Most surprising/shocking/interesting thing you've seen

TexMex22 · Mar 28, 2015

I have more than one, but one that comes to mind is an older female that came in with a raging yeast infection she'd had for "about" TWO YEARS.

BlueChocolateCat · Mar 28, 2015

I'm ready for the day that someone gets their chest re-opened at the bedside and we do direct cardiac massage.

I think the best one was the patient who was doped up on PCP or some crazy stimulant and was able to pick up a total care bed and actually throw it.

LakeEmerald · Mar 28, 2015

Pt bought in by EMS to ED. Wife called them because her husband wasn't eating x 1 week. Essentially no chronic problems. Paramedic met me outside the room and told me to prepare. I girded my loins, went in and greeted the patient, who appeared to be an alert skeleton. He was cheerful and kind - age upper 80s. He told me he hadn't been feeling well and wasn't hungry lately.

I lifted the sheet to examine him. He was naked and was all ribs and sunken belly. Arms twig-like. In his lap was a glistening, red, purulent patch of raw chopped meat. It started at the suprapubic area, stretched from hip to hip, and terminated above the orifice. There were no recognizable genitals. No testicles. Nothing that even resembled them. It was as if someone smashed 3lbs of ground beef between this guy's legs. There was yellow, foul pus oozing from the tissue, but not gangrenous in smell. I internally took a step back on that one.

After obtaining bloodwork and searching fruitlessly for a source of urine (there had to be one???), I put the patient on contact precautions. The family who live with and assist this man with ADLs insisted this was the first they knew about it. The man maintained (denial?) he did not realize that it was there.

Turns out it was cancer. You oncology nurses probably knew this at the outset, but this was new to me (and to the MD). MD transferred him to another facility which was a teaching hospital. She stated they planned to do surgery, but that it amounted to experimentation and a teaching opportunity for an extraordinary case. She said he likely wouldn't survive a week either way.

Sorry so long.

This is a quickie: Got an EMS. Report - weakness. Man had a lopsided, deformed-looking skull. OK. Went to assess his abdomen and found the top part of his skull residing in his RLQ. Plans were to replace it later after brain procedures were completed. I had heard of this, but it was still weird and surprising.

klone, MSN, RN · Mar 28, 2015

A patient in labor who had polyhydramnios. Baby wasn't engaged, thus was not dilating her cervix. AROM would put her at great risk for cord prolapse. So the OB "needled" her, instead of using the normal amniohook to break her water, he used a 18g syringe and just poked a hole in it, allowing the fluid to leak out slowly.

Long Term Care Columnist / Guide · Mar 28, 2015

I once cared for a patient who had an abdominal wound the size of a honeydew melon. She was the victim of a gastric bypass gone horribly wrong (she got a severe infection) and had had repeated abdominal surgeries since then. She was diabetic and still overweight, but she was suffering from malnutrition and was on NGT feedings. Anyway, she had a wound vac and since they were new at the time, it was fascinating to watch the wound grow smaller over the weeks and months she was in the hospital. Eventually she healed up enough to go home, but every now and again the wound opened up a little and she had to come in to see the WOCN for wound care.

She was thin the last time I saw her, but she looked terrible and as far as I know she never completely recovered from the original surgery and subsequent infection. Sad case.

allnurses Guide · Mar 28, 2015

Had a lady with a severe sinus infection, lot of pain from the pressure. ENT came in, poked an 18 gauge regular needle up through her nose into the maxillary sinus (I can still hear the crunch as he pushed it through). Green pus started pouring out through the needle into an emesis basin, and the lady felt much better. But I still shudder remembering the sound of that needle going through the sinus bones.

Nibbles1 · Mar 28, 2015

I had a man with necrotizing fasciitis on his gentials. I literally held this man's hand as he screamed to his death. It was one of the worst days for as a nursr.

heron, ASN, RN · Mar 28, 2015

@Nibbles1: been there, done that and kudos for staying with him. This is why I believe in terminal sedation as a last resort to relieve suffering.

imintrouble, BSN, RN · Mar 28, 2015

Out here in the boonies we don't get much that is surprising or shocking.

The one patient that I remember most weighed 650-700 lbs.

I can see that room in my mind as clearly as I see this screen.

We see those kind of patients on TV, but the reality is so much more overwhelming. (Not meant to be funny)

Is it possible we remember the one we don't want to be?

That Guy, BSN, RN, EMT-B · Mar 28, 2015

Well most painful for me to see was my gentleman who had his scrotum split open, one of his testes on the outside and having his member degloved from the base to the tip.

annie.rn · Mar 28, 2015

Rectal CA. Had to change the dressing on wound described as "rectal abscess". From the outside, everything looked fairly normal but when the buttocks were gently spread apart to reveal the wound there was a huge cavern inside. I could have easily slid my entire hand inside w/ plenty of room to spare. The tissue was cold, pink and hard w/ no signs of granulation. It was so painful for this young pt. Pt. was unable to sit and spent life laying on side in a specialty bed. Stage IV CA w/ terminal diagnosis but was still actively searching for tx. options. Made me very sad b/c I had never seen such a cavernous, unhealthy looking wound. Short of a miracle, I knew there was not much hope.

In reading the chart, the CA was connected to one of the HPV viruses. A good reason to get your sons and daughters vaccinated (even if vaccine does not cover all strains it's better than having no immunity at all). My two cents.