Help! Need tips to speed up with wound care

[pn5437]

Hi

I just started a new part time wound care position (more info is in previous threads). Anyway, i have some wc experience, but I'm finding that I'm scheduled 5 hour days/6 days a week but im clocking out 2-3 hours after that I do all the wounds for a 120 bed facility, am responsible for updating orders/treatments, wound rounds with the physician, initiating orders, and of course get pulled left and right for new wounds. I enjoy my job and don't want to cut corners on performing the actual treatments.

The issue I'm having is showers. I get the list daily and wait until after their shower to do treatments, but it's either the patient i need is in the shower, or they're in the dining room, or therapy....errr! I end up running in circles or popping in to find my patient 2-3 times. I know how huge a waste of time this is. I'm supposed to be out by 11:30 am.

Does anyone have any suggestions on how to be more time efficient? Also I've noticed aides stop me to "look at something" often instead of finding their nurse first, and then calling me if needed. I asked them to please not do this and i got the evil eye LOL Any help???? Thanks!

[pn5437]

Getting really desperate for suggestions. If I continue getting out this late it's going to start affecting my schooling. I talked to my DON about me getting stuck with the skin tears, etc. which i shouldnt be doing. I had one very experienced RN tell me to look under a patients breast bc she had bleeding (like 2 drops!) and asked me to discontinue an ointment she was on. Then on my way out i had ANOTHER ask me to look at a patient "whose bottom is red but blanchable." I was like, uh....how about i NOT look and suggest some calmoseptime cream, better personal care and keeping her off her bottom?? Its getting really frustrating

[TammyG]

I'm not sure anyone here can tell you anything helpful since the problems all relate to working in your organization. The only solution is to say NO. Usually there is a formal process that must be followed for a patient to receive a wound consult, or to get on your list. It seems a lot of aids and RNs are going around the formal process, which is not only elongating your day with work that your supervisor cannot quantify, but gives a false impression as to how many patients have wounds in the facility. The only way for you to correct that is to insist that the process in place for documenting wound requests is followed. That is the only way that the facility will recognize that they need to hire a second nurse, or that they need to extend your schedule. If you don't say no, things will not get better.

[Loo17]

Are you actually doing all the daily wound care as well? If so that sounds impossible!

Something that worked really well at a facility I worked at was that they scheduled wound rounds for each unit. There was a list of patients that would be seen on rounds and the unit managers ensured the primary nurses were aware of who was on the list and when rounds were scheduled. The primary nurse for each patient was responsible for having the wound undressed and cleaned for rounds. The patient would not be scheduled for therapy or showers during this 30 minute period and it was never during meal time. If the nurse did not have the patient ready they were skipped while the team rounded the rest of that wing. The unit managers were really good about making sure the nurses were prepared. During the rounds it was very organized and the average was 5 minutes per patient. Wounds measured, described, treatment plan discussed, notes jotted down, move on. The primary nurse remained bedside and redressed the wound while the rounds continued on. If you could get the facility on board with something like this maybe that would help?

[pn5437]

Thank you both for the great suggestions!! Tammy you are so right-today when i went in i put my foot down and pulled the aides to the side and explained that the nurses are responsible for x,y and z. I also spoke to the shower aides so that we could have better communication. My DON agreed an inservice is in order for the nurses-theres no way i can look at every little thing and be expected to leave in 5 hours, plus do all the wounds.I like the idea of a documenting wound requests.

Loo17 wow i could only dream of such organization hahahaha. that sounds amazing! The facility i work at is a pretty good one, but they have a big problem with call off's, which throws everything off. Today went alot better but it could be improved.

[TammyG]

Excellent result! On the positive side, obviously the staff really like you and think you are providing a helpful service. So that is great.

[BonnieSc]

I was going to say the same thing... I can put myself in their shoes and feel relieved that finally there is someone who knows what she's doing. The aides may be burnt out from getting ignored by the nurses (who I'm sure are just as busy). Very likely no one really explained what your role was going to be. I know I have been taken aback when I've consulted the person I thought I was supposed to consult on various matters, whether that person is a nurse, pharmacist, doctor, patient advocate, and been told that wasn't this person's responsibility. Who knew?

Good luck--sounds like you're doing great work!

[pn5437]

Thanks! I got my review today and it went excellent so at least I'm ok there. I still have so much to learn but learning is one of my favorite things to do. They are sending me to a 3 week wound course (once a week for 8 hours a day). I'm an LPN but the Rn's there have taken it and they all say how much I'm going to learn and that I will love it. It is a stressing job, plus state is coming any day now but honestly I'm just going to do the best i can and try to improve day by day. Its all I can do. I had one nurse try to freak me out about state, I responded that yes I should be worried LOL (I just started and am fixing things left and right) but im not going to lose it either. It is what it is. Hopefully that goes well...