I work home health, and have a patient who is .....lets put it "rotting" away. I have tried multiple times to get her BLE amputated but the dr said not medically stable...and has sent her home to die. she is only on hydrocodone elixer TID. This last hospital stay....at some point someone 'broke' her ankle and now when you raise her right leg her ankle drops at a 90 degree angle. Let me say I am no wound care nurse, but plan to go to school for wound care/ostomy and these legs/smell make me sick to my stomach. As soon as you walk into the house you smell it. we only see the patient once a week dt it is a non healing wound...duh....and medicare will not allow us more....I don't want to see those legs more...the family does wound care daily....or at least they are supposed to. we clean with NS, and then do a W/D with NS and then also they apply hydrogel also...and wrap with kerlix. these wounds are from behind both knees to the tips of both toes. Black, unstageable, you can see bone dt at parts the flesh is now fallen off, and the muscle is hanging out of the leg. I think at any time the toes will fall off into our hands. What do we do for this patient? This patient pain would be gone if the legs were gone. but the dr does not want to operate, and the family at the same times does not want the operation......why you ask? the monthly check the patient gets...the family takes.
This patient is in the bed moaning at all times of the day and night, only getting hydrocodone TID, with a broken right ankle, and rotting lower extremities. She has been like this now for at least 4.5 months. Any suggestions? I know I won't heal her.....I want any either support, anyone I can talk to to help this lady. Or I guess I just really needed to hear what other nurses thought of this case. my heart goes out to this patient, and I wish I could make her pain go away!