I recently found myself in an extremely uncomfortable and infuriating situation. I work in a SNF as acting wound care nurse. During my weekly rounds, I noticed a patient with a chronic but stable wound suddenly had worsening of the wound (increased size, purulent drainage, redness, odor). I realized the dressing he had in place was dated for 3 days prior, this is a dressing that should be changed daily. So for 2 days, the nurses did not complete his wound care, leading to worsening of the wound (which constitutes neglect and potentially abuse). I investigated, gathered evidence, then reported the incident to my DON per protocol. My DONs reaction was to suggest to me that I "don't tell the nurse practioner that our nurses didn't do the dressings changes, just tell her the wound is worse but don't say why". I was shocked, and refused, and proceeded to update the nurse practioner on the situation. I could not believe my DON encouraged me to withhold vital information. My question is how severe is this? Does this warrant me reporting the incident and subsequent conversation to someone above her? How far should I take this? Or should I talk to her one on one first and give her a chance to apologize for her response? Also I'm concerned that the nurses involved causing the harm will not be investigated and disciplined accordingly. My DON doesn't seem to share my same concern for the seriousness of this situation.