Out of Sight, Not Necessarily Out of Mind

December 29, 2008

What is the worst thing you’ve seen as a nurse?

What is the worst thing you’ve seen as a nurse? We’ve all seen things that are shocking or upsetting, I’m sure, but sometimes, there’s something that’s just over the top for you.

In my years as a nurse, I’ve encountered many different kinds of problems. When I worked in ICU, I had a patient who fell off scaffolding and impaled himself on a fence (he was fine, the pole missed all vital organs — other than the skin, that is!). I had patients with bones sticking out and since orthopedics is a weak spot for me, that didn’t go over well. But, to me, the worst thing I ever saw was such a shock that it took me a while to get over it.

It was when I was working in a palliative care setting and the nurse I was relieving wanted me to assess something with her. She said that the patient had a trach and she wasn’t sure about something she saw. I walked into the room, completely unprepared and saw not a trach, but a huge *hole* in the man’s neck. Big enough to put my fist in. I had to fight to keep a professional face on, but to tell you the truth, I was furious at that nurse for not preparing me.

There are other images I have trouble getting out of my mind and some of them are pressure sores. Not too long ago, I saw a man with a 6 inch by 3 inch stage 3/4 pressure sore on his buttock. I saw tendon, necrotic tissue and lots of stuff I shouldn’t have seen. A few years ago, I remember packing an ulcer that reached down to bone. I remember it looked so dark and painful.

What is it about certain sites, as well as sounds and smells, that stick with us for years? I remember a Russian patient, who spoke no English or French (I’m in Quebec), but he had necrotizing fasciitis and we had to change his dressing several times a day. We gave him as high a dose of analgesic beforehand, but I still remember his screams and my inability to say anything that could help. Or maybe there wasn’t anything one could say. I know that we get memories like this from every day life. Who doesn’t smell a particular scent that brings them back a few years or to childhood? Who doesn’t hear a particular song on the radio and remember back to when they first heard it. But in a profession like nursing, we see so much more and so much can stick with us.

What do you remember? How do you manage if it’s something particularly disturbing?