Every once and a while a patient enters your care who presents with an unusual situation. I’ve been a nurse at some capacity for about 16 years (LPN-MN) and there are lots of things I have seen, but still many that I haven’t!
One thing I check off my list is maggots in a wound, and not there on purpose. Maggot therapy has been in medicine for a very long time. It’s intended usage is to utilize the maggots for wound debridement (link below). Of course, the maggots are sterile and a regimen of routinely replacing the maggots is important to maintaining a healthy wound healing environment. However, this particular situation (person, place, & time avoided to protect the identity of the patient) was due to poor hygiene and a reluctance to seek medical treatment.
When an interesting case presents to the emergency department, news travels fast! Basically, when a patient is checking into triage, charge nurses are notified of specific situations to help facilitate an appropriate room/space for the patient, especially if they require some kind of isolation. The downfall to this kind of pre-notification, is the anticipation of the unknown, and as the nurse, now my brain is in full though process of “how do I care for this situation”.
On the day the patient arrived with the infected wound, I was made aware the patient would be coming to my assignment, I had an open isolation room. And before I even met the patient, I could feel myself reacting to the idea of seeing these creatures crawling and I was having a difficult time preparing myself to maintain my professionalism while caring for this patient.
After learning the story of a battle with cancer, failure to seek treatment, and an underlying mental health diagnosis, the compassionate nurse in me found its way out to ensure an empathetic and professional approach to caring for this patient. It was certainly not the patient’s choice to have the wound get to this level of infection, nor did they intend for this path to their ultimate demise. But due to lack of insight to the disease process and inability to process consequences the patient found themselves in this situation and I found myself learning how to flush maggots from a wound.
Although I can whole heartedly say that I do not ever want to complete this task again, done & done! I can say that having had this experience allowed me to get to know this patient on a different level than expected and it helped me understand that although resources are available to people, they might not have the capacity to utilize them. What we gave this person was comfort care; however, our interaction was brief, and it is unknown how they will navigate the system from this moment forward. I can only hope, that the care I gave in that moment was more than just flushing those creatures out of the wound.
(https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-4362.1999.00770.x)
Have you experienced and unusual treatment or procedure? I’d love to hear about your experience! Feel free to leave a comment!
Trudi
The Nomad Nightingale 
Great post 😊
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Thank you!
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