Poo Poo and yes, More Poo

One of the things they don't tell you before signing up for nursing school is just exactly how much poo you get to observe and evaluate for its color, consistency, amount, and unfortunately, the odor is an added bonus, and I cannot forget being prepared to scoop for specimens. One thing is for sure, nurses must have a keen sense of smell and a strong stomach. They can identify the differences between tube feeding poo, c diff poo, gi bleed poo, iron poo, and so on. And it is always good to have something special that helps sidetrack the odor once a whiff is in... we use shaving cream, a cheap odor buster that doesn't irritate the bottom.

These past few days, I got christened with starting my first tap water enema. I worked the floor with my first year instructor -- she was excited for the experience it would give me. I wasn't necessarily thrilled, the pt drank the whole gallon of golytely and didn't go one time the entire shift---- so I knew it was not going to be pretty. And it wasn't. The pt was being prepped for a colon, however it was a no go. After the 3rd one, it was clear the pt would not be having that colon that morning. It would have to wait for the next day. I felt so bad for the pt. Over 90, state dnr, but yet the dr insisted on the colon d/t the possibility of a lower gi bleed. After the colon was finally done, nothing was found. There was probably a bleed somewhere, but they do not know where. That night after the colon, they had to be transfused with 3 units prbc. And this was nothing new for the pt as they have had multiple transfusions over the past few months. My preceptor didn't think the pt would make it through the night, that all of this was too much for them to handle. They were still alive when we left this morning, and hopefully they are still alive by the time I go back on Saturday.

Sometimes, I just wonder when enough is enough as far as taking into account the person's age and etc. I have seen them do a colon upstairs, it's not pretty. If I am over 90, just LET ME BE. I think I will create a do not do these procedures on me list for when I am that old. If I make it that long, I expect to be able to eat what I want, or what I can. Drink what I want, and golytely isn't going to be on that list. Sign me right up for comfort measures only, and let me enjoy my last days in peace. Just turn me over every 2h so I don't break down.

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And I just wanted to do a small update on the intubated pt from the previous post. They had been extubated, but the sats fell down to 19% and they were coded and reintubated. It's unclear whether or not they will be able to come off of the vent. The tracheal deviation was d/t a mass pressing on the trachea. However, they were flown out to a bigger hospital yesterday, but I don't know why. It's obvious the condition was much more critical than we could handle.