What Is Your Most Gross, Yucky, Disgusting Nursing Horror Story? - page 79

:D Here is my most gross, yucky, disgusting nursing story! I was working a night shift on a tele floor as a new Nurse. We had this one poor old lady who was confused and was restrained as... Read More

  1. by   RedWeasel
    One time one of my pts had come back from a day pass. He was A&O but felt he could wait to get back to his room on the unit to empty his colostomy (maybe it was an ileostomy?) anyway, he shouldn't have waited I was detailing every corner of the room with those qtip thingys for an hour. I even had to detail his cell phone. Oh the smell. Turned out I had the same cell phone. Couldn't answer it without thinking of that. Had to get a new model for myself.
  2. by   EmmaG
    Got a call near the end of my shift that we were getting an ED admit with diagnosis of psoriasis.

    All I could think was psoriasis??? What the hell...

    The report I got was crappy and vague and all I was told was the man had a "rash".

    I have never seen anything like it before or since.

    He was in his 40's, had come from the state mental hospital (where he'd been a long term patient), and (aside from his scalp and eyelids) the entire surface of his body was raw and oozing serous fluid. There was no damn 'rash'. The man had no skin.

    He stood up and the fluid poured off of him, leaving huge puddles all over the floor. Could barely get a BP on him, as the cuff kept sliding off. He came up without an IV; they'd not been able to get one in ER or draw any labs because for the same reason, the tournequets wouldn't stay on. I just grabbed the largest bore angio I could find and plugged it into his AC, drew the labs then hooked him up to fluids as fast as I could run them.

    I was beyond furious. He had NO business being on an onc/MS floor. I couldn't believe the ER doc...

    I called the supervisor (who only had the crap report from ER about the patient) and told her this man needed to be transferred to a burn unit, as the admitting doc came in (who had never seen him before, thank God he was always the first to make rounds in the mornings), took one look and had him flown out to the burn unit.

    I found out when I returned that night, he died within hours of getting to the unit. He was too far gone. It still infuriates me that he was let down by so many who were supposed to be caring for him. No way in hell that happened in a day or two. The negligence of the state hospital was appalling in waiting so long to get him medical treatment. I'm not a CC nurse, but it was obvious the man was critically ill. He had no freaking skin!!

    But, he was a ward of the state; paranoid/schiz; and of course nothing ever came of the situation. How those people can live with themselves is beyond my comprehension.
  3. by   ktwlpn
    Quote from Emmanuel Goldstein
    /I] infuriates me that he was let down by so many who were supposed to be caring for him. No way in hell that happened in a day or two. The negligence of the state hospital was appalling in waiting so long to get him medical treatment. I'm not a CC nurse, but it was obvious the man was critically ill. He had no freaking skin!!

    But, he was a ward of the state; paranoid/schiz; and of course nothing ever came of the situation. How those people can live with themselves is beyond my comprehension.
    It sounds like a little more then psoriasis-did you ever hear what his final dx really was? TENS,maybe? I've seen that-it was really something (ps-unless you have experience in LTC both geri and psych-you don't really understand how difficult it can be to treat these people-it's very easy in the ER to look at some dirty LOL or psych pt.with massive pressure ulcers or a black foot and blame the nursing home without knowing that perhaps the resident was admitted from home in that condition and refused care for months or years-Maybe nothing came of this situation because there really was no one to blame.Our system is not perfect but it is better then what goes on in many other countries)
  4. by   EmmaG
    Quote from ktwlpn
    It sounds like a little more then psoriasis-did you ever hear what his final dx really was? TENS,maybe? I've seen that-it was really something (ps-unless you have experience in LTC both geri and psych-you don't really understand how difficult it can be to treat these people-it's very easy in the ER to look at some dirty LOL or psych pt.with massive pressure ulcers or a black foot and blame the nursing home without knowing that perhaps the resident was admitted from home in that condition and refused care for months or years-Maybe nothing came of this situation because there really was no one to blame.Our system is not perfect but it is better then what goes on in many other countries)
    It wasn't like anything I'd seen before; he essentially had no skin. Aside from his scalp and eyelids, you could not reach out and touch intact skin anywhere.


    He was calm and compliant. In reading the transfer note from the hospital, he was there as well. He had been a ward of the state for years. My anger is that once he developed this condition, it was allowed to reach this stage before someone decided to get him treatment. So yeah, I DO blame those who cared for him in the state hospital.
  5. by   ktwlpn
    Quote from Emmanuel Goldstein
    It wasn't like anything I'd seen before; he essentially had no skin. Aside from his scalp and eyelids, you could not reach out and touch intact skin anywhere.
    He was calm and compliant. In reading the transfer note from the hospital, he was there as well. He had been a ward of the state for years. My anger is that once he developed this condition, it was allowed to reach this stage before someone decided to get him treatment. So yeah, I DO blame those who cared for him in the state hospital.
    PLease read about TENS -put aside your judgments for a moment-is it possible he had something other then psoriasis? Once you see this you never forget it-it can move fast and it's deadly..And once you do see it it qualifies for this thread-the patient I cared for even had sloughing of her eyes.After her skin peeled off in sheets she was just raw meat.She was an elderly gal and had a reaction to a med.Before she was diagnosed many of my co-workers reacted just like you did---they looked at her flaking and raw body and thought her family had neglected her and that was far from the truth...Could you be mistaken,too? Consider the list of meds linked to TENS-very common in psych and geri populations.....

    Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis can start with non-specific symptoms such as cough, aching, headaches, and feverishness. This may be followed by a red rash across the face and the trunk of the body, which can continue to spread to other parts of the body. The rash can form into blisters, and these blisters can form in areas such as the eyes, mouth and vaginal area. The mucous membranes can become inflamed, and with Toxic Epidermal Necrolysis layers of the skin can also come away with ease and often the skin peels away in sheets. The hair and nails can also come away in some cases, and sufferers can become cold and feverish.
    With Toxic Epidermal Necrolysis the most common cause of death is infection, which can enter through the exposed areas. This disease can leave the skin looking as though it has been burned, and areas where skin has flayed away can seep copiously and quickly become infected.
    Both Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis can start with non-specific symptoms such as:
    Coughing
    Aching
    Headaches
    Feverishness
    Vomiting
    Diarrhoea
    This is usually followed by a red rash across the face and the trunk of the body, which can continue to spread to other parts of the body. Blisters then form across the body in places such as the nose, mouth, eyes, and genital areas, and the mucous membrane becomes inflamed. With some people the nails and hair begin to come out as well. In the case of Toxic Epidermal Necrolysis patients, the skin can start to come away in sheets leaving exposed flesh that could be likened to serious burning and is very susceptible to infection. Both of these disease variations are potentially deadly. In drug related cases, the symptoms for both diseases can take one or two weeks to manifest from the first time the patient takes the drug.
    Drugs that have been linked to Stevens-Johnson Syndrome include:
    NSAIDS (non-steroid anti-inflammatory drugs),
    Allopurinol,
    Phenytoin,
    Carbamazepine,
    Barbiturates,
    Anticonvulsants,
    Sulfa Antibiotics,
    Children's Motrin,
    Advil,
    Children's Advil,
    Cox-2 Inhibitor
    In some cases, the condition is caused by a bacterial infection. However, in many cases there is no known cause for the onset of Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis. These skin diseases can cause massive pain, suffering and anxiety. People that have taken or are taking medications such as the ones mentioned above are urged to familiarize themselves with the symptoms of SJS (Stevens-Johnson Syndrome) and Toxic Epidermal Necrolysis (TEN). This will enable you to seek immediate medical attention should the need arise, and early initiation of treatment can make a big difference to the seriousness of the disease as this can stop any secondary infections. The aim of this website page is to help educate and informed the public about the symptoms, causes and treatment of SJS and TEN, and also to offer advice with regards to possible legal options of those affected by these diseases.
    As stated above Stevens-Johnson Syndrome is a potentially deadly skin disease that usually results from a negative drug reaction. Another form of the disease is called Toxic Epidermal Necrolysis, and again this usually results from a drug-related reaction. Both forms of the disease can be deadly as well as very painful and distressing. In most cases, these disorders are caused by a reaction to a drug, and one drug that has come under fire lately is the cox-2 inhibitor Bextra, which is already linked to these disorders.

    other drugs that have been linked to Stevens-Johnson Syndrome include:

    NSAIDS (non-steroid anti-inflammatory drugs),
    Allopurinol,
    Phenytoin,
    Carbamazepine,
    Barbiturates,
    Anticonvulsants,
    Sulfa Antibiotics,
    Children's Motrin,
    Advil,
    Children's Advil,
    Cox-2 Inhibitor
    >>>>>>> I don't mean to hijack the thread-as a nurse with experience in both acute care and LTC I have seen both sides of the fence.I hate how quick we are to bash each other whenever we can.We all have our own unique challenges every day
  6. by   TDub
    WOW, excellent above post! Thank you ; very informative.

    I had a patient with Stevens-Johnson once. It must have been a mild case because the pt lived. However, their bed was constantly filling up with what looked like dirty cornflakes. It was the pt's skin flaking off.
  7. by   Christie RN2006
    Quote from ktwlpn
    PLease read about TENS -put aside your judgments for a moment-is it possible he had something other then psoriasis? Once you see this you never forget it-it can move fast and it's deadly..And once you do see it it qualifies for this thread-the patient I cared for even had sloughing of her eyes.After her skin peeled off in sheets she was just raw meat.She was an elderly gal and had a reaction to a med.Before she was diagnosed many of my co-workers reacted just like you did---they looked at her flaking and raw body and thought her family had neglected her and that was far from the truth...Could you be mistaken,too? Consider the list of meds linked to TENS-very common in psych and geri populations.....

    Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis can start with non-specific symptoms such as cough, aching, headaches, and feverishness. This may be followed by a red rash across the face and the trunk of the body, which can continue to spread to other parts of the body. The rash can form into blisters, and these blisters can form in areas such as the eyes, mouth and vaginal area. The mucous membranes can become inflamed, and with Toxic Epidermal Necrolysis layers of the skin can also come away with ease and often the skin peels away in sheets. The hair and nails can also come away in some cases, and sufferers can become cold and feverish.
    With Toxic Epidermal Necrolysis the most common cause of death is infection, which can enter through the exposed areas. This disease can leave the skin looking as though it has been burned, and areas where skin has flayed away can seep copiously and quickly become infected.
    Both Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis can start with non-specific symptoms such as:
    Coughing
    Aching
    Headaches
    Feverishness
    Vomiting
    Diarrhoea
    This is usually followed by a red rash across the face and the trunk of the body, which can continue to spread to other parts of the body. Blisters then form across the body in places such as the nose, mouth, eyes, and genital areas, and the mucous membrane becomes inflamed. With some people the nails and hair begin to come out as well. In the case of Toxic Epidermal Necrolysis patients, the skin can start to come away in sheets leaving exposed flesh that could be likened to serious burning and is very susceptible to infection. Both of these disease variations are potentially deadly. In drug related cases, the symptoms for both diseases can take one or two weeks to manifest from the first time the patient takes the drug.
    Drugs that have been linked to Stevens-Johnson Syndrome include:
    NSAIDS (non-steroid anti-inflammatory drugs),
    Allopurinol,
    Phenytoin,
    Carbamazepine,
    Barbiturates,
    Anticonvulsants,
    Sulfa Antibiotics,
    Children's Motrin,
    Advil,
    Children's Advil,
    Cox-2 Inhibitor
    In some cases, the condition is caused by a bacterial infection. However, in many cases there is no known cause for the onset of Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis. These skin diseases can cause massive pain, suffering and anxiety. People that have taken or are taking medications such as the ones mentioned above are urged to familiarize themselves with the symptoms of SJS (Stevens-Johnson Syndrome) and Toxic Epidermal Necrolysis (TEN). This will enable you to seek immediate medical attention should the need arise, and early initiation of treatment can make a big difference to the seriousness of the disease as this can stop any secondary infections. The aim of this website page is to help educate and informed the public about the symptoms, causes and treatment of SJS and TEN, and also to offer advice with regards to possible legal options of those affected by these diseases.
    As stated above Stevens-Johnson Syndrome is a potentially deadly skin disease that usually results from a negative drug reaction. Another form of the disease is called Toxic Epidermal Necrolysis, and again this usually results from a drug-related reaction. Both forms of the disease can be deadly as well as very painful and distressing. In most cases, these disorders are caused by a reaction to a drug, and one drug that has come under fire lately is the cox-2 inhibitor Bextra, which is already linked to these disorders.

    other drugs that have been linked to Stevens-Johnson Syndrome include:

    NSAIDS (non-steroid anti-inflammatory drugs),
    Allopurinol,
    Phenytoin,
    Carbamazepine,
    Barbiturates,
    Anticonvulsants,
    Sulfa Antibiotics,
    Children's Motrin,
    Advil,
    Children's Advil,
    Cox-2 Inhibitor
    >>>>>>> I don't mean to hijack the thread-as a nurse with experience in both acute care and LTC I have seen both sides of the fence.I hate how quick we are to bash each other whenever we can.We all have our own unique challenges every day
    I seriously think I had a patient with this!! His skin was literally flaking off. He was losing all of his hair and his skin was just peeling off in sheets. He had multiple stage 2-3 wounds all over his body. When I had him, I noticed a red rash all over his arms, chest and abdomen. I told the doc about it and he said that he just thought it was a mild reaction to a med... He also had a fever!
  8. by   EmmaG
    Quote from ktwlpn
    PLease read about TENS -put aside your judgments for a moment-is it possible he had something other then psoriasis?
    I didn't say he had psoriasis... that was his diagnosis on admission. I probably wasn't clear in my post, but I didn't for a moment believe it was that. Sorry for the confusion, I can see where you'd think so. From the transfer notes, this condition (whatever it was) did not appear rapidly as you describe, but had progressed over a period of time in that it was obvious someone had dropped the ball in getting him the treatment he needed.

    But then, we never heard a definitive diagnosis on this case. The attending did not mention either condition in his assessment. If (whatever it was) was due to a not-so-uncommon side effect of psych meds as described, then they were even more lax IMO for not picking up on it. This wasn't someone who'd just come into the system. He was a long term resident and ward of the state.
    Last edit by EmmaG on Jun 24, '07
  9. by   tiggerforhim
    Quote from TDub
    WOW, excellent above post! Thank you ; very informative.

    I had a patient with Stevens-Johnson once. It must have been a mild case because the pt lived. However, their bed was constantly filling up with what looked like dirty cornflakes. It was the pt's skin flaking off.
    I had a patient at a major research facility come in with a very, very, very RARE condition, and I can't remember the name of it, sorry. His skin was bright pink and it flaked off in sheets, not flakes. He had to wear socks as part of his dermatologic treatment and taking off his socks, sheesh. They were full of flakes and chunks. He was peeling like the worst sunburn ever. The weird thing about his condition was that his outer (skin) temperature stayed low, about 95 or 96, but his inner core temp was very high, about 99+. He told me if he wasn't careful he'd give himself a stroke from overheating. He had to do the typical skin condition things - cover up in the sun, not get much exposure, etc. He was there for a second opinion and treatment if possible. He was also one of the nicest patients I'd ever had.
  10. by   NurseKatie08
    Classic Dirty Old Man story--my second day working on a busy adult medicine unit at a large hospital this summer as a student nurse tech. I thought I'd seen my share of crazy things working in Alzheimer's care, but I was wrong. The nurse manager asked me if I could feed a patient for one of the nurses, so I said sure, that's fine. She tells me, he's mostly non-verbal, dementia, etc...so I'm thinking this is nothing I'm not used to. Well, boy was I wrong! I go to feed the guy, and for half the time I'm feeding him, he repeatedly pulls down the covers and plays with himself. And became rather verbal when he said what he wanted to do with me--I'm sure you can use your imagination. So I put the food down, tell him that this sort of behavior is not ok. I then leave the room and let the nurse manager know he was a heck of a lot more verbal than she thought! I still get the creeps every time I remember that story, but its not as bad as the ejaculation one
  11. by   EmmaG
    Had a crazy old man who would climb out of his bed and into those of other patients where he'd proceed to have a BM, then return to his own bed. He even got out of restraints (placed for obvious reasons) to do so.
  12. by   uraqt2
    I was working acute care and had a pt. who had originally came in with a fx of the femur. He developed numerous other problems (too many to list) but when he developed pneumonia we couldn't figure out why he wasn't responding to tx. Finally one day the pt. coughed up a 6 in. long thick green something that didn't look normal and the smell was something that is indescribable. His wife came to the nurses station to get me and tell me what had happened. Well I placed the specimen in a cup and called the doc to find out if he wanted any labs done. Took the specimen down to lab holding it as far away from me as possible and out of sight trying not to gag all the way down and dropped the specimen off. When lab called with the results it was no wonder why he hadn't responded to tx. The specimen turned out to be a piece of steak that he'd aspirated on. Ok so its not the grosses story on this site but imaging the smell of rotting flesh that has been caught in the bronchial branch for a week covered in phlegm EWWWWW I will never forget that smell. To this day I'll still gag at the thought.
  13. by   ktwlpn
    Quote from uraqt2
    Finally one day the pt. coughed up a 6 in. long thick green something that didn't look normal and the smell was something that is indescribable. The specimen turned out to be a piece of steak that he'd aspirated on. Ok so its not the grosses story on this site but imaging the smell of rotting flesh that has been caught in the bronchial branch for a week covered in phlegm EWWWWW I will never forget that smell. To this day I'll still gag at the thought.
    ew! But-very common-I had a youngish guy at our small local community hospital once that came in because he had choked at dinner 2 days previously and felt like "something is caught in my throat" Small SMALL community hospital-the guy had a strong odor of ETOH and a good airway so they admitted him and bronched him late the next afternoon...His breath was AWFUL! The doc said it's always the drinkers eating steak-they forget to chew.I never have drinks at the steakhouse with my dinner now...... OH!! And talking about masturbating! Just today in the LTC another nurse and I went to assist a resident.He has a "telethon" disease (can't tell you more) and he was lying on his back with his right hand down his pants.A cna called us into the room because he "does not look right" Of course he had a funny look on his face! Yup! He was spanking his monkey.We had to put him back in his w/ch because he was supposed to be eating lumch.When we went to pick him up my co-worker said ' I'll take his left side".She's a little stinker....

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