« A Sampling of Acute Care | Fingertips Home | The Top 50 Massage Blogs »

September 1, 2010

Gross Stuff

It's day 3 of acute care physical therapy in a busy, regional, level-one trauma center hospital. We serve all of Alabama, east Mississippi, and the pan-handle of Florida. We are also a regional disaster center, meaning if some place in the southeast US is overwhelmed because of some type of disaster, we are prepared to take overflow patients in the event of a crisis.

Every hospital has emergency codes. The rehab hospital I had during my previous rotation had color-coded emergency codes. The University Hospital uses alphabetical codes. So, in the event of a disaster, we would be alerted with Code D. Of course, I had to crack up during the orientation tour, while being treated to the sights and smells of the hospital environment, my CI alerted me to a Code Brown. The smell of bowel movement wafted down the hall. I said, "Ah, that's nothing!" recalling a bowel accident that fouled half of the gymnasium one morning during in-patient rehab. "Well, I can see that we're not put off by smells," my CI observed.

In my short time here, I've been exposed to gangrenous toes, a fasciectomy, edematous scrotum, and weeping legs. When I attended lymph drainage therapy classes, I heard about people who had so much edema in their legs that it would literally ooze out of their skin. For that reason, therapists specializing in treating edema were discouraged from having treatment offices with carpeted floors. Thanks to the acute care setting, I have now witnessed this phenomenon.

Ah, bodily fluids -- so many opportunities to come in contact with it. Or step in it -- as with the previous example. Something else that's easy to step in is urine. PTs are often put in close proximity with what is known as the "dump zone." This presents a wonderful opportunity for a slip and fall hazard. Add to that scenario: contact precautions. Contact precautions are in place when a patient harbors bacteria or other infectious agents that can be contagious to others. Does custodial staff put anything in their mop water to neutralize bodily fluids that may carry MRSA, C diff, or VRE? I certainly hope so.

So what do I do with my shoes? I wish we had a trough we could walk through with a disinfecting agent, the way that cattle farms do when transporting steer from one barn to another. When I get home, I take my shoes off immediately. I'd leave them outside my door, if I thought they'd still be there in the morning. After this internship, maybe I'll just burn them.

Posted by linda at September 1, 2010 1:37 PM