Probably the worst was a 400+ lb guy brought in by EMS because he couldn't care for himself any longer. He was early 50's and was still wearing the hosp gown he was d/c in 3 weeks before.
He was so big and the house was so piled up with garbage they had to cut a section of wall out to get to him. When he got to us he was covered neck to toe in fecal material.
Me and 2 other nurses went in to start giving him a bath. Lots of hot soapy water and about 50 towels. As we turned him onto his R side, we noticed something hairy stuck in a fold.
It was covered in poop, and upon futher inspection we noticed it had blown pupils. That was the first rat I have ever had to pull out of a fold. We also recovered some Little Debbie wrappers in other folds and a crushed coke bottle stuck in his a$$
We did get this guy admitted and sent to a nursing home for better care.
Cetacaine! Just a little on a 2x2 stuck in your mask will cover the deadliest of odors...of course, you'll be smelling bananas for the rest of your shift but hey, sometimes it's worth it!
Most of the odors I don't have any trouble with--but gangrene..OMG...
Dakota
We used to always use oil of wintergreen--you can get it from the pharmacy. If you put some on a 4X4 and hang it from an IV pole, the entire department will smell good. A teeny drop on the inside of a mask works great, too.
I used to use Cetacaine too, and it did work great...but I found out that some people may have a very serious adverse reaction to Cetacaine, called Acquired Methemoglobinemia. :imbar See the article: Read Page 4
So I no londer use it, as it is not worth the risk. I was taught that "trick" by another nurse many years ago, so I know it has been around awhile. The article stated that excessive use can increase your chances of this adverse reaction.
So please, do NOT use CETACAINE to block out odors....
you have not smelled anything like a homeless lice infested fesces and urine covered homeless person from New York City. the best thing to do is bathe the patient with lindane, then betadine and green soap combo. stinky feet can be helped by spraying an amp of bicarb on the feet. youd be suprised how well that works.
also, a vapo rub mustache works well. you should insist that your ER be equipped with a high turn over rate ventilation system. its better for you, and your ppd conversion rates will drop significantly.
Couple of years ago had a 60ish male brought in by EMS. Apparently the pt had been working at his computer at home when he started to feel dizzy. He attempted to take his own pulse, but was unable to feel it. Therefore, he layed down on the floor and instructed his wife to start CPR on him and call 911. Ems arrives to find the wife valiantly performing chest compressions on her husband as he lay there wide awake and talking. Turns out the pt had never lost consciousness during this whole episode. Did a little teaching to family re: when it is appropriate to start lifesaving measures. It was really hard to keep from snickering as numerous family members trooped through the ER sobbing after their loved one's "near death" experience- we could not make these people understand that he was never near death.
Didn't ACTUALLY witness this, but know it to be factual from very reliable sources...
A dark night, an ambulance bay, and a handful of employees smoking by the ER door. A car comes careening into the bay, and hysterical people come flying out of the front seat.
"Grandpa is in the back seat, he's not breathing, please help!!!"
A familiar scene, indeed. Someone grabs a stretcher, another person gets an AMBU bag, the ER doctor is notified.
But when they pull Grandpa out of the backseat, he has rigored. Alot.
The doc asks the family "When did he stop breathing?"
"Somewhere around Denton."
That would be in DENTON, TEXAS. This happened in OKLAHOMA CITY. About 3 hours north of Grandpa's point of departure.
While i was working as a tech in a busy ER, one of the nurses asked me to see what her patient was yelling about. I went into the room of a 63- year old woman who spoke very little english. She was there for possible GI bleed and I had a hard time understanding what she wanted me to do for her. She kept yelling "DOUCH, DOUCH ME!" I explained to her that I we dont douch women in the ER and that she could take care of that on her own. She started yelling at me for being a bad person because she couldnt reach. She went on to crawl out of bed and give her husband money to go to the grocery store to buy her a douching kit. That is just one request of many that I hadn't heard before.
The scariest was when a van and 10 squad cars pulled up right outside our trauma bay. Not knowing what was going on a nurse and I walked out to see these people and the cops were firing at each other. The people dropped their guns and started screaming at me to get this guy who had been stabbed out of the van. I said "No, not until he's been searched for weapons." My god, I've never been in the middle of a hold-up before!
I have a couple classics. Had a woman come in BAC up in the 4's Massive lady partsl bleeding, She had just been D/C from the hospital the day before post TAH and her and her other half decided to celebrate with some copulating; tore everything apart had to go to the OR for repair. Have another frequent flier nice guy just rotten luck was in a MVA ended up with an ex fix a few days later he arrived again he was driving his car while lighting a smoke ended catching the cling on his ex fix on fire and crashing again no injuries the crash impact put the fire out
my friend and i have worked together in multiple ed's for a long time now - our best story is our frequent flyer who weighed >600lbs -came in at least 3x on a wkly basis - of course we did everything for him including holding the urinal over his turtled member when needed - after a few months - we finally talked to his sister who informed us that he walks and did his own adl's at home w/o a problem - we promptly stopped helping him - of course he would just urinate all over the floor - one nite while on the code team we were called to pcu for a code - guess who - he was laying on his side and he was too big to roll over w/o lifting him - which 15 of us could not do - we did cpr on him - she held his back - and i had to compress his chest - which basically ended up like punching his chest - needless to say - we couldn't intubate... finally someone called his doc - who informed us he was a dnr ------ we still talk about this all the time - just one of those things you cannot ever forget!
See this is the part of nursing that I NEVER EVER want to have to do. I dont like wiping my own butt let alone someone elses!!! Thats gross. can you refuse to do that type of stuff? or are you pretty much prepared for that by the time you take your first nursing job?
Probably the worst was a 400+ lb guy brought in by EMS because he couldn't care for himself any longer. He was early 50's and was still wearing the hosp gown he was d/c in 3 weeks before.
He was so big and the house was so piled up with garbage they had to cut a section of wall out to get to him. When he got to us he was covered neck to toe in fecal material.
Me and 2 other nurses went in to start giving him a bath. Lots of hot soapy water and about 50 towels. As we turned him onto his R side, we noticed something hairy stuck in a fold.
It was covered in poop, and upon futher inspection we noticed it had blown pupils. That was the first rat I have ever had to pull out of a fold. We also recovered some Little Debbie wrappers in other folds and a crushed coke bottle stuck in his a$$
We did get this guy admitted and sent to a nursing home for better care.
after reading that i almost had to throw up. anyone who lives in that kind of filth should be sprayed down outside with a garden hose!!!
Makes me think about my nursing instructor who is extremly compassonate, she had the same kind of incident and all the nurses were hiding b/c they didn;t want the assignment.....she marched right in there and bathed him and gave him a massage........he cried b/c it had been "so long since anyone has been nice to me or even touched me"........sometimes people just need to know you give you a crap....
See this is the part of nursing that I NEVER EVER want to have to do. I dont like wiping my own butt let alone someone elses!!! Thats gross. can you refuse to do that type of stuff? or are you pretty much prepared for that by the time you take your first nursing job?
NOOO, of course you wont have to wipe butts (wink, wink).
One time, we had a 6'5 or 6'7 man (very tall) die in the ER. We prepped his body for family viewing. We had to wait a long time for them to come. They stayed in the room a loooong time. Anyway, after they left - I went to put him in the body bag. OH MY GOD!! Do you know how hard it is to get a 6'5 pt with rigor mortis into a body bag? It took several of us stretching the body bag to get his feet in. We had considered cutting a hole at the end of the bag and letting his feet hang out. We decided from now on, we will get the pt in the bag before viewing and hide it with sheets from the waist down.
We had a pt expire in our ER-- the tech was new and had never done post mortum care and so I was called in to help "orient/educate" her..... Now we must preface this with saying that I really enjoy teaching, I am typically a very compassionate and sensative person. This happened to be 3 AM, I had had sick kids at home for a week and I was a little tired ( and really should not have needed to be called in for this --all of which would equal one rather punchy nurse!!
The patient hadn't been gone too long, still a bit warm and we were getting him cleaned up before the family came. Ya know that weird clicking noise a couprse can make as air escapes from the body -- he was clickin' away! The tech was frecking out -- idn't believe that he was really dead -- thought we should get O2, do CPR etc -- Finally convinced her to check for a pulse and/or apical rate -- nothing!!!! As we turned the guy to clean him up, the corpse "belched" -- I thought she would pass out -- then, when we rolled him back, one eye slowly opened -- without even thinking I said, "Oh look! He's winking at you!" She ran from the room and tried to convince the ER charge that I was doing post mortum on a live pt and that she thought this had gone far enough. The charge came is and reassured said tech that the pt was indeed gone, that it is not terribly uncommon to see and hear these things and then sent her to the morgue to get a cart -- when she got back to the ED, she was complaining about how "hard this cart pushes" I checked for a brake on, something caught in the wheel.... NOPE!!! Yeah, you guessed it -- lifted the cart cover and found that the the cart was already occupied!! Again, without thinking, my response was -- "We try not to bunk the corpses -- unless all the carts are full". I took the carted corpse back to the morgue and picked up another -- empty cart. When I returned, newbie tech had gone out for a smoke break, family came in and viewed body -- id'ed the guy etc...... When she returned, she and tech-boyfriend said they would
move pt to morgue cart and transport him to the morgue. OK! I was charting the education record and heard this loud thunk and a scream. I rushed into the room to find my tech with her shirt unbuttoned, clasp of her bra undone and the corpse ont he floor -- seems while she and her friend were making out, they somehow "bumped the gurney" and the corpse fell to the floor. Big guy -- took 4 orderlies to get him onto the cart -- still amazes me how one little bump could send him flying off the gurney!!!! Needless to say, new tech and her boyfriend were let go -- I was nearly hysterical by the time I got home -- just in time to shower, change and go back to work for a new orientation group!!!
About 3 hours north of Grandpa's point of departure.
stevierae
1,085 Posts
We used to always use oil of wintergreen--you can get it from the pharmacy. If you put some on a 4X4 and hang it from an IV pole, the entire department will smell good. A teeny drop on the inside of a mask works great, too.