....you open the door, and the odor of urine gags you.
Today, I got a resumption for a pt who is well known to me, from when I was her case manager 3 years ago. She was a problem then, and we still keep accepting her back on service. 
Anyway, one of the last times I admitted her, she was to get a PCA from Medicaid. She was unhappy with her present PCA company (different than us) and wanted a recommendation for a new one. I gave her one that was very reliable. She asked me to call for her, so I did, and she was to get a PCA the next day. They never showed, and she reported me to my sup, which fortunately I had documented the process very well, and my sup knows me better than to be a BSer when it comes to that.
Anyway, this young lady is IDDM, s/p old amputation W/C bound, but still cannot manage transfers from bed to W/C etc.. I was to do a second visit on her after the PCA complaint, but she didn't answer the phone, or door, and it was locked. I left a note and a message for her sister. I hadn't realized at that time...yet...how many times she fell. So then her sister called the agency to report me for not calling 911 or the guard station because she had been stuck in her BSC overnight. (She was so concerned I guess when she got my message she waited til the next day to check on her)
So, I get this pt today, and she doesn't answer the phone. Call the hospital, she is d/c. I called every emer contact, no answer, or machines, or they don't know if she is in her apartment. (Or care I suspect.) So, I go, and I speak to the guard at the station, and asked him if he would unlock the door if I couldn't get in, he said no problem. This woman already lied about me, so I hate the thought of entering her appt, then being accused of taking something. I go up, knock on her door, a neighbor say she's in the hospital. I explained they told me she was D/C (I know what you're thinking HIPPA, but it is the culture of the building to help each other.) He says try the door, if its unlocked, she's home. It's open.
The smell of urine is overpowering! I call out to her, and she says very quietly, Im in the bedroom on the floor.....she didn't mention in a puddle of urine so huge the entire floor was wet! Her housedress was dripping. She had no obvious injuries, so all I needed to do was get her up, but she is BIG, and I knew I couldn't do it myself. I called down to the guard, and asked if he is allowed to help me. He says he's not supposed to, but if it comes to calling 911, he will, turns out he's an off duty city cop, and he says I know how those guys hate getting called out for floor lifts. So the pt tells me to go next door to her neighbor I was speaking to in the hall. I do, and he very generously came over and we had a hell of a time getting her up. She couldn't get her butt onto the W/C the wet dress kept slipping off the plastic seat and she would keep sliding back, gently, to the floor. We get her super duper W/C, and it has brakes that are better, and we get her into the chair. I swear, It was such a strain to lift her, it's a good thing I had a panty liner on, because my own pants would have gotten soaked. Once in the W/C, which I had lined with a big towel, I gave her a wash cloth and basin, and she wasked herself up and I cleaned up the room as bet I could. Then we got her all dried up and re-dressed. All I can say is good thing I know her and it was a resumption, because I didn't have to do as intense of an assessment, I already know her social/CG situations etc... She had none of her meds in the home, and no way of getting them til Monday (her family will likely blame us for that too). She is pretty non-comliant anyway.
In the process of all the lifting, we had her in a close hold, and all of my clothes were moist with her urine. My shoes, and not just the bottoms, were wet. I mean, it was gross!!
It was my last visit, and I was going home to do paperwork anyway, so I walk into the house, my husband and dtr are in the kitchen, and I just start stripping naked. They looked at me like I was nuts, and were afraid to ask questions. I took my clothes to the washer, started it, and walked back up from the basement to the second floor shower buck naked, lol. that was a really loooooong hot shower! I didn't know what to do with my new leather shoes, but my dtr suggested clorox wipes. Thankfully, it didn't hurt the color, so I scrubbed them down with those, and no odor remains, thank goodness.
So, how was your day??
