hanoverianfever

Yes, thankyou dressagediva. That is definately a concern, we will have to assess it and see.

Actually, it is a circular foam piece which sits around the calf. The pressure/blister area is on the heel, so we are not creating any pressure. I am a nurse who works in Canada, and I have not heard of any liability issues r/t pictures of wounds etc...especially if it is for the benefit and wellbeing of the resident in pursuing the primary goal of wound healing. Thanks for your feed back though!

I understand your frustration. I have been in a similar situation before. The problem is, is that she wants to be in this position alone. She wants to appear much more credible to families,residents and staff. This is what you need to do. 1. Sit down with her. Maybe come in on a day off. Meeting her in person and setting up a meeting definately means business. Tell her how you feel and that she needs to trust you in your abilities. Tell her you are capable and as experienced as she is and are completely capable in what you do otherwise you would not be in this position. 2.Tell her that you have discussed this with her in the past, and if it does not resolve TODAY, you will have to talk to your boss. 3.Explain how she is trying to take away your credibility in what you are doing and if roles were reversed what would she do. Tell her you want to work together to establish goals. 4. Leave the conversation on an up note. Its called the sandwich effect. a. The problem (which the other party will become defensive about because they will feel criticized) b. Solution c. Problem d. Solution and how you can work together with her in the future.

yes thanks, we are using a donut like cusion and making sure that we are not putting any pressure to the area. I had the doctor look at it, but doctors usually are not the greatest at wound care lol!! The picture idea is great, never thought of that. In any case , we are not going to touch it. Thankyou all for your opinion, it just reinforces what I have already thought.

We have a patient who is 93 years old. She is well nourished, but has been failing over the past few weeks. She has just acquired a Blister/pressure area to her heel. The area a few days ago appeared to have serous fluid inside. The blister is approx 4cm in diameter. Today, the blister looks darker containing serosanguinous fluid. She also has some edema to her legs. Do we debride the area or not? These are my thoughts. I would like to leave the area covered for at least a week. With the diuretic, I am hoping that circulation will improve and the fluid will reabsorb. Also, with the blister intact we are providing a sterile environment which will prevent infection. Presently we are 'floating' the heel so as not to have any pressure to the area. I am definately conflicted because, if I leave it for a week the area may get worse. Does anyone have any thoughts on this?

I was just wondering if any long term care facility's were using pcc. We are located in B.C. and have just started using this system a few months ago. The problem we seem to be having is related to pharmacy and doctor regulations. We are required to have a 'wet' signature on all the orders that are being processed. Electronic signatures (when the doctor sign in) is not accepted. This seems to double up our workload , as we have to print off pharmacy requisitions in order for the doctor and the nurse to sign then file these in the residents charts. We are not using the emar system yet. I am just wondering if other care facilities have encountered this problem and if so , how have they dealt with this. I have spoken with the pcc representatives and asked if there was a signature pad that is compatible with the program. So far they don't have anything like this.