Here’s a story from my memorable archives, and one that illustrates how nurses assess their patients with all their senses:
My patient that day in the ICU was a middle aged female named Mrs. Owens, admitted for pancreatitis. She was no longer critical, and was due to be transferred out as soon as there was a bed. Easy day ahead.
Except that, first thing in the morning, I noticed a really foul odor coming from somewhere around the bed. My sense of smell is hyper acute, (click to read about my terrifying Overload Disorder Syndrome), and this smell was particularly unpleasant. I was reminded of the time my husband had to crawl under our house to find the source of a decaying odor. A dead mouse.
I bathed her meticulously and changed her linen, searching all the while. Still the odor persisted. I emptied the trash, and checked the cupboards. I got down on my hands and knees and looked under the bed. Nothing. She had no dressings, no wound, no foley, no drainage…? I ran the water at the sink, and sniffed the drain.
Mrs. Owens was a nice, quiet lady. As the day progressed, she told me she liked to garden and arrange flowers. She adored her cat, Bella, and really missed her. She wanted to get home as she knew that Bella would not eat unless she were there.
The day wore on, and the smell persisted. Surreptitiously, I called my co-workers in one by one to see if they noticed it, too. Almost all didn’t. One co-worker said she thought she vaguely smelled something, but she didn’t seem concerned enough to jump on the bandwagon with me. She was probably appeasing me.
But it was such a bad smell! How could they not notice? Like something dead or rotten. I couldn’t get it out of my nostrils, and I was really puzzled.
I had to find it! Suddenly, a light went on in my head. Had she perchance left a Tampax in place, and forgotten about it? It had happened recently in the ED, with a teen-aged girl who was quite ill. The girl had used two tampax at the same time, as a safeguard against overflow, and had simply forgotten about the second one. It was plausible, right? I was excited to think I may have solved the case!
So I asked Mrs. Owens if she would allow me to do a vaginal check. She agreed without hesitation. I donned gloves and inserted two fingers.
To my shock, my fingertips hit something hard and glassy smooth. I couldn’t process what I was feeling. What the…? I tried to get a grasp on the object, but it was too slippery, and there were no edges. I tried hard. I really wanted to pull it out, whatever it was! But it was impossible. I conceded defeat, withdrew my hand, and asked, “Did you know that there’s something stuck in your vagina?”
She looked down and away, and said softly “My husband was playing around and did something to me.” I asked if she knew what was up there, and she replied “It’s a vase.” My reaction? The most important thing to me in that moment was to act as if this was an every day, ho-hum kind of normal occurrence.
The last thing I wanted was for her to feel any more embarrassed than necessary. However it came about that she had ended up with a flower vase inside of her… was her business. Mine was to care for her.
I explained, “Mrs. Owens, I’ll need to call your MD in to have a look.”
I called the MD, who came in, and performed a bedside exam with her pelvis elevated on an upside down fracture pan and a bright spotlight. He wasn’t able to remove it, either. He called in Dr. GYN, who called in Dr. Surgeon. Mrs. Owens ended up going to surgery. For removal of a vase. A vasectomy?
Twisted nurse humor aside, I’m glad I could be the one to help her. I’m glad she didn’t become septic. I’m glad for the doctors who helped her. I’m glad for my nurse peeps who know we have to let it out occasionally with a little humor.
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Until next time friend,