I am frustrated at work. I have a co-worker that gives me the impression that she believes she knows everything, and is supperior to everyone else (I think she can even smell when a doctor is present). background info is she assists the wound nurse sometimes in the clinic. I have a patient that has a resolved by scar tissue stage III ischial tuberosity pressure wound. The patient has become weak through the long healing process. The patient has been working on transfers with PT (oh yea parapalegic) and the inadequate strength and shear has created one intact bullae and one that ruptured each 1cm diameter. I am not a wound nurse yet but I am currently in school for certification. I called and got an order to cover area with tegaderm, rational being it will keep a proper moist wound healing environment, provide protection/skin barrier and will be easy to visibly monitor. I applied dressing, had 2 days off and return to a patient with a 3 cm long 1.5 cm wide denuded area on the ischial PU scar. My frustrating co-worker had the order changed to butt paste. I was irritated because the patient has had a long road of healing and didn't need this set back. I called the doc explained the wound and asked what dressing he wanted. Once again I write an order for tegaderm. Over the next couple of days the wound made visible progress, smaller. The patient was then moved from my hall to make room for a new patient. The same day as the patients move my frustrating friend changed the order back to butt paste. I know I can be critical of Ms. Frustrating because there seems to be a personality conflict but come on. The second order for butt paste was written to be applied before patient is up in chair and leave wound OTA while in bed. That would just create a bigger wound from washing the butt paste off. I have seen Ms. Frustrating do similar things to other nurses. How do you deal with a person who needs to be so important? Or is it just me and I should shut up and just go to work.