Three things I've never seen before while doing an observation day with the Wound Care Nurse, all of them vaguely horrifying.
1. The fattest man I have ever seen. I'm not prejudiced against large people, but this guy weighed in, on admission yesterday, at 904 pounds. Yes, NINE HUNDRED AND FOUR. He is scheduled to have some sort of pannus-removal surgery. The docs are pretty sure he has a heart condition, but he's too big for ANY nuclear medicine studies (the tables aren't big enough, and he wouldn't fit inside the machine, and too big for the cath table, the OR table, and pretty much everywhere else. They're planning to do the surgery IN HIS HOSPITAL BED because they can't move him. It took 7 of us to roll him to assess his skin integrity.
2. Somebody's tendon. No, not in surgery, he had a pressure ulcer from where another hospital put pressure ulcer preventing (o irony) boots on him. The inside of said boots were hard plastic, so the skin over his achilles tendon broke down. Voila! Tendon! He was really out of it, and on a vent, but it was still horrifying. I mean, insides are supposed to be on the INSIDE. Also, his big toe was BLACK and about to fall off. I don't think he'll be walking again.
On the other hand, I doubt he's going to be CONSCIOUS ever again either. Sad, either way. He just took really lousy care of himself (smoker, alcoholic, morbidly obese, no exercise, diabetic, dialated cardiomyopathy, cardiogenic shock, etc.)
3. A wound-vac. They're gross. I'm sorry, but I don't know how the floor nurses can deal with that. I mean draining normal stuff like blood or serum? Fine. This was draining...infectious goo. NOT fine. Gross.
And she had the inevitable NON EXISTANT pain tolerance. She screamed when the nurse POINTED at her, and demanded more "mo'phine", because we were "torturing" her. Without touching her. When she said she was comfortable when we walked into the room. Oy.