Turtle in scrubs 4,721 Views
Joined Mar 8, '07 - from 'Kansas'.
Posts: 207 (43% Liked)
A&D ointment and/or hydrophor is regularly used in our clinic.
In our clinic we use Remedy lotion (a Medline product) to intact skin on the leg. We use a moisture barrier cream to the periwound. So far good results with no maceration.
ETA: if they have really dry, scaly skin on the ankles and heels we also use Urea 5% cream.
Due to random drug tests and my children wanting to eat every single day, I can not smoke the reefer. But, I am counting down the years until I can retire.
I went to Indeed.com to find my new job. I found that it was easy to navigate and filter and I used some basic search words to find the types of jobs I was interested in and also by location. I started by looking for wound care jobs but ended up looking outside of wound care. I ended up leaving the world of wound and ostomy care because I decided to try something entirely different. I did wound and ostomy care for 12 years but I think it was time for a change. I will never say I wasn't challenged though.
Try Indeed. That is where I found my new job. Also, if you have a good relationship with vendors, they often have the some tip about jobs that are open or will open.
How was I anti-catholic? I just quoted what several of the staff had said to me when I asked if they would mind praying with the patient while I did their dressings or something. In small towns where everyone works together and goes to the same churches with the people they work with you would be surprised at the discrimination. And actually it's not illegal. The U.S. Government has granted churches, religious schools and religious hospitals the right to discriminate based on religion. The hospital could fire me because I am atheist and the only reason they don't is I went to catholic school with the chief of staff
When a patient asks you to pray, it's not about you at all, it's about the PATIENT and his needs. He may be terrified and he needs that support. Just think of it as a placebo that will help your patient feel better. If you can't think of any appropriate words, ask a colleague or go online and find a little prayer. It WON'T hurt you. Kindness won't cost you a single thing.
I clicked because of the allusion to "A Connecticut Yankee in King Arthur's Court." I stayed because I've had this problem.
I live in a secular region, but work at an extremely religious organization. Charge nurses are required to ask if anyone would like to pray at the beginning of each shift (no one has to pray, they just have to ask). The hospital shares a campus with a church, and a lot of our patients and staff are part of that congregation. So, I get asked to pray a lot, and other nurses do pray over people a lot. I wouldn't mind standing silently while someone prays (what I do at shift change), but I don't know how to pray. I tell them I need to spend time with other patients but I'd be happy to have a chaplain come pray with them.
"Hi God. Please, umm, keep an eye on Bob in this time of recovery. He presented to the ED with rales bilaterally, sating in the 80s, complaining of shortness of breath. He was started on Lasix and admitted for observation overnight. He put out about 1,300ml of urine since 5pm last night. Lung sounds are improving and O2 is now in the low 90s. So, uhh... amen?"
Emory is an AWESOME program. When you go to Bridge week you'll get some practice there as well. Just remember the guidelines and review before going to mark a patient. If you work with another WOCN it doesn't hurt to go together and eyeball the patient together. You will get a cool little pocket guide that is a good reference as well. As far as suggestions you may want to mark more than one site and mark one w/ a number one and a 2. Additionally, during your assessment if you notice a fold or indentation that appears flat when the patient is supine clean the site with alcohol, mark "NO", and cover with tegaderm. That helps the surgeon out when they are in the OR. You won't always get to have your patient stand, twist, or lift their knees because sometimes the surgeons will call as they are ready to roll in so get a good look at them in a sitting position and look for a pannus. You don't want to have to go through extra adipose tissue which could cause stomal retraction. Good luck to you!
Hello ~ I've been a nurse for many years, but within the last year I've become a WOCN; I don't have a lot resources where I work as a WOCN, who can help guide me with some more complex/advanced recommendations. I understand that every hospital and patient is unique, but generally speaking I'd love to have an online mentor, who has a lot of WOC experience, that won't mind helping me, occasionally, to work through some questions that come up. For example, what criteria do you use (generally) for consulting surgery for an operative or more advanced bedside debridement of a pressure ulcer or how do you treat an ostomy with mucocutaneous separation leaving an area of mucosal tissue around the stoma instead of peristomal skin.
Please send me a message/email if you'd be interested in sharing your knowledge and mentoring an old nurse but new WOCN
Yes, certification matters! Shadow as many WOCNs and CWSs as you can, most are more than willing to precept. Not everyone goes to WOCN school, some go through the preceptor pathway and some through the experential pathway. I would suggest finding certified nurses and asking them how they started their journey and how they value their certification.
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Just that it explains why the patient would all of a sudden have a severe and rapid skin breakdown.
Denuded means skin gone via chemical means (urine, feces, sweat). Excoriation means linear scratching by mechanical means.
Wouldn't it have to be a stage 3 or 4 to have granulation tissue? Doesn't Stage 2 heal by epithelial proliferation and migration? Perhaps it would be better to say granulation tissue is only seen in full thickness wounds versus partial thickness wounds, because you have granulation tissue in wounds other than pressure ulcers. Does this sound correct?
I'm thinking in a perfect world this might work. In the real world 2 nurses are not always available...
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