Friday, September 12, 2008

Code Brown

I was asked to come in early for my night shift yesterday and agreed---not for any altruistic reason---for the double overtime. I was supposed to start at 2330h but instead started at 1930h.

I arrived and my first task of the day proved to be helping a 75 year old woman out by disimpacting her. That's right, sticking my hand up inside her rectum and pulling out clumps of poo. (To my delight I only gagged once and didn't get the usual waterbrash and watery eyed reaction I get when dealing with #2. I also couldn't believe my luck that I had made it this far in my nursing career without doing a disimpaction. It is somewhat of a right of passage.) The best part was when I stepped out to grab some more gloves she decided to give it a go herself and when I re-entered the room grabbed my forearm with her poo-mitt to steady herself.

Um...can you say "clorahexadine shower"?

Unfortunately it appears that the baseball sized lump of badness was what was keeping in her G.I. bleed.

Yeah. If you've never smelled a G.I bleed you ought to crack a beer and toast the universe now because you've got something to celebrate.

My problem went from dealing with someone who couldn't let it out to someone who couldn't stop letting it out. Just as fast as we stripped her bed, changed her gown, rolled her back and forth about 7 times to put new sheets and pads down, the great tide of feces flowed forth. I resigned a couple of times within a half hour period but the site leader wouldn't accept said resignation. I started using the "I love my job" mantra to ensure I was mouth breathing.

After a few hours of this her repeat troponin came back elevated indicating that there was some cardiac cell death likely happening...oh and her lactate was high as well...oh and her WBC...shall I go on?

So she needed to be transferred from the sub-acute section of the department and into the cardiac monitoring area. I gave report to the other nurse, scrubbed every square section of exposed skin on my body until it was raw, and sat down for the first time since arrival to chart.

I looked at the time:


Which goes to show, you should never do anything for the money.


Ryan said...

Oh my glory. God have mercy on your soul.

Albinoblackbear said...



Bostonian in NY said...

"Which goes to show, you should never do anything for the money."

Nursing: what a shitty job

Albinoblackbear said...

Yeah, I've spent the last few years carving out a poo-free career for the most I'd almost forgotten how 'shitty' nursing can be sometimes.

Rogue Medic said...

One of the nice things about EMS is that we don't do disimpaction - not that I haven't provided some care that was beyond the call of . . . (no that will be a pun that stays impacted).

Foleys are in my scope of practice for some bizarre reason - maybe to deal with Lasix - but I was trained in a different state and have never been on either end of one. I'd like to keep it that way. Unfortunately, it looks as if the state will make them required equipment on ambulances, soon.

The most appropriate emergency use for a Foley is to provide balloon tamponade of otherwise uncontrollable bleeding. Or for some comic relief. Laughter is the best medicine.