September 18th, 2005

Yellow head

On the Dementia Ward

It's been a while, but I'm now back and will make writing in LiveJournal a regular event again. Since I was last here, I've completed a three month stint on the hospita dementia ward. I'll be writing about some of my experiences there over the next few entries.

Incontinence is, of course, a big issue on the dementia ward. If you've got a problem with faeces or urine, then this isn't the job for you. It's not nice to have to wipe another person's bottom, but somebody has to do it.

On Tuesday, I and a staff nurse, were in the process of helping a male patient to the toilet, when we noticed another patient, taking his trousers down on an adjoining corridor. Well we decided we just had to get on with what we were doing and deal with this other matter later. The gentleman we were assisting was bad on his feet, so he needed a nurse on each elbow to help him along. Toileting can be problematic with many patients, and particularly with this one, because he's quite far gone in the process of dementia, and can strike out when being manhandled. The man used to be a boxer, and although one arm is now weak, the other is still strong enough to knock you flat if you're not careful. He's got a very healthy grip on him too.

That particular job done, we went in search of the guy we'd seen taking his trousers down.

Now this other patient is something of a character. He's a ninety year old Italian guy, who speaks not a word of English. He's a tiny fellow, thin as wire, with a big nose, who wears a battered hat. We've given up trying to take the hat off him at bedtime, because of the fuss he'd kicked up. So he sleeps with his hat on. He's generally an amusing fellow though, with an obvious eye for the ladies (well, he is Italian).

Well, Mr Italian never bothers to find a toilet. It's a problem we have with him, that he'll just find a convenient out of the way place, and just do it there. It generally takes three nurses to shower, change or toilet this patient, because of the resistance he puts up: kicking and punching.

Sure enough, Mr Italian had left us a pretty present of a huge turd in a pool of urine at the end of one of the corridors. He'd also wiped his hand along the handrail, leaving a long smear of faeces. Three nurses took on the job of cleaning the patient up, while I dealt with his mess. Nothing is simple in nursing and that includes using a mop. All mop buckets are colour-coded for different areas of the ward: yellow for kitchen and red for general, while there are two green buckets for bodily fluids: one to be used only in MSRA infected areas.

It's a hateful job, cleaning up faeces and urine, but it's basic nursing and if you can't do the job, then you shouldn't be a nurse. I find vomit even worse.

One nurse told me a story I'd rather have not heard, about how, on one occasion, the Italian gentleman had left a bowel movement in the corridor, which wasn't spotted for awhile. By the time a nurse discovered the turd, it was unfortunately in the hands of another patient, who was eating it, thinking that it was a chocolate bar.

Dementing patients are like children. You have to watch them all the time.
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