This patient showed up in the ER the other day... came in by ambulance. Apparently he called 911 because his colostomy bag exploded. On further investigation, I found out that not only does the guy have a colostomy, but is HIV positive, is homeless, and recently moved into the area from another city in the state. I also found out that this was not his first visit to our hospital. He'd been here almost twice a week for the past several weeks, and the nurses all knew him well already. I'd been away for a while, so he was new to me... He was also showing up at other emergency departments in the area as well; all for his exploding colostomy bags...
The thing about colostomy bags is that they tend to fill up with shit and need to be emptied once in a while...
Just like a water balloon; if you let them fill up, they tend to explode. Now picture a bag attached to your body, over-filled with shit to the point where it explodes... Now you can imagine what this guy looked like.
The nurses went in to get him cleaned up, and I started to do what I needed to do to get this guy taken care of. When they were done wiping the large clumps of shit off his body, we were going to get him to the decon room to let him take a shower. He was new to town, and hadn't been "plugged in" to our HIV clinic; so I called the social worker to come see him and get him an appointment. I called the general surgeon, so I could get him an appointment in the surgery clinic to evaluate his colostomy for possible reversal, and I called the ostomy nurse to come see him and teach him how to care for his ostomy site and to get him some bags so he wouldn't let them explode on himself anymore...
Unfortunately, once the nurses wiped most of the shit off of him, they attached a clean colostomy bag to his ostomy site, and with that, he wanted to go "home." They came to get me to intervene, and I asked him why he wanted to leave? He said that all he needed was a new bag and he was ready to go. I explained to him, again, all the things we had in the works for him... shower, social worker, ostomy nurse, a supply of bags, the surgery clinic appointment... He said he didnt' need any of that and he just needed to go.
Then I realized it... He didn't want our help. He just wanted to keep calling 911 when his colostomy bag exploded and have them bring him to us to clean the shit off of him and give him a new bag.
So I told him, very calmly I might add, that it wasn't appropriate for him to just leave. I said, "You're still covered in shit, we just were able to wipe most of it off. There's still shit underneath your fingernails... and we're trying to get you over to the shower." He was still in bed butt-naked with just a sheet over him. "I've got the Social Worker on her way to see you and the Ostomy Nurse is on her way to see you, too. We're trying to get you clinic appointments so that we can take care of you."
"I don't need any of that," he said. "Just get me out of here." So, I told him that was fine; we couldn't force him to do anything he didn't want done, and he was certainly welcome to leave. I also told him he was welcome to leave butt-naked and without the new colostomy bag, at which point he went ballistic.
He screamed at me in a high shrilly voice, jumped up out of bed and started running out the door crying... Naked. Except for his colostomy bag.
The nurses didn't know what to do... I told them to let him go. The police outside would certainly stop him, so he really wasn't going anywhere. Can't have a homeless man running around the city naked with an exploding colostomy bag.
I don't think it's appropriate for us to continue to enable this man's behaviour. He's taxing the EMS system by calling them for a non-emergency, and he's wasting the time of the Emeregency Department staff and the hospital's resources when there is appropriate outpatient care readily available.
The nurses eventually caught up with him and gave him a hospital gown... He left with the hospital gown and the new colostomy bag.
He'll be back when it explodes...
5 comments:
I always wondered if you wore a colostomy bag and then rolled over onto it in your sleep, does the shit get forced back in? Kind of like a big squishy bagpipe.. Also, if you farted, would the bag just inflate?
My ex girlfriend lied about a lot of things. She lied about having cancer, and then about having Crohns Disease. She said she was getting a colostomy bag fitted, 1 week after being "diagnosed" with Crohns. The date came around and she wanted to go bowling. When I confronted her about it, she got violent, so I left her.
@anonymous 1/6/12 2:16 am. Cool story bro....this was relevant how?
I will never be a nurse.
I know that the first response is 4 years old at this point, but as someone who has a bag, let me address it so if anyone else sees this, maybe it answers some questions.
No, shit does not go back in. It will most likely collect at the top of the bag and spread out a little...something we call "pancaking". Yes, if you pass gas, the bag does inflate a bit. Some bags have filters that let the air out to help prevent this but it's just a temporary thing as they tend to get clogged. The other way it do this is a process called "burping". If you wear a two-piece bag, you can pop the bag off the wafer (it's the piece that actually attaches to your body), and let the air out.
Chrons is one of the leading factors for people needing to get a bag. One does not get "fitted" for a bag though. The fitting comes after receiving the ostomy and even then, one is not "fitted" since the stoma will change size from time to time, especially at first.
I've got an colostomy and I am homeless living in a shelter. I empty my bag in a sewer once because I had no access to a washroom. It's not easy to be this way. It's probably gona happen to me. Or miss some ostomy supplies.
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