COWman's Corner of the Web

I soooooo wish we could set up our ER like this! But of course, in our ER, we would have to change the doors to simply clean and dirty. I realize that as an ER, our patient load has an over representation of the lower socio-economic groups, and that the area served by our hospital borders on Appalachia. And I remember from nursing school that different cultural groups have different expectations about things, including hygiene.

But still, come on people if you know that you are going to see a doctor, and you have the strength and/or energy (I can make an exception in cases of sudden injury or severe illness), do everyone a favor and wash!

It never ceases to amaze me the wonderous, olfactory experience that a day at work is. The majority of the smells come from just general, old fashioned BO, some of it older than others. This I have learned to simply tune out. I have also become pretty good at ignoring the smells of the bedside commodes/bedpans (except in cases of GI bleeds, those are a whole different animal).

Then there are the smells that I don't think I will ever get used to. The first is the smell of necrotic (dead and rotting) tissue. Last week, I had a necrotic foot ulcer. It took some major willpower to get down there close to it so that I could do an assessment. The patient tried to tell me that it developed since the last doctor's appointment, but there is no way you get that much rotted flesh in 10 days.

The other smell that I almost could not deal with was the smell of what I affectionately referred to as "Kentucky Fried Foot". I had a patient come in at 0100 saying that they spilled a pan of grease on their foot. Appearantly, they had been frying chicken and they decided to dump out the pan in their bare feet, and spilled it all over their foot. Judging from the barely pink look of their foot, I'm guessing the grease was pretty much cooled. Of course, behaviorally, you would have thought that there were third degree burns all over their whole foot. Of course, the foot was not washed before coming to the ER, so the whole area smelled like fried chicken. Again, it was a real test of will to get down close to assess that fried foot.