The home again

The theme for the day: poop and penises. I'm not sure how I've avoided the two in previous clinicals, but today I must've been making up for lost time. I followed a CNA around for most of the day and watched her replace a condom catheter (it's like a gluey condom ending in a hose which attaches to a bag) in room 663 and then we helped room 691A get onto a bedpan and room 667 needed to be moved onto the toilet and so on.

Poor Mr. 691A. After getting the bedpan all squared away, a crowd of people gathered around (2 CNAs, 3 students) to watch or assist in getting his suprapubic catheter attached to a leg bag so he could be transferred into his wheelchair. His new pants were around his ankles and his gown had been removed and as we all watched M try connecting the leg bag this way and that, Mr. 691A was lying naked on his back with a little erection. After 10 minutes of fiddling, a few people left to get more supplies and I asked the patient if he'd like me to pull his sheet up over him.

I knew that poop and urine weren't going to be all that fun or glamorous to deal with, but of course they're a natural and very healthy process and something important for nurses to deal with. Still, I wasn't quite prepared because I'd never really considered that the poop and pee in a hospital doesn't look or smell like anything natural. I think the urine was bugging me the most. In the several run-ins I had with the stuff today it was very cloudy, almost like a muddy brown and I swear it looked on the verge of having solid matter in there. The smell was also not so nice. Poop, same thing, although I won't go into detail on that one (see? I'm nicer!).

But you can't fault Mr. 691A or Mr. 663 or Mr. 667 who threw up on his gown and needed to be cleaned up. These poor guys are so incredibly dependent and are acutely aware of it. It's a pretty humbling responsibility to try to protect the dignity of the individuals you're caring for in the face of all of the indignities they suffer at the hospital.

Also today, I got to follow the NP into a patient's room to unroof a herpes lesion. Apparently the NP and the doc were having a disagreement as to whether the patient was experiencing an outbreak of varicella zoster (shingles) or of herpes. It had spread across one buttock and on the corresponding side of his penis and scrotum. Given the interesting pattern, I'd put my money on zoster...I'll have to check in a couple of weeks for the results. Anyhow, the NP was checking it out and demonstrating that it was causing pain to the patient. "Look, if I flick the unaffected side of his scrotum it's okay" flick. "But on the side with the outbreak, it's really quite painful" flick . "Aaaargh!" "See?" she asked flick. "Aaaaargh!"


note: all patient room numbers and names have been changed and purposely confused to protect privacy and all that. God bless HIPAA