Nasty feet

[Stcroix, ASN, PhD, RN]

The other day we had a new admit from the ER; she was not remarkable in any particular way. I came into the room as the the tech was covering her with the sheet. I got a set of vitals and a quick assessment. As I was getting to the 'toe' in head to toe, I lifted the sheets to expose her feet. My first surprise was she still had on her shoes. Oh well, not so strange I thought. I asked "Can I take off your shoes now that you are in bed? "Sure" she replied. Second big surprise, the most God awful smell this side of C-dif! One foot had on a nasty filthy sock that had not seen water since the last rainstorm, while the other was sockless. That particular piggy was covered with crud and what looked like some type of crushed dried vegetation. I asked her if she had been walking around barefoot and she looked at me in a puzzled way. I said "you have some of Mother Earth down here". She smiled and I scraped away the crud and removed the single sock. A couple of bath wipes were employed to remove the first two layers of offending stink-O.

Got any good foot stories? (I know you do)

[Rhi007]

Yeah the pong that comes from mine after 8hrs in work socks and steel cap boots.

[SwansonRN]

Hahaha mother earth.

I think if you work in the ER you may have the most experience with horrible feet. Or if you work on a floor or unit and you get a brand new admission. Otherwise bed baths are a beautiful thing :)

I work in the ICU and I always say we should have a podiatrist come by every so often and help with the scary toenails our patients grow! Obviously it's not their biggest problem, but I bet it would make them feel better .

[sharpeimom]

I wonder whether she has good arerial blood flow to her lower legs and feet? My husband had an RFA done on his legs slightly more than a month ago and the increased blood flow his given him back more normal looking feet. The way the specialist explained it to him was that it was like roto-rooter snaking out unwanted tree branches from a main plumbing line. Except, in this case, it was excess veins they got rid of. My husband's excess vein growth was apparently just a congenital fluke.

Even if your living conditions permits daily showers, weird conditions can crop up and if your living conditions are poor, some things can still be medical zebras instead of horses. It took almost three years to uncover my husband's excess vein problem. The smell makes me wonder too. Before, when he took his shoes off... it almost made my eyes water! Now, no smell whatsoever.

My strange story: As a student nurse, I was assigned a very very elderly man as my patient. He had Reynaud's

disease and scleroderma. I was talking with him as he ate, when suddenly I noticed one of his toes on edge of the bed about to roll off! Any confidence I had vanished then and there! I tried to ignore it so I could regain some composure, but he was African American and the toe was very dark brown and silvery gray, and my eye kept wandering back to it against the stark whiteness of the sheet.

He noticed both the toe and my discomfort and said, "It's all right, darlin'. It didn't hurt." He was a real sweetie! I thought long and hard about quitting because I felt, for a long time, as though I let that dear sweet old man down.

[FLmed]

I'm wondering if the toe you assessed that had "crud" on it was the piggy that went to the market or the one that had roast beef? Lol! Poor thing more than likely had some kind of bacterial, fungus, or combination of both going on.

[VICEDRN, BSN, RN]

No you know why we leave the shoes on in the er. You should've too. Ha ha (Yes, I know why you took them off)

[Stcroix, ASN, PhD, RN]

No you know why we leave the shoes on in the er. You should've too. Ha ha (Yes, I know why you took them off)

Ya, I guess I do! Anyway, there seems to be no underlying issues with her skin/ circulation. The stink was due to neglect, not pathology, but I appreciate other poster's comments. The one thought in my mind was, why did my tech leave them on when she put her in bed!

[amoLucia]

I'm always amazed at what I call 911 toenails. Also known as 'Howard Hughes' toenails. These are overgrown toenails that are sooooo overgrown that they curl back into the toe flesh and dig in. If really bad, the pt has pain and a possible limp. But sometimes pts just compensate and become used to the discomfort and gait difference.

Some pts with diabetic neuropathy or other PVD/PAD problems don't even feel it. And some pts really can't see down to their feet so they miss it. And then there's those who just can't reach their feet to cut their toenails.

I've called in 911/emergency podiatry consults for these pts. It's almost like minor surgery for toenail clipping.

I like to watch the Animal Channel. Animal Cops: Houston has lots of horse rescues and I always think of these 911 toenail pts when the horses on TV experience laminitis/founder, like overgrown equine hooves. Sometimes their hooves are so bad, the horses need to be put down.

[OnlybyHisgraceRN, ASN, RN]

When I worked in ICU I had a man with a really nasty looking foot. It was ashy, dirty, and dry. He had the worse personality ever to match. During my down time I provided foot care, and it looked ten times better. He was ungrateful and not thankful at all but when we do it until the least of these.... well you know the rest!

[missnurse01, MSN, RN]

Pantyhose the flesh has grown through...

[K+MgSO4, BSN]

The worse was an 18 y/o boy brought in with police escort after being found assulted. Had to take off his shoes for a full assessment in ED. The cop turned an amazing shade of green that I had to call for help for him!

This kid wasn't homeless or anything, turns out he NEVER took his sneakers off........even in bed. Had some mental health problems!

That poor cop! He was as experienced as I was at the time 2 months in.

[BostonTerrierLover, BSN, RN]

I had this guy that couldn't reach his to clip them, and our policy was no clipping Diabetic feet. I had to really pull a rabbit out of a hat to get them clipped. I can't remember who eventually done it, maybe a Pod? But, anyway, they were curling already with a dark black tarry substance under them. I nicknamed him Mr. Talon. I know, I'm going to Hell:)