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Dealing with a “Code Brown”

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As much as we may like nursing and the fun parts of our jobs, like talking to patients and getting to do procedures (yes, this is fun for us students!), there are the parts that make us feel sort of like the “Dirty Jobs” guy. Cleaning up after our patient’s is definitely low on my list of “why I love nursing,” but it’s something we’ve got to do. And while we ALL have our funny stories that go along with each “Code Brown” we experience (helping my 92-year-old patient race to the toilet while she was forgetting she was hooked up to an IV pole and Foley cath hooked to her bed), it’s actually a very basic, and almost vital part of our jobs.

While I am not saying that I enjoy cleaning up poop, it’s just another part of my job. It’s not fun and it’s not pretty, and it sure smells pretty gross, but SOMEONE’S gotta do it, right?  When I first started nursing school, that was the one question my family always asked me, “doesn’t that bother you?” “don’t you get grossed out?” Yes, I get grossed out. But does it bother me? No. It’s just another part of the job. My response to them was this, “If it was ME lying in that bed, unable to take care of myself, and probably humiliated for not being able to do it, I would hope that the person cleaning me up wasn’t ‘bothered’ by it.” I would hope that they wouldn’t think twice about it, or think it belittles or degrades them because they have to do it. I try to take that approach, “what if that was me lying there?” and just do my job. I feel like if you look at it that way, it puts things into perspective. Nursing isn’t a fancy job, it’s a humbling job.

However, even when you are putting yourself in their shoes and doing your best to get your patient cleaned up, there is still that smell issue that can get in the way of your ability to focus and get in and out of there quickly! While it’s not guaranteed, you can try these tricks to protector your olfactory senses:

  1. Breathe through your mouth - If it’s a quick job, you can usually just avoid inhaling through the nose until its over. Hopefully you’re not like me and can breathe through your mouth without feelings of impending doom and suffocation.
  2. Vick’s vap-o-rub -  a little dab under the nose has been said to clear the nasal passages and have a strong enough scent to mask anything else with competing odor.
  3. Wear a mask - They aren’t smell proof, but if it’s a small job, it can do the trick. Try a mask and breathing through the mouth. Or double mask.
  4. Double mask with toothpaste – I have yet to try this but heard it from a friend and then had it confirmed by a nurse. Apply one mask, then squirt toothpaste on the inside of another mask and apply that one over the first. Then you are doubly protected with minty freshness to keep your nose happy.

Does anyone else have any suggestions? What is the general feeling about cleaning up after patients out there?

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Ani Burr, RN

I'm a brand new, full-fledged, fresh-out-of-school RN! And better yet, I landed the job of my dreams working with children. I love what I do, and while everyday on the job is a new (and sometimes scary) experience, I'm taking it all in - absorbing everything I can about this amazing profession we all fell in love with.
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9 Responses to Dealing with a “Code Brown”

  1. cc

    i work in a snf; i have NEVER seen a nurse tend to a code brown. ever.

  2. Shawnee

    Put something strong in your mouth like a cinnamon candy or halls cough drop. It’s so strong, you almost don’t notice the bad odors (almost…). Also good when doing pap smears on someone who hasn’t bathed in a couple of weeks…

  3. Ani Burr Scrubs Blogger

    @cc – sorry your nurses aren’t helping out, where i work, and in all the hospitals i’ve rotated to, this is something nurses help out with.
    @Shawnee Re: papsmears – yuck! i’ve heard cinnamon altoids are good – got any candy/lozenges you recommend?

  4. amy mickschl

    i was a night shift rehab nurse for 3 years. our census was rarely high enough to require a nursing assistant. we had a high number of recovering neuro patients, many of them with peg tube feedings. needless to say, i responded to a lot of code browns. i will never forget one particular peg tube patient with what seemed like continuous loose stool. everytime she would cough or laugh more stool would explode out. i was changing her soiled bed one night and was just getting ready to put a new brief on freshly cleaned patukus when she coughed and sprayed diarrhea all over the bed, wall and me. thank god it didn’t hit me in the face! i called the nursing supervisor to see if she could bring me some clean scrubs from the locked storeroom. she said i’ll be there as soon as i can, we just got a stemi in the emergency room.so i cleaned myself up as best as i could and i had to wait an hour to get out of my poop stained scrubs. thankfully, no-one put their call light on during that time.

  5. Heather

    Before I went into nursing, I was a medical assistant, which I know is not looked at as a nurse by the nursing community, but if you ask me, they should be. I used to assist with everything in the doctor’s office and things can get pretty ugly. @ Shawnee, I definately agree, the paps can get just as fowl as “code brown” and I always did the strong candy which worked well. I also worked in a nursing home laundry when I got out of high school (in the summer, when the AC didn’t seem to work) and the strong candy method worked a little there too.

  6. Tara

    I laughed so hard at Amy M.’s story. I reminded me of why I got into nursing. Just to see if I could handle myself, I went through CNA training and worked at a Nursing Home. I loved it!! I loved all my ladies and guys, even thoughthey gave me the hardest time. I did this throughout my 1st and 2nd trimester, and thought that it was going to be really hard when it came to poop. It wasn’t, the hardest part for me was finding mucus on the floor and bed-railings. Keep up the good work everyone, there is a higher calling for why we do this work. Thanks for the article, it really put into words, the feelings that I couldn’t express fully myself.

  7. Sherry

    I am a CNA and have had many experiences with Code Browns! The worst is C-diff and GI bleeds. The only thing I’ve found to work is Hall’s! They work like a charm! I always have a few in my pocket! There was only one time that I ever had to leave a room because of the smell. It was a very large patient and when we (it took a small army) turned her over, the horrific smell just overtook me! I was going to hurl in my mask. I had to leave the room. So sorry! OMG it was awful – nothing has topped that one!

  8. Ruchoma

    I think the worst is when not only do we clean a “code brown”, but we’re also supposed to measure the amount over a day to chart small, medium or large. Then you end up debating whether it’s relative for each patient or if small, medium, large are the same for all. I remember when I started my job that was one of my biggest “dilemmas”

  9. TiaKay

    http://allnurses.com/general-articles-about/till-we-meet-294062.html

    This was probably one of the most profound and moving experiences of my career in the nursing field… I have found if I reframe these nasty experiences into “this could be my mother, or this could be my granddad, and I want someone to be as kind and helpful to them (or to me one day) as I will be to this patient”, then it really does make it easier, even when it is EWWWWWW!