Tuesday, April 06, 2010

Nurse Follies: Ummm...Yuck!

Part of the nursing job entails wound care. It can be as something simple as a blister (don't pop them!), and can be as complex as a deep, gaping maw which requires more than one person to do. I call those the "It Takes a Village Dressing Changes".

I kind of like wounds. Not enough to branch into the field of wound care nursing, but it's something interesting to look at.

One such wound was that of an unfortunate individual with gangrenous feet. Dressing changes, twice a day. It was painfully obvious (to everyone but the patient), that these feet were toast and it's days attached to the patient were numbered, but we still had to unwrap, clean, slather with extra-special cream, and re-wrap once a shift.

Gangrene is nasty. It looks nasty. It smells nasty. An Internet search of gangrene will reward you with images that will haunt you, and pretty much decimate your appetite for the remainder of the day (unless you are in the medical field).

Now, I consider myself as having a strong constitution for such things, and the first two times I changed the feet, things were pretty uneventful. The only residual was some nausea I had for a few hours following because the smell was that bad (the stinky Easter flower sitting at the desk didn't help either). The next time I changed the dressing, I was smart and wore a mask, having rubbed a bar of Dial soap on the inside before putting it on. I'll take the smell of Dial soap over rotting feet any day.

And so I'm plugging along, first foot done. A tech who was assisting me was holding the leg, the patient watching in interest, and I'm carefully cleaning off the old cream so I can put on new fresh cream. And then it happened. A toenail fell off and landed on the bed.

The tech and I both looked down at the black, rotten, toenail, solitary on the bed sheet, forever parted from the piggy that went to the market. We looked at each other. We looked at the patient who didn't realize that his feet were falling apart in wet, disgusting hunks and chunks. Silently, I quickly slathered on new cream, wrapped the feet, and disposed of the offending toenail. All the while, bile is rising in my throat. The tech looked stricken.

The Dial soap did not help my nausea that day.

For the remainder of the shift, I was traumatized. Someone would ask a question, I would answer, and then immediately follow up with, "Mr. Bob's toenail fell off." The unit educator came in early and asked how I was. I replied, "Mr. Bob's toenail fell off."

Some things seen, cannot be unseen.

I am reminded of the story I had heard about a lady who had gangrenous feet, had been home one night watching television, when she decided to cut off her dead, dried, shriveled, black toe with a pair of kitchen shears (those suckers will cut through most anything). She then decided to go to the ER, and brought the severed toe in a sandwich bag. I don't know why. Was she hoping the surgeon could put it back on? Was it meant to be a trophy of her Midwest Can-Do Attitude that she felt the need to share with the staff? I never heard the answer. In truth, I didn't want to know. I was still trying to figure out what she was thinking as she was cutting away at her toe as she watched Dancing With the Stars.

All this talk of gangrene is making me nauseated. I'm going to stop right now.


Donna said...

My diabetic mom had gangrenous feet and finally had one leg amputated below the knee; if you think it's bad now, wait until it's your mamma.

me said...

A toenail??? BFD! I once had two toes fall off in my hand!!! Fortunately, the patient was also blind...

BTW ~ there's the first of many pup pix up on the blog ~ I just got home...

Candice said...

Thanks for fucking up my breakfast. I didn't want those biscuits anyway... ;)

Let me guess, Diabetes or PVD?

Compliance people!! Compliance!