Trach Mouth-Help!

[maryen]

Hi- I need help! I received a new home care patient who is long term vent/trach and has the most horrible mouth/oral situation I have ever encountered. The pt. palate, mouth, teeth are all deformed and have lots of "pockets" for food/debris to hide thus creating the most horrible odor ever. Never been to the dentist-cracked and missing teeth-major plaque and only does oral care 1x day. From the minute I enter her room the smell is just so strong. During the course of the day I get as much liquids into her as possible, swab her mouth with saline and a bit of mouthwash and provide oral care once she is up. But it does not even make a dent in the odor. I literally go home smelling like the odor and have to take a shower. And I am not a smell sensitive person but this one has me thrown for a loop.

I spray febreeze and my favorite body spray on myself during the shift to help elevate the smell but I would love any other suggestions.

[caliotter3]

What can you do to initiate dental care? Probably only some good dental care can help this situation.

[maryen]

Yes Caliotter3- That was my question to her and her Family. She has never gone and never will.

[caliotter3]

If it is that bad and no one is willing to address the issue to resolve it (I don't think you can do it even if you spend 8 hours working on it), you may have to leave the case. I can't imagine working somewhere that kept my stomach turning for eight hours and then kept on afterwards. I am certain other nurses have left that case in the past for just this reason.

[maryen]

You are so right! They cannot keep night nurses-who would want to be enclosed in the pt. room all night with the horrible smell?! Hygiene in general is a red flag with this case-I am going to give it a few more shifts but not sure if I will continue.

Thank you for validating my situation! It is easy to feel so alone in home care!

[caliotter3]

My tendency is to want to make it a mission for myself but sometimes we have to acknowledge when we are fighting a losing battle. You could start approaching your supervisor for assistance in this matter, but if they are anything like the supervisors I have encountered, they will give you the brush off. While you are on the case, do the best you can so that your conscience is clear when you leave.