mrosette

Don't forget domboro's solution for weeping, denuded, inflamed skin. Helps dry, ad provides comfort. It is frustrating but rewarding as you say...

Sorry, spell check, povidone should be enough

Xeroform provides a bacteriostactic moist wound environment, bismuth is impregnated into the gauze, similar to silver in its ionic ability... Don't think you want to keep those toes moist...providence should be enough, unless there is a small amount of epidermis that would benefit...I would clarify the orders with physician...

I had to do it all on my own, went to webwoc, great online experience, I passed all three board exams on first try. There are opportunities, just have to look. Once certified makes a big difference...

Look at the wound: if you assess more than 60% yellow slough then vac is not appropriate tx for wound. Needs more vigorous cleaning before vac will do its job. Alert physician and ask for another tx till they can see. My humble experience... CWOCN since 2012, many vacs since then. Good luck!

Looking for backup on four eyes skin assessment, anyone found any research that supports this practice? Any help appreciated!

I paid for everything myself, roughly $8,000, at the time my hospital provided a $2000 tuition reimbursement, but that program disappeared. My preceptorship did not charge, as they were in my system. It was a good investment from my standpoint. I love caring for these patients, and the autonomy in my practice. Good luck to you. I went through webwoc, and they prepared me well for the exams (3).

Thank you all for your suggestions. Been so busy with patient care and never ending support mtgs. Persons of size, incontinence care (no briefs) and other issues. Appreciate your comments. Interesting thing just happened. Our hospital has entered with two other health systems in an "alliance". Just been "shut down" in an attempt to review practices within the woc's in our groups to meet informally to discuss workflow and practice. I guess I will wait and see what happens. Trying to keep patients safe and provide best practice for all affected. Feels like restriction to me. Oh well, I will wait for powers that be to prevail.

Any comments appreciated...I am a CWOCN practicing in MI, 3 yrs in acute care, 8 yrs RN, looking to advance but SO confused on next step. Can't afford to stop working FT, no help tuition wise from hospital, but looking for the quickest, less expensive route to advanced practice prescriptive authority. Can I go from MSN in nursing education to Cwocn-ap? I have been to wocncb document, still confused, any real life experience? I will be 55 this year... Thanks in advance

I feel for you. Please consult with charge RN. There may be cultural factors in play here. It is NOT your job to deliver that information to the patient, it belongs to the doctor and the family. Make sure you do your job to comfort, clean and care for pt. Let pt know you care about their comfort and well being, as far is information regarding Plan of Care, Medical Diagnosis, or Nursing Diagnosis, that is domain of RN, PCP and immediate next of kin. Best Wishes to you, Maureen, 1 yr RN