Dirty Jobs

I used to think that going to the "field" when I was in the military was pretty dirty...yucky even. Digging and sleeping in foxholes, not washing (except for out of your canteen cup) for days/weeks, finding sand in parts of your body weeks after you've come home and subjected yourself to home hazmat & decon. DIRTY.

However, my current job as a Clinical Consultant for a wound therapy product has moved WAAAAAAY up the list of not only DIRTY but down right GROSS (and a lot of the time depressing). I spend a lot of time in clinic, consulting with patients and medical providers on whether or not they (or rather their wound) would be appropriate therapy for their wound...and let me tell you, by time they get to me...they definitely need it...BAAAAD. I'm talking about patients (primarily diabetics) that have chronic, long term (some 3 years old +) ulcers (venous stasis, pressure, dehisced - surgical wounds that reopen, traumas to diabetic feet and more) that have stagnated and no matter what you do to them, they don't heal.

I am usually in the room as the nurse or doctor removes the dressings...and BAAAAABY...every time I thank God that I did not eat breakfast or just had something light cause between the gruesomeness of the wounds to the smell (of some) it takes a stout heart not to just swoon. I've been SOOOO close to just running from the room. I keep saying to myself..."Stay clinical list, stay clinical...discuss the quality of the tissue...how the edges look...etc." to stay steady. I've started carrying Vicks in my purse and have learned to hold on to the counter or sit as they take the dressings off. WHOA NELLI! Steady Yourself Girl.

Let me give you a couple of examples:

Monday, I saw one patient that was diabetic, morbidly obese and had just let his legs & feet go because "the home nurse wasn't coming everyday." Listen dood - nobody gets 7day/week home health nurse - especially a man that is ambulatory and can change his own dressings. This man had not changed his socks or dressings in a week. When the nurse peeled off his sock, I thought I was gonna just damn die right there. The bottom of his feet were so macerated (soaked wet) that they skin was falling off (Are you freakin out yet? I was).

Tuesday morning, I saw an 70 year old woman who had a HUGE diabetic ulcer on the bottom of her foot. I sat there while the doctor took a scalpel and a tool that looked like mini-plyers and went to work debrieding (removing the huge callus & dead skin) surrounding the wound bed. The doc was slicing, pulling, snipping, scraping, dabbing up blood like she was carving wood. All the while, I'm chatting with the woman about her friends & grandchildren...she isn't feeling a thing. There was so much blood and skin. JEEEEEEESUS.

Later that afternoon, I had to go and check on the status of a patient that we were planning on using the therapy on, but I had suspicions that I was gonna have to discontinue him because of non-compliance and other various reasons. I was absolutely CERTAIN I was going to have to discontinue him as I rounded the corner for the hallway to his room. I smelled this man's wounds 8 rooms away. He had wet gangrene on both feet. My eyes started to water as I got closer and closer. The Nurse Educator I was with had me wait outside his room and asked me to pray for her while she went in. NOW YOU KNOW IT WAS BAD. I came home and had to immediately put my clothes in the laundry room cause I felt like I could still smell it.

I got me a necessary, quality of life altering -----but DIRTY JOB. Sigh.