wounds and ostomies
Last summer at the nursing lab, we were taught the basic skills necessary for carrying out wound and ostomy care. We practiced on dummies and models that approximated the real thing, and were checked off accordingly.
Today, I had the opportunity to work with Brenda, the nurse on the Wound Team, whose specialty is wounds, ostomies, and continence. The Wound Team is a component of the Rehabilitation department, and is comprised of nurses and physical therapists who work all units that have patients with these special needs.
The day saw us moving from floor to floor, pushing around a supply cart, and caring for a variety of patients with ostomies and decubitus ulcers in different stages. No model or dummy, no matter how life-like, can compare with a living patient whose wounds are actually oozing. There was even one patient in the ICU whose wound brought back the memory of microbiology lab class with the familiar smell of pseudomonas. We had to debride the wound of necrotic tissue.
One interesting method the team uses is picture-taking to document their assessments of wounds. A measuring strip with the patient’s name is positioned alongside the wound and a digital picture is taken. This helps a great deal in giving an actual appraisal of the wound’s improvement or deterioration that no amount of words can describe. I learned how to accurately measure a wound’s size and depth, and was able to work with a variety of dressings and packing materials.
I was fortunate to have been assigned to a nurse who let me do things “hands-on” with a genuine appreciation for the help that my presence afforded. I learned how a pro-active attitude can bring about cooperation and trust in a patient. I saw the importance of discharge teaching and discovered that the nurse’s support for a patient goes beyond the hospital stay. Brenda tapped into corporate sponsorship by giving an ostomy care supply kit to the patient’s family and prefilling out forms that they would mail out in order to receive a month’s supply of materials and equipment from the company that makes them. She also encircled on the catalogue what they would need to order from the company to continue with home care of the ostomy.
One patient had lost her big toe and pinky toe to gangrene. We were there to evaluate the wounds for a vac dressing. Since there was still active bleeding in one of the sites, the vac dressing had to be put off for a later date. The wound nurse is consulted on matters of this nature and can in turn recommend consults with plastic surgeons and the like after assessing a patient’s wounds.
When dressings are dated, it is indicated also who the next dressing change will be done by. On some dressings she wrote “rehab”, on others she wrote “nursing”. When I asked her the rationale behind this, she told me that it helps “preserve boundaries”. I understood.
Tomorrow, I head for the Operating Room. The last time I witnessed a major surgical procedure was some thirty years ago back in the Philippines. This should be interesting. I want to see how things are done here in the USA with regard to routine and protocol. I also want to know how much has changed, or not. For now, all I can say is my day has been good. Time flew by so quickly as it always does when one is engrossed in something interesting. I got out of North Florida at 3:45. The extra time I spent there was well worth it…
Today, I had the opportunity to work with Brenda, the nurse on the Wound Team, whose specialty is wounds, ostomies, and continence. The Wound Team is a component of the Rehabilitation department, and is comprised of nurses and physical therapists who work all units that have patients with these special needs.
The day saw us moving from floor to floor, pushing around a supply cart, and caring for a variety of patients with ostomies and decubitus ulcers in different stages. No model or dummy, no matter how life-like, can compare with a living patient whose wounds are actually oozing. There was even one patient in the ICU whose wound brought back the memory of microbiology lab class with the familiar smell of pseudomonas. We had to debride the wound of necrotic tissue.
One interesting method the team uses is picture-taking to document their assessments of wounds. A measuring strip with the patient’s name is positioned alongside the wound and a digital picture is taken. This helps a great deal in giving an actual appraisal of the wound’s improvement or deterioration that no amount of words can describe. I learned how to accurately measure a wound’s size and depth, and was able to work with a variety of dressings and packing materials.
I was fortunate to have been assigned to a nurse who let me do things “hands-on” with a genuine appreciation for the help that my presence afforded. I learned how a pro-active attitude can bring about cooperation and trust in a patient. I saw the importance of discharge teaching and discovered that the nurse’s support for a patient goes beyond the hospital stay. Brenda tapped into corporate sponsorship by giving an ostomy care supply kit to the patient’s family and prefilling out forms that they would mail out in order to receive a month’s supply of materials and equipment from the company that makes them. She also encircled on the catalogue what they would need to order from the company to continue with home care of the ostomy.
One patient had lost her big toe and pinky toe to gangrene. We were there to evaluate the wounds for a vac dressing. Since there was still active bleeding in one of the sites, the vac dressing had to be put off for a later date. The wound nurse is consulted on matters of this nature and can in turn recommend consults with plastic surgeons and the like after assessing a patient’s wounds.
When dressings are dated, it is indicated also who the next dressing change will be done by. On some dressings she wrote “rehab”, on others she wrote “nursing”. When I asked her the rationale behind this, she told me that it helps “preserve boundaries”. I understood.
Tomorrow, I head for the Operating Room. The last time I witnessed a major surgical procedure was some thirty years ago back in the Philippines. This should be interesting. I want to see how things are done here in the USA with regard to routine and protocol. I also want to know how much has changed, or not. For now, all I can say is my day has been good. Time flew by so quickly as it always does when one is engrossed in something interesting. I got out of North Florida at 3:45. The extra time I spent there was well worth it…