Doctor My Eyes.....

[VivaLasViejas]

For better or worse, I have decided that a nursing career is essentially an unending series of full-moon weekend nights.

All of you who've been doing this for any length of time at all know exactly what I'm talking about: that free-floating weirdness we really can't describe, or identify, but which we spend a lot of time dodging because we don't want to get any on us. It tends to peak during the full moon, especially during hot summer evenings when the booze flows freely and the crazy and the stupid get amped up; but it can happen at any time, and anywhere. And after a while, it all becomes....normal.

I had this discussion just the other morning with my son, who works nights as a medication aide at my assisted living facility. For all his youth, he takes his responsibilities seriously and does his best to appear unflappable, but he was obviously rattled by the experience of doing the last routine check of the night on our resident Munchausen's patient......only to find the 55-year-old sitting on the floor without a stitch of clothing on, practically folded in half and performing an act of, shall we say, autoerotic stimulation (and NOT in the usual fashion, if you catch my drift).

Oh! the humanity! I think Ben's still assessing the damage to his psyche (not to mention his visual acuity after his corneas melted). But the incident got me to thinking about all the traumatic, ugly, obscene, funny, and downright absurd things we health professionals see during the course of a career, and I've got to say there's probably a hundred and one that have burned themselves into my own memory. Unfortunately, they have this annoying tendency to pop into my mind's eye at THE most inconvenient times, like now....when I'd really rather go to sleep for the night.

I can't forget:

.....The patient whose toes resembled Raisinets. I was working my very first nursing job in a SNF, and when I went to unwrap the bandage, two of them dropped off the foot and right into my gloved hands, prompting a rather unprofessional (and almost overwhelming) urge to blow my groceries. Only the presence of the CNAs saved me, and only because I didn't want them to know how green I really was!

.....The 80-something telemetry patient whose 40-something girlfriend snuck in after visiting hours. The tele nurse called the floor to ask me to go check on him since his rhythm was doing some crazy stuff on the monitor. I went in to see if he was OK, and.....well, not to put too fine a point on things, they were going at it hard and heavy. 'Nuff said.

.....The LOL who ripped a catheter out of a confused patient who'd been yelling all night, apparently disturbing her beauty sleep, and strolled down to our nurses' station with the drainage bag and tubing still in her hand. "NOW he's got something to cry about!" she said with a gleam of triumph in her faded blue eyes.

.....The grimly determined expression on the face of a grandfather who'd just been diagnosed with stage III esophageal cancer and decided he didn't want to be a burden to his family. He informed me very calmly that he intended to kill himself. I begged him not to. He promised me he would think about it. Three days later, I read in the newspaper that he had shot himself in the head the day after being discharged from the hospital.

.....The litter of kittens, complete with the mother cat, that an asthmatic patient's family had brought in to "visit" her. (I wound up taking one of them home, a little sleek black kitty who's still with us over a dozen years later.)

.....The new parents who couldn't read or understand the instructions that came with their infant's car seat. The grandparents were just as useless; Grandpa even came in to see the baby with a beer tucked in his back pocket. I had to install the seat myself in their borrowed vehicle, put the baby in it, buckle her in properly.....and then send her home with this illiterate, dysfunctional family.

.....The elderly diabetic with Stage IV decubs on her coccyx, right heel, and both greater trochanters, whose son and daughter-in-law had neglected her so badly while she lived with them that the hospitalist made them stay in the room and watch as a surgeon performed sharp debridement at the bedside.

.....The nineteen-year-old primigravida, with multiple piercings and tattoos, who jerked her hand away when I tried to start her IV because she "hated needles".

.....The hilarity that ensued when said nineteen-year-old primigravida was also found to have dyed her hair "down there" to match the bright blue streaks in the dishwater blonde locks that grew on the top floor.

These are but a few of the scenes that have amazed, disgusted, angered, and otherwise entertained me over the years. What are some of yours?

[Tynurse]

One of the worst of many patients seen at a trauma center. Had EMS call with an "industrial accident with facial trauma". They bring in a 28 y/o male who fell face first into an industrial fan. His entire face wash shredded and we were only able to tell anatomical positions by his ears and forehead. Worst of all he was completely alert during the whole incident. That is one of a handfull of times I have seen someone trached in 2 mins. He ended up living but had numerous operations and from what I was told never even came close to looking like his old self again.

[cherryames1949]

OMG, I don't know whether to laugh or cry, we are a jaded bunch aren't we

mb1949, I laughed out loud 'til I cried! Great stories that only nurses can tell......while eating even!

[Guest372004]

I was a new RN and the admit needed his necrotic foot soaked in a betadine tub for 20 minutes. When I came back to empty the basin, it was full of maggots.

When AIDS was in the beginning stages, I had the nicest young man whose abdomen had split apart after surgery (and never could be put back together). We had to put sterile saline dressings over his organs that were totally seen with his intestines moving and cover with large bandages. He thought he would "grow" his skin back together. He did not last too long.

Had a man who sundowned pee in the closet, thinking he was in the bathroom.

Then there was the alcoholic brain messed up patient who was so confused we had to hire a tent like bed. We told him he was camping. He took off all his clothes and it looked like a circus tent from our side. That thing had so many zippers and he somehow managed to figure it out from the inside until we figured out how to close it properly. Never saw that tent again.

[Luna Nightingale]

Thought I'd add a few... During my clinicals for nursing school, working "hands in" with the assigned nurse who was changing the dressings, packing, etc. on a paraplegic who had three decubs on his buttocks large enough to literally put my whole fist in (and bone could be seen). Thank goodness he was not able to feel it. And never forgot my instructor saying, once I was outside and done, "Amazing! I could smell that out in the hallway!" She preferred to view my work from the doorway....

As a nurse, being asked by the young transvestite (admitted to our floor for a baseball bat hate crime against him) to help with his wig, and to get his lingerie out of the bag because he really couldn't bear to wear the hospital gown without something underneath. By the way, a lacy pink set.

Oh, and the inmate brought from the local prison who periodically would take a pen apart and put the internal piece up his member. Oh, the list could go on....

[RN2064]

How about getting a home care assignment to go cleanse and wrap a client's bilateral lower extremities. No one bothered to mention that the client was completely necrotic below the knees. She was not a diabetic, but had poor circulation obviously. Long story short the family believed she was getting better, refused the MD recommendations to amputate bilaterally and believed they could pray her better while she received homecare TX. My care consisted of unwrapping, applying betadine (I assume to dry out the tissues), and rewrap. There were a few open areas. But it was the most disgusting thing I have ever seen. Grant you, I use to be the go to person for decubs, especially stage IV. I have dealt with many of wound vacs and generally have seen allot. My job was practically wound care nurse. I could deal with the smells and all. But something about dead toes, feet, ankles, and chins on a live person really bothered me. I knew eventually without TX this client was gonna get septic and die. I had to grin and bear it anyway. The family made up their minds, No TX except the wraps. The toes were so dried out they could break off at any time. From the knee down the tissue was all dead, black, and crusty. I was always respectful, methodical, took my time, and tried to provide the best possible care I could give. I did not want a toe popping off, let alone a whole leg coming off in one of my hands or during the wrap changes.  The funny thing, if I can say that without offending anyone, the family was adamant that I kept everything sterile during the dressing changes. I complied, but did not see the point. Whatever infection that caused the tissue death wasn't being treated. This client only received pain medications no antibiotics what so ever. And thank goodness the family at least allowed that. Needless to say this client got septic and passed.

[mercurysmom]

LOL in LTC facility came out of her room around 2AM...attempting to wear her roommate's glasses, hearing aid, and dentures. Her response when asked if she was OK?.........

"I don't feel like myself today.":uhoh3:

[VivaLasViejas, ASN, RN]

LOL in LTC facility came out of her room around 2AM...attempting to wear her roommate's glasses, hearing aid, and dentures. Her response when asked if she was OK?.........

"I don't feel like myself today.":uhoh3:

ROFLMBO!!!! :hhmth:

[Zebro2010]

OMG!!!!!!!!!!!!!!!!! I can't stop laughing and am admittedly a little excited and anxious about my future in nursing. The stories are sooo bazaar, touching, and FUNNY. I am a nursing student with pretty vanilla stories thus far, but I am sure I will have some real winners to add to the collection in time. NURSES ROCK!!!

[Zebro2010]

LOL in LTC facility came out of her room around 2AM...attempting to wear her roommate's glasses, hearing aid, and dentures. Her response when asked if she was OK?.........

"I don't feel like myself today.":uhoh3:

OK.... of all the stories I have read I keep thinking of this one and it just makes me giggle... CAN'T STOP GIGGLING!!!! :nmbrn:

[kbrn2002, ADN, RN]

I think we've all probably had the LOL who carried her F/C bag around insisting it was a purse (I'm just thankful that she never tried to open it to look for her wallet).

And my favorite memory of all... My first attempt at applying thigh high TEDs on a 95 yr old ER admit at 2 am. I was in my last year of nursing school and working as a tech on Med/Surg. By the time I finished, I was practically in bed with her and we were both laughing so hard that we were crying and couldn't talk. 22 yrs later, I can still see her sweet face laughing at me...

Heaven's yes! Thigh high TEDS are a bear, aren't they?

[kbrn2002, ADN, RN]

Probably the most horrific traumatic injuries I ever saw were as follows:

Man changing a tire on a semi when the tire exploded shooting the rim right across the top of his head. The prison doc accompanied me out to the area of the accident. As I stood slack jawed at the sheer amount of gore and tissue strewn about I heard a quiet eep followed by a thud behind me. The doc had fainted at the sight before us.

The young soldier who was sideswiped while fixing his car on the shoulder of the road. His ass was literally ripped off. It looked like gigantic jaws had taken a chomp out of him. He never passed out either at the time of the accident, during the trip to the ER and I have never seen anyone come out from under general anesthesia so rapidly. His pain was so horrific all he could do was moan and weep non stop for days. It was a blessing when he got air evacuated to a larger hospital.

I must really be a horrible person...as horrific as those injuries sound, I couldn't help but giggle at the mental picture of the doc passing out.

[Blueorchid, ASN, RN]

Hehe, I love hearing stories, my turn!

From tech to newbie nurse

- Pulling back the sheets on a 78 y/o LOL that came into the ED for AMS to find the most spectacular misplaced set of DD implants. We were getting ready to start the routine fingerstick, EKG, and labs when I went to put on the leads and my eyes bugged out of my head. Bit my tongue to keep from laughing but learned alot about hiding facial expressions after that :)

- Changing the dressings on a 43 y/o 500 lb woman with calciphylaxis. When she came in to the ICU the whole process took about an hour with half the unit coming in to hold open her legs as we crammed silvadene and chlorpactin gauze into her buttocks, between her thighs, what must have at one point been her perineum, and around her breasts. She cried out "stop!" a few times when she was extubated before she couldn't keep an airway and they trach'd her, then she just cried silently. It was made all the more fun when she had liquid BMs that would seep into the wounds and took piston irrigation to get clean. The family made then overturned multiple DNR orders on her before we learned her two youngest daughters were living off her disability checks so they wanted her alive. 6 months later, several hundred pounds lighter, an arrest and a nasty STEMI and she finally passed. Ethics finally stepped in and told the daughters where they could stick it (or at least I like to think so).

I still wonder if that one will stick with me when Ive been doing this for 5-10 years and so forth. And as far as her kids go I hope karma's a ***** :)