The Smelly One
Did you ever see 'Big Daddy' with Adam Sandler? The little boy's teacher is talking about him being "the smelly kid." In the ER we run the risk of having the smelly patient. I have found that smelly patients are like hurricanes... they can end up anywhere, but everyone can get one at some point. Fortunately, they seem to rotate pretty evenly through the department so you aren't always stuck with them (unless your sense of smell does not work, and then you are S.O.L.) .
Well, tag, I was it last night. Picked up this 96 year old nursing home patient with "belly pain." Not sure how the nursing home came to this conclusion, but oh well. Maybe it was the chronic diarrhea she had. So, for the record... necrotic bowel and oral contrast that has run the length of the gi tract... bad combination. The surgeon actually described it in her note as "tomato bisque." OK, so I'm never eating that again!
I cleaned this lady up several times, but the scent lingered. You know its bad when other parts of the department are complaining about the smell. I had other nurse's patients gagging from the stench!!! Usually we try to put them in one of the few rooms with a door, but a curtain is all that separated my old lass from the rest of the ER.
This poor lady was so sick. She had a valid DNR with both she and her grandson signed. THANK GOD! When given the details of her illness he wanted to revoke it!! The doc had to remind him that he witnessed this document and these were the patient's wishes. Finally he said, "if you want to change her DNR status, then you need to come in and do it." It helped that it was almost 2am.
Not too much else to talk about. Nice patients otherwise, quiet night. I'm gonna get my ass kicked tonight!
Things I recommend...
not drinking and driving
having a power of attorney (POA) for healthcare
respecting the wishes of people who are DNR/DNI