When the ‘@?*#’ hits the fan (or the floor)

Last week on clinic a patient was transferred to our ward from the Intensive Care Unit of the hospital where I am placed. The physios in ICU had suffered some problems transferring the patient who was of considerable weight and was in considerable pain. The patient had required four (4) assist to ambulate just a couple of metres to a chair so they could sit out of bed. Our supervisor is a new grad who has only been working for around 5 months now and one of the friendly ICU physios decided to help out and came up to our ward to teach us the best way to transfer the patient.

Here’s the scene: Two physios and two students all gathered around this poor patient’s bed getting ready to help them to transfer to standing and then (if all goes well) maybe take a couple of steps. Now what we hadn’t been told by the nursing staff is that the patient had just been given an enema. Dictionary.com defines enema as:
1) A solution introduced into the rectum to help promote the evacuation of faeces.
2) The enemy/bane of all physios.

Our patient was on some serious pain killers and might possibly have had some communication difficulties before being admitted to the hospital, so when he/she mumbled something about need to go to the toilet, the ICU physio decided that it wasn’t a priority problem and the IDC in situ would probably solve the problem the patient was referring to. So we stood the patient and soon realised that the problem should have been a lot higher on our list of priorities. We did manage to catch a lot of the faeces in a bed pan before they hit the floor but were still left with a nice smear down the side of the bed, on the back of the patient’s legs and a few dollops strategically positioned on the floor.

The first question in my mind (after considering the patients safety of course) was whose responsibility it was to clean up all of the mess. Our supervisor had always told us that we should work closely with the nurses and help them out as much as possible so honestly they weren’t at the top of my mental list of people to do the cleaning up. This probably also has something to do with the fact my housemate’s mum is a nurse practitioner from South Africa who frequently complains that nurses in Australia are treated as nothing more than glorified cleaning maids and not qualified professionals. I wasn’t sure if there was anyone else who we should be asking to help but in the end I was very impressed by what happened next.

The ICU physio immediately said “I made the call to stand the patient up so you guys don’t have to help clean up.” Fortunately for him everyone chipped in; we grabbed a fresh sheet and hospital gown from the linen cupboard, an oversize box of cleaning wipes were found and a couple of nurses came over thanking us for finally helping the patient get his bowels moving. In the end it was a team effort in cleaning the patient up and getting them back into bed. Each of the physios and students did their bit after donning a pair of gloves and the mess was cleaned up in no time.

I hope that in the future when I come across situations like this again they are resolved in a similar way with physios and nursing staff both chipping in to ‘fix the problem.’ I think it’s key to developing a good working relationship with the nurses and we should all be working together for the patients good anyway.