Okay, nursing veterans...help out this newbie nursing student. I've talked with a number of nurses and NPs and, in the course of conversation, an alarming number of them have told me I will encounter more poo in my clinicals and first year of nursing than I ever imagined was biologically possible. Are they right? I fear they are.
Go ahead, warn me. Terrify me. Tell the stories you definitely can't tell at dinner parties. Make sure I know exactly what I'm dealing with. Any and all stories of grossness are welcome--if I'm gonna do this, I really, REALLY need to know.
Patient came up from OR (as an emergency ICU admit which we didnt know was coming until she rolled in the door). She was morbidly obese (600 plus pounds) and had surgery for a bowel obstruction, in which they removed part of the bowel and resected the rest. Came to us for monitoring because they were unable to get her off the vent due to her history and size. She was very restless and had to be restrained, and no legal amount of medication was controlling her anxiety or pain. After about a week of TPN she was started on tube feeds, and was on that for about a week before she finally opened her bowels. And when i say opened, i mean OPENED. Pools and pools of it. Rolling off the bed, into the floor. Head to toe. She was very non compliant and had to remained restrained because she continually extubated herself. Once she started pooing, she never stopped..because of her size, it took many of us to clean her continually..FMS did not accomplish anything but making a bigger mess, because she had lost all rectal tone. She was eventually trached, and still pooing. Everytime we got her approved for a long term facility, something would happen to set her back. The worst setback we had...one day while we were swimming in poo, trying to clean her up, and trying to make sure she remained restrained, someone failed to make sure they had a good hold of her hand while we rolled her..she reached up, after pushing one of the techs down, and managed to completely yank out her newly inserted trach. Completely out. Stitches and all. What a MESS!!!
momofthreeRN
1 Post
Patient came up from OR (as an emergency ICU admit which we didnt know was coming until she rolled in the door). She was morbidly obese (600 plus pounds) and had surgery for a bowel obstruction, in which they removed part of the bowel and resected the rest. Came to us for monitoring because they were unable to get her off the vent due to her history and size. She was very restless and had to be restrained, and no legal amount of medication was controlling her anxiety or pain. After about a week of TPN she was started on tube feeds, and was on that for about a week before she finally opened her bowels. And when i say opened, i mean OPENED. Pools and pools of it. Rolling off the bed, into the floor. Head to toe. She was very non compliant and had to remained restrained because she continually extubated herself. Once she started pooing, she never stopped..because of her size, it took many of us to clean her continually..FMS did not accomplish anything but making a bigger mess, because she had lost all rectal tone. She was eventually trached, and still pooing. Everytime we got her approved for a long term facility, something would happen to set her back. The worst setback we had...one day while we were swimming in poo, trying to clean her up, and trying to make sure she remained restrained, someone failed to make sure they had a good hold of her hand while we rolled her..she reached up, after pushing one of the techs down, and managed to completely yank out her newly inserted trach. Completely out. Stitches and all. What a MESS!!!