Here is a real account of an event that happened recently on my ward, it is a bad story.
Mr B is reviewed on the ward round and told the plan for the day, get an endoscopy and a transfusion of blood, standard morning ward round stuff for the admissions unit. As we carry on reviewing the other admissions, he decides to head off to the toilet to open his bowels, he negotiates the obstacle course in front of the loo; linen trolley, dirty linen bins, BP monitors, super sized veterinary style weighing scales and numerous medical students and eventually arrives on the toilet pan. Sadly it is here that he takes suddenly unwell and rings the buzzer for help, a nurse attends and checks his obs (BP, heart rate and O2 saturations). The BP is critically low, 57/40 and he is tachycardic at 125, she calls us to come immediately. In we trot, four of us to see Mr B, who is sitting stark naked on the pan, “right Mr B” says my boss “let’s get you off there into a bed and have a look at you”. Mr B looks at us all, ” no way” he says “One of you will have to wipe my shitty arse first”.
Retreat, retreat, not our department …out we all shuffle “nurse, nurse, Mr B, he needs cleaned up”.
Mr B is naked, he is unwell, he has just passed a bowel movement the smell of which is like nothing on earth (digested blood), he has it all over his legs and his behind, there are 4 doctors standing in the toilet with him sniffing the air and agreeing that this was indeed melaena, all of us desperate to plonk him in his bed and get busy saving him. Also in the toilet, is another person, one who has been there all along, since Mr B first pitched up clutching his stomach and bursting for a crap…..it is the ward cleaner. The cleaner is mopping away, seemingly oblivious to the going’s on around him, mopping the floor and wiping the surfaces.
Bad of us, I am sorry Mr B.