I do home care through agency and have limited supplies at times. So I was sent to do a tx on a stage 4 ulcer to the coccyx. My instructions were to clean the wound, apply isosorbide with gauze , pack and apply occlusive dressing. I get there and have 2 packages gause 4x4, nothing to clean the wound, isosorbide and the wrong occlusive dressing. So, I improvised and used what was available. Problem is this patient is very very picky and I really had to talk him into letting me do the dressing change. No instuctions were left for me there. I am covinced I somehow have messed this up.
Now for the back ground. This pt is suppose to have this tx done 3 times a week starting last Friday. The FNP I follow has not done it since it was the origional dressing, but she is documenting it as being done. The pt even says I am first to do tx. So, my question is am I going to be in trouble for improvising with the dressing change? I did improvise according to the directions I was given verbally. I thought when I got there I would have a treatment description/order there and the supplies needed would be there. ( naive I know )