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The Dirty Details

May 14, 2012

It was my second shift as an intern in the hospital. Even so, I had finished training about two weeks prior and was confident because all the information was fresh in my mind. I know how to bathe a patient, how to ambulate a patient, move a patient from bed to wheelchair, etc. On the mandatory written and practical tests, I had received high marks. I was feeling good and was just about ready for anything. However, this was a slow morning. I counted how many times I walked around the floor looking for something to do, managing to do over fifty laps. My new Target watch was getting a lot of action as I constantly looked at my wrist to see if any time had passed. With all the walking, I definitely got my recommended exercise for the day. Just when I couldn’t hide my yawns any longer, an aide poked her head out the door of a room and waved me down. Finally!

“I need your help changing this patient’s diaper,” she sighed, “It’s already his fourth since I got here.” I should have realized then that this wasn’t going to be good. It was only 11:30am and her shift started at 7am. This patient was averaging one new diaper per hour. That’s a lot of dirty diapers. Nevertheless, the training manual stressed, “Assist hospital staff and physicians as requested” and I didn’t want to disappoint anyone my second day.

I walked into the room and began putting on my gloves. With one more step inside, the smell hit me like a semi-truck. It smelled like a park bathroom in the middle of a heat wave. Oh well!, I thought, This is what I signed up for. Time to start breathing through my mouth.

The patient looked frail and sickly, sort of like Gollum from The Lord of the Rings. He wheezed in and out,

periodically hacking in an attempt to cough something up. His arms were restrained to railings on the bed and he wasn’t able to communicate in any way. I went to the patient’s right side of the bed and the aide went to his left side. When you change a patient, you roll them to one side of the bed, remove everything, and clean them. You put in a clean diaper, roll them to the other side, and pull the clean one completely on.

Everything was running smoothly until the patient rolled towards the aide. At this point, the dirty diaper was removed. I was just about to put the clean one on him. Before I could do so, he began going number two straight onto his bed. It was like molten lava erupting from a once-extinct volcano flowing onto the blue protective pad and pristine white sheet. We couldn’t do anything but wait until he finished, cursing under our breath at our bad luck. Internally, I was freaking out since this was my first real diaper change.  Once he stopped, his condom catheter decided to fall off.  As he couldn’t control when he urinated, we now had a bed full of number one and number two: a bloodbath of brown and yellow. As if this was not enough, one of the ties from the wrist restraints decided to drift into the mess as he began thrashing, dragging the tie and what was stuck to it across his naked body. Everything that could go wrong went wrong.

In a wise move, the aide said we needed to get extra supplies: wipes, diapers, and sheets. When we came back to the room, we decided to protect ourselves. We suited up in full isolation room gear (yellow gown, mask, and gloves), which typically is reserved for only the most contagious patients. We were ready to conquer this mountain.

From here on out, the aide did the majority of work. As she could probably tell from my shocked face, I had been thrown into the deep end of the swimming pool a little too fast. I basically began handing supplies to her as she did the dirty work of cleaning this man and restoring our sanity. At the okay from her, I quickly dismantled my protective shell and raced to the sink. I couldn’t shake the feeling of having poop all over me. I felt like this until I got home, took a shower, and burned my clothes. Only after a couple weeks was I able to laugh at what happened as if I was part of a prank or a cast member on Scrubs.

Looking back, even though I can find humor in what happened, it is important to realize that this patient is human. Even if we had to deal with the mess he caused, it wasn’t his fault. However sick he was, he obviously couldn’t control his actions and what happened wasn’t because of malicious intentions. About nine million men and women in the United States over the age of sixty-five similarly rely on permanent long-term care. It’s always important to remember that this patient, and those like him, is human. He was once a son, brother, or father. At one time he was able to do things for himself and this episode was probably more embarrassing for him than it was for us.

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