Nurses Facing Difficult Patient Situations
12 posts in the last 60 days, all from r/nursing.
“Trying to argue with a bariatric patient that they need to let me clean them after they soiled themselves is infuriating. And you cant really just leave them in cuz then youre gonna have to report the PI.”
“we do have those (I think we almost entirely use those ones), but still it’s the turning to the side for more than necessary/setting the hips off kilter that can be so difficult for patients, I’d say. and yeah I’ve run into the same issue w/ bigger patients where it…”
“Also a solution I’ve used before (which depends on the kind of stooling your patient is producing) is to attach a fecal incontinence bag to a foley bag. Get them REAL clean, then put skin protectant all around their sphincter. Let that dry, then put the incontinence bag on, then…”
Multiple posts discuss challenging patient care scenarios, including dealing with complex ostomies, anticipating patient decline, and experiencing unsettling gut feelings. These nurses are seeking advice and sharing their experiences.
SOURCES (28)
“Also a solution I’ve used before (which depends on the kind of stooling your patient is producing) is to attach a fecal incontinence bag to a foley bag. Get them REAL clean, then put skin protectant all around their sphincter. Let that dry, then put…”
“"properly" is doing some seriously heavy lifting, ive seen a fair amount of situations where it either wasnt really possible to maintain sterility from a combative patient, or the nurse had poor technique. i just mean to say, i am surprised that in a real clinical context , doing a procedure 10x isnt more of a risk in and of itself. it would also depend on how clean youre able to keep your patient but i dont even remember the last time i saw a long term inpatient with a chronic foley g”
“I don't remember the details surrounding the episode, but years ago I had a patient that was bed bound and incontinent. He was on an air mattress, and it was deflated slightly in the center where he was laying, so sort of in a little dip. I don't remember why, but he had a massive diarrhea episode. The tech and I had gone in expecting to do a regular clean up and bed change, but what we walked into is forever seared into my memory. This poor guy looked like a boat floating in a lake of c”
“All good except the one that wants to go home to remove his ostomy bag to substitute with "special plastic" because we don't know how to do it apparently submitted by /u/OhShitzies96 [link] [comments]”
“Trying to argue with a bariatric patient that they need to let me clean them after they soiled themselves is infuriating. And you cant really just leave them in cuz then youre gonna have to report the PI.”
“Smell test confirmed. They blew up the patient with enemas and suppositories though.”
“Yeah, this is like the nurse who packed the patient’s anus instead of the wound literally inches away. It at least makes me suspect that it was patient abuse under the guise of being sublimely incompetent.”
“My mind boggles at how they can cook for themselves, with that much weight it's incredibly hard to work in a kitchen.”
“I used to work in a SICU. We would try to take huge initiatives to prevent skin break down or damage. This would involve turning patients every two hours. We would have these awesome wedge pillows, but the turning is (at least) a two-person job. It would involve taking another nurse away from his or her assignment. This is even more difficult during bathing or changing out the pad or bedding from under the patient, as one nurse needs to hold the patient on their side while the other is doing the”
“One time a pt “threatened” me with shitting off the side of the bed. He told me at the last hospital he was at they didn’t come right away when he pressed the call light so he had to poop off the side of the bed. The way him and his wife were smiling and laughing about it and told me about it was them telling me this is what he would do if I took too long. They told me this as I was admitting him too. I told him if he did that here he’d be cleaning it up and if he didn’t want to do that it’d sit”
“You’re good. Also, ask for a laxative but preferably stool softener to start like miralax, senna, docusate. You’re on pain meds that can cause constipation, you should already be on the stool softener. If not, ask your nurse who can page the doctor.”
Thank goodness not yet, been there 6 months no poop escapades as of yet
“Sort of a rock and a hard place. What can we do? I’ve had similar experiences as well. At the end of the day, they have the upper hand so to speak? They can dedicate in their bed and dirty themselves and what are we to do? Leave them dirty? I can’t help but to resent those types of patients. Partly because of their behavior, but also because I ultimately HAVE to clean them afterwards no matter what. Better to not fret imo and just get it done and move on.”
“we do have those (I think we almost entirely use those ones), but still it’s the turning to the side for more than necessary/setting the hips off kilter that can be so difficult for patients, I’d say. and yeah I’ve run into the same issue w/ bigger patients where it overflows/pushes stool up the front. we put chux under almost all our patients but an extra one definitely helps if they don’t want to actually go on the bedpan”
“Do you not have the special hip fx bed pans? I’m sure it’s still not fun, but they were better than the regular bed pans. I also agree about them being more trouble than they are worth sometimes, especially for obese pts. I’ve seen too many smashed bedpans spill all over the bed, that oftentimes we would just cover the bed in chux and not even bother with the bedpan.”
“I dont now which is worse. The people shitting the bed or the 30something climbed out of the stretcher n shit on the floor. Full squat.”
“IR/Radiology here - Please for the love of all that is holy, back away from any dressing with scissors. Adhesive remover and time works wonders without the risk of cutting a tube! Signed - one too many call backs to replace damaged CVC's and perc drains.”
“Non a WOC RN, but I personally detest tefla pads because it adheres to the wound/healing. It’s ironically named “non-adherent”; it’s worse than smashing dry gauze on a wound. They are terrible. If I want non adherent, I’ll use adaptic. Or hell. Dap of neosporin/hydrophobic paste and a dry gauze. Anything but tefla.”
“Look, I’ll keep it short and sweet…. Had an explosive disaster in my scrub pants as I didn’t make it to the pot on time. I blew out the whole ass end of my scrubs (they were yellow, now they are, well, Dark Yellow). I tried taking a couple hand towels here in the restroom to smear sideways in different angles to get all the shit off, but in a sense it kinda made it all worse because the shits all over my hands now. I am trying to type this but the shi affexts the scrreen while m typing and I sti”
“I admitted a patient with stage 4 pancreatic cancer to med Surg for nausea, vomiting, abdominal pain. Fecal impaction was found. So the point was to enema and laxative our way through while controlling nausea and pain. Patient was female and in early 60s. We had a lot of good conversation. She spoke with a Connecticut accent like my mother in law, who I look up to. She carried a strong, don’t-feel-sorry-for-me attitude but it was combined with sarcasm and humor. That warm toughness that reminded”
“Had a guy once that was retaining like 1100mls of urine according to scans. We couldn’t get the carb to work and we had uro come up and try to cath him. Didn’t work. Turned out it was ascites fluid and not urine. We all went 🤦”
“Eh, some ex-lap in discontinuity. Patient was freaking out on the vent the day prior so the doc just asked “you just wanna be extubated till surgery, it’ll hurt but you won’t be on the vent” Pt was doing fine but something was fucking wrong the next shift, the behavior, the little signs of anxiety, random moments of panic before denying complaints. Something weird Kept running to the doc about em, and to the docs credit he was cool and let me report every little thing. He kinda tried to hide his”
“I have a patient with a very long (almost 3 inches) very oval ostomy that is recessed in a abdominal fold. I have tried to put a shit ton of ostomy paste, a molded wax ring, stoma powder and tape on the ostomy bag and it still leaks. The patient is having skin breakdown because if this and the stool is getting all over their wounds. I need some advice from some badasses with more experience than me. -A frustrated younger nurse of 2 years. 🩷 submitted by /u/PelliNursingStudent [link]”