Wash time

Sometimes one engages in a conversation that is just not wanted from the beginning. This is one of those conversations. It started months ago when the nurses aids (CNA’s) came to me to complain about a patient. The patient is in his mid 60’s and has multiple medical problems including mild dementia, diabetes, Parkinsons, high blood pressure (HTN) and just plain nasty body habitus. That’s a polite way of saying he stinks, but his stench goes well beyond a mere days build up of body odor.

I’ve written about this type of thing before. Stories about patients are just not the same because the reader can’t immerse themselves in the stench that won’t die. Part of the stench is because this particular patient has the habit of disimpacting himself without the end benefit of washing his hands. Put plainly he sticks his own fist up his drain pipe and pulls debris out. And I don’t mean a small pile of winter leaves, I mean huge mounds of gooey poo piled at the base of his shower chair. He manages to do this to himself because he can put one leg behind his head and really get a good grip on things.

Aside from his contortions to stick his own fist up his exhaust pipe he demands the CNA’s attend to another rather disgusting task. But he won’t just let any nurses aids assist him with the task he only wants the 18 year old CNA’s to do it. It has to be done just right and if it’s not he tells the CNA’s to do it over (at least four times) until they get it right. The task he demands the “young” CNA’s perform is the washing of his diminutive manhood.

My feeling on this is that if he can stick his own fist up his bum and he can reach his own jolly rodger he can damn well clean it himself. He not only demands the CNA’s pull the foreskin back and forth at least four times to clean his pickle but he makes lewd and suggestive comments while they are doing it. He has started to make lewd comments to the nurses and other female staff as they walk down the hall.

This whole situation came to a head and I along with the DON, ADON, nursing instructor, nursing students, and the CNA on duty met to discuss what was going to happen. I listened to the students (who were at their first day of CNA school) tell how the patient became verbally abusive to the CNA and the students. They told how he yelled at the CNA that she wasn’t washing his choking chicken correctly and that he was going to refuse any further care if she didn’t listen to him. The CNA recognized at this point that there was nothing to be gained by continuing to wash the patient and made sure he was safe, then went and got the nurse. She moved the patient back to his room and addressed his yelling at the student nurses. He became defensive and denied everything stating that the only CNA’s who properly wash his dangling participle are the two 18 year olds.

After I met with the staff and students in the DON’s office I the floor nurse to bring the patient to the office. When he arrived the ADON asked him for his events of the shower fiasco. He started with a song and dance and finished with a genuflect but it didn’t help. He was still full of it. He talked for almost an hour.

What I had to say was short and to the point. You will wash your own pudgy pencil I told the patient and you will stop insulting and making lewd statements to the nurses and other female staff.

But it’s shaped like a cauliflower and I have trouble retracting it.

(I’ll never eat cauliflower again)

I explained that sense he can reach Mr. jungle gym he can wash it himself. If he is worried about developing penile cancer I will be more than happy to arrange for a urologist to see him and perform a circumcision. Believe me a circumcision in your sixties is not a painless procedure.

I have not had any problems since our talk.

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