Bodily fluids

Last week I was asked to speak on a panel of nurses who had 1-2 years of experience for the nurse residency program at my hospital. Here are a few past events that I thought of as a result of our discussion.

Grossest things I've ever seen:
One time, I took care of a woman who had breast cancer that had metastasized to her brain. I'll always remember her for two reasons. One was this horrendous day she put me through once that all had to do with her taking a shower. The other was a time on a different admission when her health was rapidly declining. Another nurse was taking care of her when she started seizing and was having a lot of difficulty breathing. We called a code and the usual chaos ensued. I noticed that a pool of liquid diarrhea was pouring out of the back of her diaper and collecting below her, so I warned everyone involved so they didn't get covered in the mess. A general surgeon was attempting to insert a central line in her groin. He had tried a few times without success, so he moved to the other side to try there. With his sterile gloves, he pushed aside her diaper and the diarrhea came pouring out there too. He wiped it away with the gloves and successfully put the line in that site. Luckily, he told the ICU nurse that came to transfer the patient, "That line needs to be changed ASAP. It's far from sterile."

More recently, I took care of a woman with colon cancer who has recurrent bowel obstructions, which means that she vomits all the time. This means that her potassium is always low, because she keeps losing it by throwing it up. I received an order to give her some oral potassium pills to replace her losses. I asked if the doctor would be willing to change it to IV form, because I imagined the likelihood of the pill ever getting absorbed was pretty slim. They wanted to try the oral form first, so I brought it in to her. She took the med cup from me, and as she moved it toward her mouth, she slowly said, "I'm feeling a little nauseous..." before projectile vomiting. I had to jump out of the way to avoid being hit by the stream of vomit. It went so far that it actually hit the opposite wall! I've never seen anything like that. And as if that wasn't enough, she did end up getting over a liter of it into a bucket. When I poured it out into the toilet, I saw some whole pills in it. One was bright red, which I didn't recognize. I asked her what it was, and she identified it as one she hadn't taken in over three weeks. Yikes!