How To Resolve A Colostomy Mishap
A couple of years ago, while working as a nursing assistant at a rehab center for the elderly and the infirm, I had a resident who was suffering from multiple sclerosis and was paralyzed from the neck down. I'll call him Tom. Afternoons with Tom involved reading him the sports page, doing "range-of-motion" exercises to keep his joints pliable, feeding and bathing him, and emptying his colostomy bag as needed.
Once a month, the ride service would show up at two o'clock PM and pick him up to bring him to his doctor's appointment. On one such day, the early afternoon went by with nothing interesting transpiring. We read the sports page and I got him dressed and lifted into his chair to wait for the ride service. While we were waiting, a nurse came in and changed his colostomy bag to a new one, as Tom had been experiencing lots of gas and loose stools lately, and he wanted the bag to be clean for his appointment.
The nurse pulled a new bag fresh from the box, attaching it to his skin with adhesive and clasping the end shut. The van arrived and he was on his way. Twenty-five minutes later he returned, pushed in the door by a flustered ride service driver.
"We need some help!" said the driver. I immediately noticed the scent of human excrement wafting through the door and a pained look on Tom's face.
"We have a slight problem here," said Tom.
Apparently, while picking up another client across town, the driver had moved Tom's chair a bit to make way for the new passenger, causing Tom to shift in his chair and squash his colostomy bag between his body and the wheelchair's arm. This caused the bag to burst and separate itself from the fresh adhesive seal the nurse had applied to his skin minutes earlier. Nobody realized that the man's colostomy bag had become unfixed until the van was filled with the scent of a particularly sloppy BM, which sprayed out of his side. The loose colostomy bag had deflected the glut, making a bigger mess than if there had been no bag at all. Considering the circumstances, the driver high-tailed it back to the rehab center to get rid of this unwelcome passenger.
A nurse came over, assessed the situation, and said, "Bring him to his room and get him cleaned-up."
We got to his room. Tom was already sitting in the sling that gets attached to the Hoyer-Lift to move him from his bed to his chair and back again, so the mess was satcheled in the sling, getting spread around so there was a dark reddish-brown stain from his knees to his chest.
I lifted him into bed and checked out the damage. With the sling now disconnected and limp at his sides, it no longer served as a levy to prevent a flood of shit from running everywhere; and so it did. It ran underneath his body, down his sides, and down between the sections of his air mattress.
A nurse came in after a few minutes to see how things were going, spraying unscented air-freshener everywhere. I don't remember what the stuff was called, but it really was unscented -- it smelled like water, and it really worked well. However, even hospital-grade air-freshener couldn't stand-up to a liter of fresh excrement smeared up and down the length of the bed and sloshing around inside the folds of an air-mattress.
I got my basin of hot, soapy water to the bedside, complete with a stack of fresh, clean wash-cloths. I put on a pair of gloves and got to work. I had to reach down into the folds of the air-mattress, about six inches down, and scoop handfuls of warm, runny, greasy shit out between the folds.
Agitating the puddle of shit made the smell worse. This stuff was fresh, and it smelled salty, somehow. Like, if you didn't know it was shit, you might think it was beef stroganoff or some kind of soup or casserole. (A woman across the hall said later that night that it smelled like Rice-a-Roni.)
The first stack of ten wash-cloths went directly into the garbage -- else I would have been there all day wringing the shit out of them and fetching clean, soapy water. Eventually, after twenty minutes or so, the exposed mattress was clean and wiped-down with disinfectant, as was most of the mess that covered Tom's mid-section. Now the trick was to clean up his back without re-soiling the mattress.
I requested help from another aide. He stood at the opposite side of the bed and reached over and grabbed Tom's opposite arm, pulling Tom's body towards him so he was lying on his side. Generally, cleaning-up someone who can't move themselves is a process of cleaning and re-cleaning the same area over and over, as each area tends to get re-soiled as you move and adjust the resident's position. Also, poop is greasy, and it sticks to skin, preferring to smear around rather than wipe off.
I placed clean towels over the exposed side of the cleaned mattress to minimize the mess and to prevent the shit running off Tom's thighs and back from completely destroying my progress. Five minutes and six washcloths later, Tom's back and left side were clean. Repeating the two-man technique described above, five minutes and six washcloths after that, Tom's right backside was clean. We got clean sheets under him, slipped a clean gown on him, covered him with fresh blankets, and were finally done after a total of forty-five minutes.
A nurse came in to fasten another colostomy bag to Tom's abdomen. We were done, and we hadn't died.
Froty-five minutes spent elbow-deep in another person's shit, trying to move and clean-up a 220-pound guy who can't move by himself. Forty-five minutes spent trying to clean-up a pool of shit, as well as the bed and the person in the bed at the same time, and then affixing new sheets and pads to the mattress WHILE it was occupied. As for the smell -- I couldn't even smell it anymore by the time we left, but residents down the hall were complaining about the odor half an hour later.
That was the day I began to think about quitting.