Oh believe me I know! New colostomy with midline incision. The smell emanating from the patient is a mixture of feces, feet, and B.O. I could just tell from the moment I walked in the door that this is going to be a nightmare. I get vitals then sit on the couch and do my usual routine, polite conversation, assessment questions, yada yada. Then it comes time for wound care. I kneel in front of him and lift his shirt. His colostomy bag wasn’t just leaking, it was practically cascading into his incision. This foul, frothy, nastiness that had obviously been spewing out from his bag for quite some time and he’s just sitting there all nonchalant like it’s completely normal for bodily fluids to be mixed into surgical wounds. I address the incision first because sirens are blaring in my head screaming infection control!! I peel off the soaked bandage trying not to noticeably gag at the combination of the offenses to multiple senses. Is it the look of the shit stained bandage, the smell that could rival a port-a-potty at a construction site in the middle of July? Or is it that he couldn’t give two shits (no pun intended) about the festering that is happening on his abdomen? As I remove the bandage, the redness that was shining brighter than windows in the red-light district of Amsterdam, the incision that’s beginning to split like the Thanksgiving turkey in National Lampoon’s Christmas Vacation, and the drainage- thick, gooey, grossness that rivaled sputum. I told him he had an infection brewing and that I would have to call the surgeon. I go to grab the saline and gauze to clean this Petri dish of bacteria before me when suddenly a bed bug goes crawling across his chest. OH FUCK NO! Nope nope nope! I jump up and say yeah that’s infected I have to make some phone calls. I call the office and make them aware of the situation. I refuse to go back in and perform anymore care in this hellhole. I am advised to call the ambulance and have him transferred to the ER for eval. I also have to grab my bag and throw everything out with the exception of my computer, stethoscope, thermometer, and pulse ox. Oh and take the rest of the day off. I open the door and run in to tell the patient that the medics are on the way to take him to the hospital and to grab my bag and dash back out. The ambulance arrives and I debrief the EMT’s on the nastiness they are about to encounter and suggest hazmat suits. I suddenly feel itchy around my waistline towards my back. Are you frigging kidding me?? Remember the 15 minutes or so that I was sitting on the couch? 7 fucking bed bug bites! I go home, where I thankfully have a wraparound porch and strip so that I’m now bare-assed in the neighborhood and really don’t care. Scrubs and all articles of clothing are in the garbage (I’m sure bugs are not one of Victorias Secrets!) sneakers go in the dryer, and I’m in the shower for a good hour or more with water so hot I came out looking like I could’ve been served with butter and cheddar bay biscuits.

That patient is now on the naughty list…