CRAZY / GROSS / NASTY

missdeevah, NP · Aug 24, 2015

A patient who had a abdominoperineal resection (removed the orifice, rectum, and part of the colon and 'rerouted' it to a ostomy). Patient had been complaining of a strong desire to defecate, despite the former "exit" was now securely (SO I THOUGHT) sutured shut.
Day 2 postop and the ostomy was already looking good, making stool and passing flatus. I figured he was just puffed up with air from the procedure (it wasn't laproscopic) and that the sensation would pass along with the gas.
About 20 minutes before shift change I hear him groan and the sound of what could best be described as someone ripping a sheet in half quickly. I hear his monitor alarm and look up at the central monitor to see his usual NSR is now 130s...briefly...and drops back into the 80s. Just as I am crinkling my brow thinking *** is he doing in there.....THE SMELL HITS US ALL. This smell was the lovechild hate-brew of all smells unholy. Fearfully I approach his darkened room, I can hear him snoring softly. Can't be too bad I think to myself, he didn't even wake up.
As I enter the room, I see the unmistakable shadow of moisture spreading across his gown. I press the call light to get someone to bring me fresh linen as I turn on the light to see....OMG IT'S [redacted] EVERYWHERE! The gown - soaked. The sheets - soaked. The bedrails, splattered. The floor, puddles forming. Pulling back the gown I see the ostomy appliance best described as blown off his body, still puffed full of air like some old school bag of jiffy pop. Stool soiling his abdominal dressings, dripped down into a bottomless, vile lake of greenish-black chunky stool over his genital area. Meanwhile the sheet under him is utterly saturated in an almost clearish green fluid that is literally dripping off the edge of the bed. These two fluids are clearly different. WHAT THE HECK!? The patient looks up at me and says, "you know, I feel a LOT better".
I now have fresh linens, but the aide is cowering in the corner trying to look busy rearranging items on the sink. 15 minutes to shift change. I sop up all I can see on the front. I rip off the surgical dressings, there is no saving them. I clean the everlasting you-know-what out of the incision area and redress them. Coax my terrified aide into helping me do a quick linen change, spritz the air with some air purifier spray, wash my hands, and walk out just in time for day shift to come out.
The oncoming nurse walks up to me and says with a voice too cheery and bright, wow it's kinda stinky in here today. I try not to throw up in my own mouth reliving the horror of the stench that was.
To this day I can only conclude he had a total blow out - from both ends. The thick nasty stuff out of the stoma, and the liquid out of the "sutured" remnants of his orifice. The man poo'd out of a surgically closed butthole. A LOT. Who knew you could poop out of a surgically removed former orifice. Sadly, I do. Now. -shudder-

Your choice of words and narrative skills cracked me up immensely. I had to re-read several parts just so I could burst out laughing again!

Nurse Leigh · Aug 24, 2015

^^^ Yeah things like that are simultaneously horrific and hilarious. There needs to be a word joining the two, like hangry for hunger and anger....

Anna Flaxis, BSN, RN · Aug 24, 2015

Horrifarius.

Anna Flaxis, BSN, RN · Aug 24, 2015

Drunk crapped himself while fully clothed, all the way down to his socks and into his shoes. The smell was godawful. I've dealt with a lot of nasty, vile odors over the years, but this required a mask with some drops of peppermint oil from the Aromatherapy Kit- a first for me, as I have a stomach of iron and can typically handle the grossest of gross.

We peeled all of his clothes off, placing them delicately into a Patient Belongings bag for him to take with him when he sobered up enough to walk.

He's buck naked, flopping back and forth cooperatively in all his naked glory as we scrub him down with washcloths and change the bed linens. At that moment, the EKG tech walks in, freezes almost imperceptibly, and backs out of the room, closing the curtain behind her as her footsteps retreat- all without saying one word.

CountryMomma, ASN, RN · Aug 25, 2015

Fungating malignant melanoma. The smell didn't bother me, the constant drainage of this strange, greyish black gritty fluid didn't bother me...

...but when one of the masses collapsed in on itself and left this cavernous mass in the pt's chest through which I could see his rib bone, I called it a day and left to take a few good deep breaths.

He had been living with them for years, just came to the hospital for pain relief. Died a month after he was sent home w hospice. Didn't come in earlier for treatment as he said, in his words, that he had "done bad s%$t in the war and deserved to die for it".

If you know a Vietnam vet, go hug them.

ilikesharpthings · Aug 25, 2015

Penile implant that became infected and eroded through the head of the member of this pleasant octogenarian who was a retired minister. ðŸ˜³ He had the offending device removed and had many visitors and I wondered what they told the grandkids about gramps was in the hospital...

ReadyToListen, CNA, EMT-B · Aug 25, 2015

That sounds just like one of the incidents described in Echo Heron's book Intensive Care. The lady had breast cancer just like you describe and kept insisting that she needed to get home to host her dinner party...

I just finished that book and loooooved it!! :up:

Anna Flaxis, BSN, RN · Aug 26, 2015

OHS pt., LOL with previous history of massive radiation tx to chest for breast cancer. Had OHS, but sternal wound wouldn't heal. Could see her pericardium pulsating in her chest, through the open wound.

Anna Flaxis, BSN, RN · Aug 26, 2015

LOL with prolapsed uterus (I mean completely prolapsed, as in outside her body), refusing surgical intervention. Funny smell....

..and then, there was "The Foot". Gas gangrene on a diabetic patient, halfway up the calf. Refusing surgery. You could smell it from halfway down the hallway, with the door closed. That was really sad.

annie.rn · Aug 26, 2015

Gosh, some of these are making me gag just reading them!

What I find super nasty is Yeasty Crotch. Male. Female. Doesn't matter.

The worst in my memory is a fairly young uncontrolled diabetic who was able to hold his urine but peed himself anyway. His A1C was 15 and his average sugar in the 300's. The sugar and the constant moisture were a perfect breeding ground for yeast. I literally could not clean all the schmutz off of his twig and berries no matter how many wipes I used. They were so swollen and inflamed a more apt description would have been branch and overripe, moldy, deflated oranges. I tried to pull back his foreskin to clean what appeared to be tablespoons of yellow gunk but I could not do it secondary to the swelling. I did the best I could and left the rest for my unfortunate coworkers w/ a warning and a request to get the guy an order for Diflucan.

Not only was the situation naaaasty, it was very awkward. The guy was fully competent but was completely o.k. w/ the clean up. He was watching T.V. and cheerfully chit chatting w/ me the whole time. I am kind of a pushover type nurse but he made me mad. I wanted to scream, "I don't get paid enough to socialize w/ you while cleaning your nasty, neglected junk!"

NutmeggeRN, BSN · Aug 26, 2015

Colostomy behaves most mysteriously, for no apparent reason... a condom accidentally found sticking out of it. Stomal sex and big surprise upon getting the news that it is not a good idea.

Winner Winner Chicken Dinner!

ReadyToListen, CNA, EMT-B · Aug 26, 2015

If you know a Vietnam vet, go hug them.

Aww, soooo sad That would be my grandfather and it did make him very hard and ignore a lot of things he needed to take care of. Needless to say, he died in the hospital.