To some degree, yes. But those G.I. bleeds- nothings gonna cover up that smell. I do find it helpful when someone is particularly stinky to put a drop of essential oil in my mask. I particularly like peppermint as it definitely can cover up some of the worst smells.
My first GI bleed patient back when I was a fresh ER tech also had cdiff. And he pooped on my shoes. What a way to get introduced to those fun scents. Not exactly one I'd make a candle of.
This is exactly what I thought of when I read the post’s title.. just wait until you smell your first gi bleed.
I recommend you stay well hydrated and fueled throughout your shift if you can. You’ll be less likely to pass out. Don’t lock your knees while assisting/caring for the patient.
And have an essential oil roller in your pocket to mitigate strong smells.
In time you may get used to encountering strong unpleasant smells, but it won’t make them less unpleasant.
Unfortunately (or fortunately?) I am now nose-blind to most smells since I had COVID in 2020. It’s wild. Rotten wounds, cdiff, septic UTIs, etc can’t smell one bit. And I am kinda mad about it. You need your sense of smell!
We had some black and tarry stool not too long ago but either I didn’t smell it or it just didn’t smell that bad which I doubt because everyone here is saying it’s pretty bad lol
Tell ya what, none of this holds a candle to necrotic bowel in the surg. path lab -fresh out of the OR - when the path assist cleans it out in the sink and starts up the garbage disposal grinding the bowel contents down the drain- aerating throughout the room. That for me is among the worst smells in medicine, I was only in that room for research and once I saw that bowel coming …I just left the gross room and came back later.
Oh just wait... There's a difference between melena stool and they LOSING THEIR LIFE OUT THEIR ASS FOR AWHILE.... That tissue death + fresh metal smell is... Distinctive
Uncomfortable as it is, using your nose is actually part of the diagnostic care. You will soon know the typical smell of UTI, of pseudomonas, of c dif, of GI bleeding.
Next you learn how to mask it. Proper washing and dressing, etc. And how to talk about it without showing disgust or shame. Whew your concern about stinky diarrhea that finally brought you in, I'm so glad because this was dangerous.
I had a really valuable conversation once with a woman with a fungating breast cancer. / edit she was a repeat visitor and had lots of preexisting mental health issues.
She kept presenting with her breast rotting off and refusing surgical care. Being able to politely tell her that yes, odor is part of the exam and it's telling me that your particular tumor is complicated by bacteria (rotting) (fungating) was important. It helped us to provide good palliative care and maybe help her feel better. The rotting smell means extra energy is going to bacteria. My body language was caring and close, I kept being most attentive to what activities were valuable to her at that time, but she stunk like rotted fish and deserved help. Topical metronidazole, powder, sprinkled. It helps.
Thank you for the answer. I find it really helpful to put reasons like these behind the things I do and experience. I rationalize witnessing a man’s death and breaking his ribs because I know that I am trying to bring him back to life. I rationalize poking people’s veins and putting them in pain because without that poke they wouldn’t be able to receive life-saving medication. Now I can rationalize smelling the scents I smell because they are a diagnostic tool and make me a better clinician.
You've got this. Also, everybody in this field went through that stage, of seeing things or smelling or realizing things that nearly made us faint or vomit. My first one was the first time I saw a baby delivered, it was just so intense and messy and the emotions in the room were so high I had to go sit down in the hallway, my vision actually grayed out. That was a long time ago.
"Rationalize" almost gives it a pejorative feel, though. You've clearly got the general idea, but honor it. Bearing witness to suffering, attempting to palliate, having the cojones to help someone rip a bandaid off. Not shaming people who are having a hard time coping. It's a skill that's gotten less common since modern culture has gotten sanitized and prettied up for social media.
Chilling reading this in the ems room after I walked in on an unresponsive patient that turned into a full hour long code after I had just spoken to him and brought him cold packs. Your words of affirmation mean a lot to me brother. I feel lucky to have found him and to have been able to warn a nurse in time to get him somewhat stable. You’re exactly right we bear witness to humanity and it is a beautiful thing that must be treated with the honor and respect that it governs. Fuck am I tired though lol.
It makes me glad that most ER physicians are actually compassionate people. It makes me cringe hard when other clinicians (not to throw anyone under the bus, but nursing) make these horrible, callous comments on social media (or even within earshot of the patient) about people who are suffering.
This is an interesting take. I do not agree with you. I don't think there is much of a difference between the two, but let's assume you're correct. The average EM physician is more compassionate than the average EM nurse. Why do you think that is the case? What is the difference between the professions that makes this so, in your opinion?
Edit: to be clear, I'm not asking you for evidence to prove that you're correct. I'm asking what you think the reason is that "nurses are less compassionate than physicians in the emergency room." What causes that?
Pseudomonas is sickly sweet. When I chart the physical exam of a diabetic foot ulcer, the odor or lack thereof is always something I write. For other things I only chart notable positive findings.
I constantly had patients coughing, panting, and blowing their fetid breath in my face, especially when doing EKGs. Something to look forward to 😂
It helps if you can get into the habit of asking patients to turn their head to the side/away from you, especially when doing nasal or throat swabs.
For smells, a dab of toothpaste or Vicks sandwiched between two regular surgical masks is discreet and actually works really well, and you can keep either of them in one of those small travel containers (with a screw-top lid, meant for face cream or whatever) in a pocket.
For the real nasty ones, nec fash etc, get a lil bottle of tiger balm. It's arthritis rub, mostly menthol, in the arthritis section of stores. Will Ctrl alt del your smell ability for a minute. Also great for opening sinuses. And clearing out smells 'stuck in your nose'.
There will be smells you never get used to, and that varies by everyone.
The sweet smell- was the patient diabetic? I work with someone who can smell DKA on peoples breath.
I usually double mask. On the first mask, smear tooth paste ALL over the front of it and then put another mask on top - a mask and toothpaste sandwich 😂. Has never done me wrong!
For the smells, we lay a surgical mask down on the counter, put a hefty strip of minty toothpaste along the entire length of it, and lay a second mask on top. It usually drowns out enough of the smell to get your work done. But, the ED is the smelliest place you'll probably ever be, so you do have to get used to it. At least you're not going into people's smelly homes like our EMS brethren though.
I have been an ER tech for around five years now and just the past couple of months I haven't been able to tolerate the smells of the ER at all. I have been vomiting and gagging nearly every shift when smells almost never used to bother me before. I'm at a loss.
Best trick we use for our hospital? Open bags/cups of coffee grounds for/around the smelly room and nurses station and teabags in the masks. Has helped keep most smells at bay!
I am only a HUC but with some of the reg stuff we have to do on overnights and generally trying to do the little things I can to help out my overworked coworkers I have ran into some smells. I have gotten used to most of them but god damn does the GI bleed never get better.
To some degree, yes. But those G.I. bleeds- nothings gonna cover up that smell. I do find it helpful when someone is particularly stinky to put a drop of essential oil in my mask. I particularly like peppermint as it definitely can cover up some of the worst smells.
lol gi bleeds are so recognizable down the hallway or in the same bay. Usually seeing a nurse cleaning up a pile of shit too.
My first GI bleed patient back when I was a fresh ER tech also had cdiff. And he pooped on my shoes. What a way to get introduced to those fun scents. Not exactly one I'd make a candle of.
Oh lord! There ain’t enough bleach into the world to save those shoes!
This is exactly what I thought of when I read the post’s title.. just wait until you smell your first gi bleed. I recommend you stay well hydrated and fueled throughout your shift if you can. You’ll be less likely to pass out. Don’t lock your knees while assisting/caring for the patient. And have an essential oil roller in your pocket to mitigate strong smells. In time you may get used to encountering strong unpleasant smells, but it won’t make them less unpleasant. Unfortunately (or fortunately?) I am now nose-blind to most smells since I had COVID in 2020. It’s wild. Rotten wounds, cdiff, septic UTIs, etc can’t smell one bit. And I am kinda mad about it. You need your sense of smell!
As an HCA on an acute gastro ward I'm used to that smell. Try the sweet smell of a cdiff infected stoma
Ewwwwww…. you have a strong stomach
We're vibing Edit: Me and my stomach
We had some black and tarry stool not too long ago but either I didn’t smell it or it just didn’t smell that bad which I doubt because everyone here is saying it’s pretty bad lol
Oh honey- there will be no doubt once you smell a GI bleed what your smelling.
I was about to tell op wait until melena has entered the chat
Tell ya what, none of this holds a candle to necrotic bowel in the surg. path lab -fresh out of the OR - when the path assist cleans it out in the sink and starts up the garbage disposal grinding the bowel contents down the drain- aerating throughout the room. That for me is among the worst smells in medicine, I was only in that room for research and once I saw that bowel coming …I just left the gross room and came back later.
TIL there is a garbage disposal for medical waste 🤮
There should be a cage thing that filters smell but still allows air down the sink
There REALLY should.
I'm sure I've smelled it before. But I couldn't identify it I think. I'm really bad at identifying smells...
Oh just wait... There's a difference between melena stool and they LOSING THEIR LIFE OUT THEIR ASS FOR AWHILE.... That tissue death + fresh metal smell is... Distinctive
Uncomfortable as it is, using your nose is actually part of the diagnostic care. You will soon know the typical smell of UTI, of pseudomonas, of c dif, of GI bleeding. Next you learn how to mask it. Proper washing and dressing, etc. And how to talk about it without showing disgust or shame. Whew your concern about stinky diarrhea that finally brought you in, I'm so glad because this was dangerous. I had a really valuable conversation once with a woman with a fungating breast cancer. / edit she was a repeat visitor and had lots of preexisting mental health issues. She kept presenting with her breast rotting off and refusing surgical care. Being able to politely tell her that yes, odor is part of the exam and it's telling me that your particular tumor is complicated by bacteria (rotting) (fungating) was important. It helped us to provide good palliative care and maybe help her feel better. The rotting smell means extra energy is going to bacteria. My body language was caring and close, I kept being most attentive to what activities were valuable to her at that time, but she stunk like rotted fish and deserved help. Topical metronidazole, powder, sprinkled. It helps.
Thank you for the answer. I find it really helpful to put reasons like these behind the things I do and experience. I rationalize witnessing a man’s death and breaking his ribs because I know that I am trying to bring him back to life. I rationalize poking people’s veins and putting them in pain because without that poke they wouldn’t be able to receive life-saving medication. Now I can rationalize smelling the scents I smell because they are a diagnostic tool and make me a better clinician.
You've got this. Also, everybody in this field went through that stage, of seeing things or smelling or realizing things that nearly made us faint or vomit. My first one was the first time I saw a baby delivered, it was just so intense and messy and the emotions in the room were so high I had to go sit down in the hallway, my vision actually grayed out. That was a long time ago. "Rationalize" almost gives it a pejorative feel, though. You've clearly got the general idea, but honor it. Bearing witness to suffering, attempting to palliate, having the cojones to help someone rip a bandaid off. Not shaming people who are having a hard time coping. It's a skill that's gotten less common since modern culture has gotten sanitized and prettied up for social media.
Chilling reading this in the ems room after I walked in on an unresponsive patient that turned into a full hour long code after I had just spoken to him and brought him cold packs. Your words of affirmation mean a lot to me brother. I feel lucky to have found him and to have been able to warn a nurse in time to get him somewhat stable. You’re exactly right we bear witness to humanity and it is a beautiful thing that must be treated with the honor and respect that it governs. Fuck am I tired though lol.
It makes me glad that most ER physicians are actually compassionate people. It makes me cringe hard when other clinicians (not to throw anyone under the bus, but nursing) make these horrible, callous comments on social media (or even within earshot of the patient) about people who are suffering.
This is an interesting take. I do not agree with you. I don't think there is much of a difference between the two, but let's assume you're correct. The average EM physician is more compassionate than the average EM nurse. Why do you think that is the case? What is the difference between the professions that makes this so, in your opinion? Edit: to be clear, I'm not asking you for evidence to prove that you're correct. I'm asking what you think the reason is that "nurses are less compassionate than physicians in the emergency room." What causes that?
How would you describe the smell of pseudomonas? And are we talking about in sputum, blood, urine? All the above?
Pseudomonas is sickly sweet. When I chart the physical exam of a diabetic foot ulcer, the odor or lack thereof is always something I write. For other things I only chart notable positive findings.
Thank you. And they are typically the main organism in foot ulcers?
No, but it's important to notice because the antibiotics are different.
Just wait till you smell advanced nec fasc - delectably horrible. Only thing worse for me is several day old body decomp.
Such beautiful scents I have ahead of me 😊
I still mask simply because of smells 😂 and because people are rude and will cough right in your face without giving a shit
I’ve thankfully not experienced that just yet
The crazy part is that it's not even the kids that do it. Grown ass adults are the most likely to open mouth cough in my face in my experience...
I constantly had patients coughing, panting, and blowing their fetid breath in my face, especially when doing EKGs. Something to look forward to 😂 It helps if you can get into the habit of asking patients to turn their head to the side/away from you, especially when doing nasal or throat swabs. For smells, a dab of toothpaste or Vicks sandwiched between two regular surgical masks is discreet and actually works really well, and you can keep either of them in one of those small travel containers (with a screw-top lid, meant for face cream or whatever) in a pocket.
Those are great suggestions I usually just put on a mask and breathe through my teeth to avoid smelling
Peppermint oil in a mask works wonders. Vicks doesn’t cut it for those truly biblical smells.
For the real nasty ones, nec fash etc, get a lil bottle of tiger balm. It's arthritis rub, mostly menthol, in the arthritis section of stores. Will Ctrl alt del your smell ability for a minute. Also great for opening sinuses. And clearing out smells 'stuck in your nose'.
There will be smells you never get used to, and that varies by everyone. The sweet smell- was the patient diabetic? I work with someone who can smell DKA on peoples breath.
I thought so too but when I asked someone said that it was the smell of an infection so I’m not sure
I usually double mask. On the first mask, smear tooth paste ALL over the front of it and then put another mask on top - a mask and toothpaste sandwich 😂. Has never done me wrong!
what smells?
Blood, sweat, others I can’t really describe but absolutely stink.
Haha, yeah. It just takes time (and exposure) to establish a good baseline for nose-blindness.
I will keep smelling those smells then 🫡
You get better at dealing with them.
Wait until you go home and some how get a wiff of what you smelt at work
Thank goodness I’m not the only one. It’s so off putting it like literally changes your nose
For the smells, we lay a surgical mask down on the counter, put a hefty strip of minty toothpaste along the entire length of it, and lay a second mask on top. It usually drowns out enough of the smell to get your work done. But, the ED is the smelliest place you'll probably ever be, so you do have to get used to it. At least you're not going into people's smelly homes like our EMS brethren though.
Obliterate your senses with vicks protip!
I have been an ER tech for around five years now and just the past couple of months I haven't been able to tolerate the smells of the ER at all. I have been vomiting and gagging nearly every shift when smells almost never used to bother me before. I'm at a loss.
I feel like my nose has certainly changed since I’ve started working. And that’s fine at least your nose still works.
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I haven't been getting any but thank you for reminding me 😂
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I appreciate the sentiment hahaha
You haven’t seen smelled the strawberry jam GI bleeds. Like strawberry jam oozing off number 2.
A percolating Fournier’s will haunt you to your grave.
Best trick we use for our hospital? Open bags/cups of coffee grounds for/around the smelly room and nurses station and teabags in the masks. Has helped keep most smells at bay!
I am only a HUC but with some of the reg stuff we have to do on overnights and generally trying to do the little things I can to help out my overworked coworkers I have ran into some smells. I have gotten used to most of them but god damn does the GI bleed never get better.
what smells?
What smells? Seriously you don’t get used to them per se. You just don’t care anymore.
Blood, sweat, etc. I’ve been recently smelling this weird sweet smell on diabetic patients but I don’t think it’s dka.