who informed me I would not be entering on this particular day. Her grand son was running a drug operation from the bedroom he had in her home. Nothing like a drug bust to jump start your morning!
4.) A patient who swore he was home bound and required an aide due to his incredible weakness was caught lifting and carrying full 50 gallon water bottles from his front door to his kitchen withut breaking a sweat.
5.) My favorite !!! I was faced with dealing with a loaded gun when I interrupted a suicide in progress.
Thank god for CRAZY people or we'd have no nurses! Thank God for CRAZY nurses or we'd be without home care!