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fredericksI worked on this patient last, a woman with a tragic background/disease history - I mean, straight up sob story tragic. My tasks with her included changing the bandages on her feet; her overarching diagnosis was septic shock, and that precipitated her necrotic extremities. In the case of her feet she ended up getting one partially amputated and the other thoroughly debraded, to the point where it *looked* like the toes had been amputated. The course of action immediately post-surgery was a simple wet-to-dry dressing. Imagine you have a huge cut and you stick some cotton in it, and then are expected to remove the cotton in a couple of hours before reapplying some fresh cotton. That mental ouch? Multiply it by, oh, two stumps of feet. The patient had an analgesia pump to help, and she was certainly laying on it as I worked on her first foot.
And even though I knew she'd gotten the debradement/amputation deal and I saw that the gauze the earlier nurse had put on had blood seeping through, nothing prepared me for what I saw when I finally removed the bandages: bone. Pieces of mangled tissue with the distinct glint of bone...and in the case of the partially amputated foot, the obvious head of 1st metatarsal. Thinking back on it now I'm pretty sure I had little reaction during the entire drawn out procedure - one foot, then the other: remove the ACE bandage, wet down the cling wrapped around the tissue, remove the cling, apply fresh cling, wrap a new ACE, tape. All soundtracked by the soft *ding* of the patient pressing on the PCA pump button. She actually raised her foot to watch me work on the second one, the more reduced one. She must have been floating on morphine at that point, because I would have screamed bloody murder if I realized that's what my LE looked like.
I'm back in tonight (switched days with a co-worker, so I end up with three days off in a row again). Praises be that the night remains relatively peaceful.
And even though I knew she'd gotten the debradement/amputation deal and I saw that the gauze the earlier nurse had put on had blood seeping through, nothing prepared me for what I saw when I finally removed the bandages: bone. Pieces of mangled tissue with the distinct glint of bone...and in the case of the partially amputated foot, the obvious head of 1st metatarsal. Thinking back on it now I'm pretty sure I had little reaction during the entire drawn out procedure - one foot, then the other: remove the ACE bandage, wet down the cling wrapped around the tissue, remove the cling, apply fresh cling, wrap a new ACE, tape. All soundtracked by the soft *ding* of the patient pressing on the PCA pump button. She actually raised her foot to watch me work on the second one, the more reduced one. She must have been floating on morphine at that point, because I would have screamed bloody murder if I realized that's what my LE looked like.
I'm back in tonight (switched days with a co-worker, so I end up with three days off in a row again). Praises be that the night remains relatively peaceful.
