Smells in Healthcare

So, after an odd day that resulted in me and my mentor coming away from a home visit smelling rather strongly of urine, I was inspired to ask my friends: what unique smells have you encountered during your time in healthcare? I was not disappointed…

Urine

This is pretty standard and is a smell that can’t be avoided. Every ward has at least one incontinent resident and I’ve definitely been handed more than one used incontinence pad as a ‘gift’ from a confused patient. This might also be something that is more commonly seen in the community where patients are maintaining some form of independence and not able to look after their personal hygiene anymore.

Had one lady then who used to dry her tena pads out on her radiator- LB

Faeces

Again, everybody poops. But there is always that little bit “extra”. Faeces nearly always has some form of ‘scent’ due to the methane produced in the colon, but if you add in infection, disease or poor dietary choices this can have added impact.

In my care job I empty commodes in the evening from the night before with poo stewed in them for 24 hours – LB

Vomit

Ditto

Body Odour

All adults have bacteria on their skin that loves to eat sweat, with a biproduct of this being body odour. Some patients either cannot or choose not to partake in personal hygiene and part of the nursing role is to either give them a helping hand or encourage them to wash.

Washing overweight people who haven’t had under there rolls washed in like a month and then when you’re the first person to actually wash them properly and lift their rolls near their groin – CR

Leg Ulcers

Venous leg ulcers often have a really unique smell, especially if the leg itself is very wet. This is often caused by  infection or tissue degradation and requires close management from the nursing team.

The smell of a dressing being taken down from a nice infected leg ulcer of an incontinent person who doesn’t change their pads enough so the dressing smells of the usual plus wee – LB

Rectal drain

Enough said.

Yellow Bags

Waste bags aren’t a particularly smelly problem in hospital as there is always a designated housekeeper to remove waste etc, but in the community, things are a bit more…relaxed. Patients with chronic wounds or incontinence may be supplied with the yellow or orange incineration bags, which are then collected by the council. However, some patients aren’t able to put their bags out or will save several up before doing so, allowing them to ferment a little.

They save them up for two weeks in their bath tubs normally and you have to untie them to put in a pad – LB

C diff

Clostridium difficile – you’ll know it when you smell it.

Macerators

A magic bit of equipment in the sluice that washes away all the pulp products. Or at least it will until someone sticks a nitrile glove or wetwipe in as well and blocks it up, at which point someone has to go fishing.

Cauterisation

Another really unique smell mainly specific to theatre environments. During surgery the surgeon or assist will use a electrocauterisation wand to minimise bleeding.

That apple airfresher in the staff toilet

Why do they make this atrocity?!

Necrotic tissue

Not something I’ve personally experienced, but have heard about…

Pets

Some patients at home may have pets that they are no longer able to walk or clean up after properly – this can lead to some interesting ‘deposits’ around the house.

Food

In the community particularly, I’ve visited patients who either cannot clean up after themselves or choose to hoard food items, giving the home a rotting food aroma.

So what?

It’s all very well joking about the ‘funny smells’ that various patients produce, and I think being able to joke about them (appropriately) is important, but at the centre of all of it is a person. Part of the role of the nurse is to work with the patient in a manner that is person centred and doesn’t cause them any unnecessary trauma or distress. It may be that your patient does find their ‘smells’ funny, and in that case, you can laugh about it together, but some people may be quite embarrassed.

It may be that the source of the smell is something easy to rectify and that they just require extra help washing themselves or cleaning up around the house. Some people do however choose to live in a certain way, irrespective of the consequences and this needs to respected and only intervened with if there is a risk to someones safety.

nurse-skunk-smell

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