PT Doing wound care?!

[Gampopa]

I just got off the phone with my sister who was DXed 9/27 c a perianal abscess. She's been on antibx and had surgery to drain the abscess and the pocket was packed. She goes daily to have the packing removed and repacked. This is done by PT. Am I wrong in thinking this needs to be done by nursing staff and in particular a wound care specialist? She's still running a temp. and having extreem pain c BMs and packing changes. When she asks the PT what she can do to reduce the pain and keep herself clean they don't give her many options. She is on oxycodon. She lives in KY and is going to a small community hospital. Is it unusual to have PT doing wound care?

[mattsmom81]

I guess this is where nurses shine as they are also able to address, administer and monitor appropriate meds pre painful dressing changes/tx. If PT's are wound care certified ( a masters degree alone doesn't qualify anyone to do wound care or manage medication situations, IMO) its OK with me. Extensive outpatient tx would concern me if there were no plan to manage painful debridements and packing.

I suppose her doc could give some extra po meds for pain and sedation pre treatment, but someone else might have to assume responsibility for the patient (transportation, etc)as I doubt a PT would want this added responsibility.

I notice rehab and LTAC facilities are doing more extensive wound care and involving PT as well.

While I don't mind as a staff nurse, I have wondered how specialized wound care nurses feel about PT taking over this duty? Do they feel their specialty is being overtaken?

[chaosRN, ASN, RN]

At my hospital, the PT's trained in wound care does the care. A few therapists take care of the wound vac. We also have a special wound care RN (only 1) who more specializes in decubs and the like. The open wounds [like faciotomies (sp?)] go to PT. :)

[CoffeeRTC, BSN, RN]

Getting back to the question...Sounds like she needs to take a pain med pre dressing change and even get an order for break thru pain at home.

The PTs don't do wound care in may facility, but will do whirlpool and e stim.

[Tweety, BSN, RN]

I'm not sure about outpatient, but inpatient our PT will do wound care if it requires pulsating lavage or whirlpool. I've never thought to question their abilities. Otherwise, nursing does all the dressings.

Hope your sister gets well soon.

[RN4NICU, LPN, LVN]

Physical therapists manage long-term outpatient wound care all the time. Those that do this usually go for the Wound Care Specialist (WCS) certification. They are perfectly qualified to do so. Not because of the Master's degree ALONE but because of the components of that masters degree program - extensive education in anatomy, physiology, kinesiology, therapeutic regimens, cell and tissue structure/healing, etc. As has been said before, PTs are wound specialists - not outsiders trying to take over a nursing specialty

[maturner]

RN4NICU is 100% correct! It is nice to read her articulate and educated posts on this matter.

[RN34TX]

PT's doing wound care was foreign to me until I moved to Texas. I thought that they were very good and definitely less hurried than the RN/LPN.

I take my hat off to them because we nurses need help and they are a very qualified and competent group.

[mattsmom81]

I guess some here miss my point regarding appropriate medications for pain, which is what one of the OP's concerns were. My response was in a general sense as obviously I don't know specifics of this situation.

I've worked with some extensive, painful wounds that required IV narcotics to debride and pack. While I don't mind at all PT's involvement, the medication end of this equation still remains the nurses' forte, IMO.

Sorry to offend anyone.

[shirleyTX]

I would have to agree, PT's are trained to do wound care. I am biased though, my husband has his DPT (doctorate in PT) and is one of the smartest men I know when it comes to the body. He's been practicing for many years at the best burn hospital in the US (Shriners in Galveston, TX) and does wound care and ulcer inservices all the time. I will say, not everyone (Like in nursing) is the same and if she is not getting her needs met, she needs to address this with the PT and Dr to get better treatment.

[Gampopa]

Thanks to all of you for your concern and comments. Being a 2nd year nursing student I'm still confused about just who does what on the care team. It was eye opening to hear that PT does wound care. I haven't talked with my sis again but will give her a call to see how she's doing and particularly her pain issue. Thanks again.

[memphispanda, RN]

As far as pain meds go, our PT folks will call about 30 minutes ahead and request the pt be medicated for pain. When they show up, med has had time to work, pt is ready for treatment, and all is well.