Most surprising/shocking/interesting thing you've seen

anh06005, MSN, APRN, NP · Mar 28, 2015

There's a couple of them.

One was a potential abscess between testicles and rectum. They wound up cutting the scrotum so the testicles were hanging loose until they were able to close him back up. We had to wrap them on moist gauze and pack everything back up as best we could.

Other was a skin cancer removed from the nose. It wound up being a lot more invasive than they expected and they took away most of the pt's nose. We could see in the sinuses and we had to basically pack his face.

KatieMI, BSN, MSN, RN · Mar 28, 2015

A child was born with ambiguous genitalia, on exploratory only streaks of poorly differentiated gonadal tissue were found and removed immediately due to risk of malignancy. Raised as a boy from age of three on because he was XY by chromosomes. Had 36 plastics to create good looking and even partially functional external genitalia while on combined sex hormones, grew up into handsome lad, matriculated in prestigious military school. He was evaluated by psycho people at least a dozen of times because of high dose testosterone required to keep his "parts" growing and so provide plastic surgeons with material to work with, so to say, and never had an issue. Then, at the age of 21, he appeared in the center he was treated and asked to make him a woman because he was feeling as one!

It was a pity to see the surgeon cutting off his own creations of many years. The young man, now a lady, managed to immigrate because "necessity of prolonged treatment" and became a successful military female leader in Western Europe.

A boy born out of hospital, in a few days brought in together with his mother, both beaten almost to death by loving relatives because "it must be devil's deed". Boy had a tail good 4 or 5 inches long and could wiggle it.

Both cases were outside of the USA.

michlynn, BSN, RN · Mar 29, 2015

Emergent pericardiocentesis at bedisde after pacemaker implantation punctured the ventricle and pt was in tamponade.

Maggots in a leg wound that I discovered after cutting the dressings off of a patient's leg that appeared to be months old. I saw something writhing underneath the dressing and literally jumped back and exited the room to find help. I can deal with sputum, poo, urine and vomit... live creatures... no.

Nursynursenurse, ADN, RN · Mar 29, 2015

A child was born with ambiguous genitalia, on exploratory only streaks of poorly differentiated gonadal tissue were found and removed immediately due to risk of malignancy. Raised as a boy from age of three on because he was XY by chromosomes. Had 36 plastics to create good looking and even partially functional external genitalia while on combined sex hormones, grew up into handsome lad, matriculated in prestigious military school. He was evaluated by psycho people at least a dozen of times because of high dose testosterone required to keep his "parts" growing and so provide plastic surgeons with material to work with, so to say, and never had an issue. Then, at the age of 21, he appeared in the center he was treated and asked to make him a woman because he was feeling as one!
It was a pity to see the surgeon cutting off his own creations of many years. The young man, now a lady, managed to immigrate because "necessity of prolonged treatment" and became a successful military female leader in Western Europe.

OMG! This is why people should wait until after puberty to do drastic surgeries on ambiguous genitalia. To see if their actual gender matches their chromosomes.

A long time ago I was at a nursing home for my CNA clinical. I was assigned a bed bath on a pleasant but nonverbal man. He had a foley and when I got to his groin I noticed his member was deformed. The catheter was inserted in the middle and his member looked split. My instructor told me the story after I was done. Apparently, a CNA was transferring him from bed to chair and forgot to take the foley bag with and his member ripped apart from the urethra down. It had long healed but just imaging what pain he endured makes me shudder. Now I'm paranoid with foley placement and never forget where it is at all times.

Gooselady, BSN, RN · Mar 29, 2015

I worked psych for 17 years, where do I begin?

The man who thought the Devil lived in his left testicle, and shot it off with a pistol. I'll never forget the dressing change.

The man who believed he looked at his four year old niece with 'lust' and literally dug his right eye out and damaged his left, but they managed to save most of the vision in it. I'll never forget THOSE dressing changes either.

The woman who pounded a framing nail over an inch into her own forehead (I saw the polaroid pic in the front of the chart).

The woman who used a kitchen knife and viscous lidocaine to sever BOTH of her achilles tendons because no voluntary unit in the area would admit her for suicidal ideation.

NurseSpeedy, ADN, LPN, RN · Mar 29, 2015

I've had a couple. A Man came out of surgery with a wound vac to clean up his "self castration" mess that he attempted at home.

Another was an ER admit. Homeless. TB positive. Told us his name was Jesus Christ. Later I went to give him his haldol and he looked at me and said, "Monkey nuts! I'm a witch and I eat monkey nuts!" He then very quietly said, "you want some?" offering me the pills. I told him I had mine with breakfast. He proceeded to chew the pills and chased them with water. I'll never forget that guy.

There was also a dementia ward patient that kept going outside to the gated garden area with her suitcases and kept trying to pile them high enough to scale the fence. Had to keep a close eye on her because unlike a lot of older people, she was in pretty decent shape and given enough time I know she could do it.

klone, MSN, RN · Mar 29, 2015

OMG! This is why people should wait until after puberty to do drastic surgeries on ambiguous genitalia. To see if their actual gender matches their chromosomes.

I don't agree. The vast majority of people's gender and sexuality match their chromosomes. I think the psychological damage that would cause by waiting until teens or 20s with ambiguous genitalia and no gender identity would outweigh the relatively small risk of the patient not identifying with their chromosomal gender.

klone, MSN, RN · Mar 29, 2015

Wow, mine is tame and boring compared to all of these!

Ruby Vee, BSN · Mar 29, 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.

How did that happen?

cayenne06, MSN, CNM · Mar 29, 2015

Just the other day we had a direct admit from the ED for a woman with abdominal pain who was found to be pregnant (by a urine dip in the ED). When she came up to the unit she looked to be about 20-25 weeks along, and birth was imminent. Amazingly, she delivered a healthy (but tiny!) baby girl who was almost term.

(details changed)

klone, MSN, RN · Mar 29, 2015

Oh, that reminds me of another cool experience! We had a woman from Mexico, no prenatal care, who presented to L&D in active labor. Based on her stated LMP, she was around 38 weeks. I labored her, and when she was ready to deliver, called in the OB. She pushed for a while and then delivered a baby who was tiny and scrawny. This baby looked to be about 3-4 lbs. I remember the OB and I looked at each other in horror, both of us thinking "Holy ****! Did we just deliver a 32-weeker here?" (we were a level one, meaning we had NO NICU, and anyone less than 36 weeks in labor was transported an hour and a half away to Phoenix).

All of a sudden, instead of delivering the placenta, the OB yells out "We need more staff in here! We've got twins!" The dad looked like he was about to pass out when he heard. The second baby came out without a problem, and looked much healthier, about 6 lbs.

Placenta (singular!!) delivered, and we realized we had mo/mo twins, twin-to-twin transfusion, and a velamentous insertion.

For non-OB people - each one of those things mentioned would make this an extremely high risk pregnancy, with regular monitoring, possible early delivery, and delivery in the OR (if not a scheduled C-Section). All of these things TOGETHER?? Holy ****, this woman was a walking time bomb, and we labored her like it was no big deal. Luckily, mom and babies were all okay. Dad, maybe not so much! :)

B52, BSN, MSN, RN · Mar 29, 2015

In med/surge I had a patient whose genitalia were amputated, a result of prostate ca.

In psych, the most shocking thus far was me getting punched by a patient. (I'm not sure why I was shocked.)

And then there was the patient who committed suicide. Can't go into details. I'll never forget that.