View Full Version : Wound Care


runningnurse
02-05-2008, 11:47 PM
Hey folks...got a question/looking for suggestions.

I currently am working in a retirement home and have a few residents with major nasty exudating/purulent wounds (gotta love coccyx ulcers/pressure sores:confused: that were pre-existing to their admission into our facility) Anyways, when I am on shift I am using mesalt (made/sold by tendra) which is a NS impregnated dressing to pack the wounds. I use it dry-as this is how the wound care nurse told me to do it in the hospital and how the manufacturer says it needs to be used and I have found other places where it says dry. My issue is that the other girls who are on when I am on my days off have been using it wet:banghead:...as per the instruction of the DOC-even though I have been thurough enough to leave exact details of dressing changes on our board in the med room. I've printed off the examples (this past week) of how to use it and have it at our nursing station for the girls to read when they get there but I also need to bring it up to the DOC to make sure we get consistency-because the wounds are not healing all that well.:(

I just recently started this job so I don't want to come off like I know things better than her but I do need to make sure that these residents are getting the exact same care throughout cause they wont ever heal. How do I bring it up diplomatically with the DOC in order to get her to teach others the right way? (I'll at least be leaving a note for the girls to have a look at the papers after my last shift tomorrow but if they go to the DOC I feel she needs to be on the same page...)

Any suggestions?
Thanks

Mother Jones, RN
02-06-2008, 12:10 AM
I would simply ask the doc if he or she would mind changing the dressing change order. Explained to the doctor your reasons for wanting the change, and ask for his or her input. Sometimes, a little salesmanship can go a long way. :rock:

MJ :pepsi:

P/J
02-06-2008, 04:33 AM
Suggest to your Director of Care (DOC) that it might be time for another in-service regarding ulcer care. New materials are always being produced and there might be a new product that could be better. This also allows for the error in technique to be fixed by the people who know (the manufacturer) without stepping on anyone's toes. These sessions are ussally free as it means more sales for the company in the long run. You could also contact your local wound care group (sounds funny but there is ussally an initative group of nurses and doctors who work for the goverment in an advisory capacity to nursing homes and hospitals) and get them to give an in-service.

If he/she (DOC) says no, well its time to stomp! You are going to have to ask why it is done one way when it is prescribed the other way. It might mean that the ulcers might heal if it is done the right way.

Mother Jones, RN
02-06-2008, 09:49 AM
If he/she (DOC) says no, well its time to stomp!

I love watching a stomping nurse. You rock! :rock:

MJ :pepsi:

runningnurse
02-08-2008, 07:04 PM
Quick update...I was able to talk to the DOC without too much incident, but not sure that it will get passed to the girls who are on this set of shifts...find out Tuesday. The one resident with a couple of nasty wounds is to get VAC therapy-YAY!(that is once the community wound care nurse comes in:banghead:...yes I have contacted her a number of times to get her to come)
We'll see what happens

NurseSean
02-11-2008, 04:07 PM
Runninghorse,

I just wanted to say that you sound like an awesome patient advocate. Keep up the great work!

geenaRN
02-12-2008, 01:03 AM
Ah, vac therapy is great in my experience. Good for you for advocating for your patients.

And way to make a good example of yourself. When you demonstrate caring and a strong work ethic, other nurses will pick up on that and want to do the same.

gracenotes1
02-18-2008, 06:28 AM
The dry packing is used as a wick--now how are they going to wick a wound if the guaze is already wet. What they can do is wet it some to remove it--but that too will not debride like it is supposed to do.

You hang in there!! You'll get those wound healed!!
:cheers: