almost no training, heavy workload

[mayawit]

Hello

I am an RN. I recently was offered a job as a wound care nurse at the rehab facility I work at. I was very interested in the position because it is specialized and it was hands on care. I like wound care a lot but feel I am being taken advantage of and/or not being trained properly.

I was only given about 1.5 days of training and most of that was for the paperwork. No real training on decub management, ostomy care, what to do with surgical wounds - I had to teach myself a lot of this....and still learning of course. I've only been doing the job for about 2 months, but it seems impossible to do everything.

On average we have 100 patients in the facility at any given time. Many of them are recovering from surgery (hip, ankle, etc) or just have general debility. I am responsible for wounds for everyone in the facility, even though everyone does not have a wound. I would say 50% have some sort of wound treatment. And I'm responsible for treating new skin tears, etc. We have 4-6 admits a day ( and discharges) that I need to do all the paperwork on.

Since I am the only wound nurse on, I also need to do all the treatments, which usually include 1 or 2 wound vacs (3-5 wound vacs change q 72 hours), write the orders, contact MDs if needed for follow up appointments, etc. Also, I do weekly skin checks and fall risk assessments of all the patients. I work 4 days a week and the other treatment nurse works 3.

I work my butt off, and can't keep up with all the work. Is this a realistic work load for a wound nurse?

[missladyrn]

It sounds like a lot, but honestly I have no experience on this! Is there a webinar or webcourse or some sort of seminar you could go to that would teach you more wound care? Although your workload sounds very high, it also sounds like an awesome opportunity! 1.5 days of training is not even close to enough. Who do you call when you have questions?

[Mudder]

I did wound care in a LTC facility for a few months. All I can say is R-U-N!!! :)

[Mudder]

SORRY didn't get to finish and somehow posted anyway, the facility SHOULD send you to some real training seminars and keep you up to date on all the latest. As I said "SHOULD". Unfortunately, most LTC facilities take advantage of their wound nurses and trust me, YOU will be the 1st to take the hit when state inspection comes along.

It is an interesting aspect of nursing but I'd never do it again in LTC just because when they get "tagged" by state, it's always blamed on the wound nurse.

Maybe you should look into home health wound care or some Long term Acute specialty Centers have wound nurses too and they seem to work more as a team.

good luck to ya!

[mayawit]

that's the thing... we are getting inspected any day soon, and I'm supposed to do things differently when the inspectors are here, although no one has really shown me how to do them "the right way", and there have even been times when I'm told to do things in a way that was different from what I've been taught in school, like signing the date on the bandages

[deemalt, BSN, RN]

Sounds like a really heavy work load! A great reference for wound care is the Scottdale Wound Management Guide. It is like a pocket reference for treatments, wound vac settings, suggested dressings, etc. You may want to consider specializing (you can study online). Seems like they can take advantage of you because you are not certified. They would have to pay you a lot more and you would probably have more job options.

Best of luck!

[Juwon]

Like the above poster said RUN. my mother was a wound care nurse at a LTC facility and it was hell. Too many residents to care for who had wounds, too much paperwork, not enough resources, and when the state comes you are the one who is going down for the blame. When dealing as a wound care nurse, you HAVE TO DEPEND ON THE OTHER NURSES WHEN YOU ARE NOT PRESENT which was a bad thing in my mother case as she worked 5 days a week 9-5. on the days she didnt work there was another nurse that slacked doing wound care tx. She put my mother behind in her work, and it was like almost impossible for her to do her job and complete it. Also, in this field you will be putting your license on the line FREQUENTLY. Ever wonder why there is so many commericals on television telling people to call this lawyer if their loved one got wounds and such when they didnt have them at first if it happened in a nursing home? Once again that blame falls on you as the Wound care cordinator. Honestly speaking, its best to pick another venue in nursing if possible.

[cherryblossom88]

You are responsible for the new skin tears? At one facility I worked at the charge nurse completed the incident report as well as took care of the skin tear and the wound nurse would follow up.

[carolmaccas66, BSN, RN]

I haven't seen a wound care nurse in my hospital yet. It would be great if we had one after hours! Us RNs do all the wound care on all shifts, as far as I know. I would like a job like this, wounds endlessly fascinate me.

There must be a wound care manual at your facility or a website that you can Google? I only did a one day clinical with an experienced wound care nurse, and she said the only way to learn was to assess each wound individually, and try different treatments/dressings. She told me she learned new things everyday.

But I would contact staff development and ask re a course you can go to, or pay for one yourself. Also, ask re reimbursement if you do pay to go to a private course.

Start Googling!

[Midwest4me]

that's the thing... we are getting inspected any day soon, and i'm supposed to do things differently when the inspectors are here, although no one has really shown me how to do them "the right way", and there have even been times when i'm told to do things in a way that was different from what i've been taught in school, like signing the date on the bandages

way too heavy of a workload! your license is on the line every day there with that kind of workload...but if you stay, yes, of course, still continue to sign and date your dressing changes.

i recall once working in ltc as a wound care nurse, an amputee had to have bid dresing changes done. i was gone a couple of days, returned and found my initials/date still on the bandage from last time i'd done the tx.

amazingly, the tx had been signed as being done by others while i was off work! :devil:the wound was disgusting! i took the don in to see the wound, informed her that my signed dressing was still intact when i came back. somehow i doubt she ever confronted those nurses who supposedly had "done" the tx in my absence.

[mayawit]

i recall once working in ltc as a wound care nurse, an amputee had to have bid dresing changes done. i was gone a couple of days, returned and found my initials/date still on the bandage from last time i'd done the tx.

amazingly, the tx had been signed as being done by others while i was off work! :devil:the wound was disgusting! i took the don in to see the wound, informed her that my signed dressing was still intact when i came back. somehow i doubt she ever confronted those nurses who supposedly had "done" the tx in my absence.

this thing happens to me quite often, and maybe that's why they are telling us not to sign them anymore, so that there will be no evidence and the patients are often disoriented so they wouldn't know the difference or wouldn't remember if they've been done daily or if they haven't been done for more than a week.