Hummy RN

Anyone out there? Guess I will take my question to the general forum. Hummy.

1st day off exhaustion. I know what you mean!!! Nobody gets it. My friends who don't work used to call me at 8 or 9 am to "see what I'm doing" and ask if I want to go to lunch. They have no clue what a 12 hour shift is like and had their feelings hurt when I said "DON'T CALL me on my first day off. Has anyone weighed themselves over these shifts, I loose about 3 lbs then put it back on my day off, something physiologic is happening. It's not just fat. I miss meals and get dehydrtated when it's busy but I think it is also fluid shifts from stress induced cortisol level changes. Hummy RN

My friend's elderly mom is a diabetic who had a perianal abscess drained about 4 -5 weeks ago in another state. It was packed and changed daily for a while but is not healing well. The poor lady sometimes refuses to get out of bed and walk, and is becoming withdrawn, even had a few instances of stool incontinence due to this. This makes her not want to eat. The main problem from her perspective is pain. I was concerned about the length of time and its still not healed, might lead to a fistula. We feel she is going to lie down and die because of this! Any wisdom for us? I have a critical care background so they ask me lots of questions, but honestly, I'm a bit out of date on these issues now. I feel the healing should be managed more rapidly and aggressively due to the impact on her daily life. 1. Can't she be given topical or local pain control instead of pills that make her mind foggy? 2. Can more be done to heal the wound? Can it be closed with surgery? Fibrin? Is negative pressure possible or helpful? I know there is much more to be done now than in my day. I hear about growth factor, is that a new treatment? 3. I feel (from what I hear second hand) that her care is fragmented. Has anyone heard of hiring a case manager to oversee all the different home health people? Would appreciate wisdom from the wound care nurses. Thanks, Hummy.