How many residents can use safely care for as full time wound care nurse

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    Iam a wound care nurse at a very large facility. I currently have 80 residents and growing. Iam interested in knowing about other nurses who have the same title. I have the responsibility for doing all treatments on a daily basis,including at least 15 surgical wounds,wound vacc, arterial ulcers, amputations, peg stomas, full head to toe assessments weekly, writing all orders, developing plans of care, braden scales, skin risk analysis on admits, changes in condition and quarterly.I write orders for turn schedules and keep a roster of all LAL's, PRD's, etc... I make referrals to other diciplines, make appointments, follow up calls, order equipment, keep weekly wound tracking and document percentages of PU's per census. After I go home at 5 or 6pm, I often get calls on treatments and have to return to facility on wknds to do wound care, ie wound vaccs. Iam very tired. Does anyone have any suggestions as how to handle a load like this without burnout. I have tried to delegate tasks, but no one wants to do wound care. I love doing this, I feel it's my calling. I guess what i want to know is that whether or not this is normal for the job. Anyone else who does this or can comment, please do. Suggestions are appreciated
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    Your role is to delegate, their role (as long as you are following the rights of delegation) are to perform what you delegate. This sounds very unsafe. Granted you aren't pushing out dangerous meds to a million patients, but mismanagement of wounds can lead to sepsis as you well know. Have you tried talking to management? I am not sure what other centers deal with in this regard, but I would call a meeting with your supervisors and the supervisors of those that are refusing your delegation. Perhaps a mandatory in service so that you can re-teach people how to deal with the wounds? If you are delegating to RNs or LVN/LPNs it's in their scope of practice to handle this type of care, but they may be afraid or just don't know how to do it. I know I have MINIMAL knowledge on dealing with wounds so I would need to re-learn (not saying I'd refuse, but I'd need you to explain to me and then I would be able to do it).

    Good luck! I'm sorry you are dealing with this.
    Bblessing2u likes this.
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    I am the new WCN at a 190 bed facility. I have all the floor nurses ( LPN and RN) doing the treatments for me unless I am doing rounds. If I am doing that I will have her come with me ( early on the shift) to watch me or to teach her/him. If there is a particular way of doing the treatment I line it out in the TAR step by step. I have no fear now of writing it all out even if it take a page to do it :-) I am getting a plan formed of how to keep all supplies at bedside for the treatments that are tougher to do. ( If I have to go to wally world to get lock boxes to do it I am getting it done!)
    We have inservices for me to explain treatments but because of all the PRN nurses, it feels like a losing battle, so the TAR is my friend. I often do rounds to look at the dressings and teach the nurse at bedside if the dressing is a mess or ( heaven forbid) not there. I try to offer help to the floor nurse by writing out the orders myself if I find a new problem IF I have time, but it is their job to get the order verified, document the measurements and do the txs.
    Does this help at all? I would like to communicate with you more....
    I am VERY interested on how you do your paperwork, and if you have an oversight NP WOCN working with you as you develop your plans and to offer suggestions as I do. This creates a ton more paperwork...and since I am NEW I am baffled by * all* I am supposed to be working on.
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    Bblessing2u , we don't have any of the charge nurses doing skin assessments or treatments, I do it all. Iam full time, so I really don't want to complain too much, but it takes a steady pace to get everything done just in one day without going into overtime. If we have admissions then it gets real tough. Those are the days that I want to throw my hands into the air. Almost everyone we admit have some sort of wound. (Often it's mutiple). We do computer documentation, so the system for charting is great. Would like to keep in touch. I sent you a pm in response to yours.


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