Question for CPNE grads

MauraRN · Jul 11, 2009

I had a wound tx done exactly as lab wound. Pt had colostomy d/c'd wound was deep, clean, round. Tx order did not include irrigation, cleansing or ointment as is common in real world. CE told me it was the most disorganized PCS she had ever seen. I held my tongue but wanted to tell her that if she moved her big fat butt out of chair that was in my way it may have gone better. Passed it and that is all that matters. Pt was A&Ox3, no complaints of pain, much easier than the wound tx pt I deal with at work.

Maureen GN

NC Girl BSN · Jul 12, 2009

My first PCS was a large abdominal wound. CE got all the supplies and I did it just like the labs and passed. I would not count anything out in the CPNE. They are always looking for opportunites to incorporate stuff.

Baloney Amputation, BSN, LPN, RN · Jul 13, 2009

I had a foot wound. The CE barked at me for not counting the gauze sponges when I took the old dressing off, so I just estimated. I did see where I had passed that particular skill, however. It most definitely was not like the EC lab wound but not anything out of the ordinary, either. :)

I also had enteral feeding for a baby. What a rough assignment! *sigh*

Law of Fives · Jul 26, 2009

Why would you count the guaze as you're removing them? It was my understanding that you were to remove the ABD and guaze in one movement, wad them in your glove as you're removing it, then throw it away. Am I missing something?

Editorial Team / Moderator · Jul 26, 2009

She's not talking about the wound lab, but a wound on a patient during one of her PCSs.

Law of Fives · Jul 26, 2009

I gathered that from her mentioning that it was a foot wound, however I have read (@ EPN) that the procedure for performing the dressing change on an actual patient was the same as for the lab(?). Forgive my ignorance, I just don't have any experience performing the procedure on a live patient, not to mention one that requires irrigation. I intend to try to get some practice before the CPNE, hopefully.

Editorial Team / Moderator · Jul 26, 2009

I wasn't sure if you realized it was on a pt. because you mentioned an abd pad, and not all wounds have those.

Remember that each AOC starts with "complies with established guidelines." Sounds like that CE was just being especially strict/harsh.

Law of Fives · Jul 26, 2009

I have much to learn.....

Baloney Amputation, BSN, LPN, RN · Jul 27, 2009

Why would you count the guaze as you're removing them? It was my understanding that you were to remove the ABD and guaze in one movement, wad them in your glove as you're removing it, then throw it away. Am I missing something?

It was a heel wound on an actual patient. It was tunnelling and required packing with a ribbon of sterile gauze of some type (don't remember which one). This patient was ambulatory and could put weight on the foot, so it mattered that there was enough padding, but not too much, on there. I had been talking aloud through the procedure, nervousness and all, and had scooped the old dressing in my previously gloved hand and contained it in that glove and pitched it. When I went to apply the new fluff gauze, I said something aloud about how many was going to go on, whether I was going to put 3 or all 4, which is what the package had in it. That's when the examiner barked in about counting the fluffs. I hadn't even thought about it, but I remembered about how thick it was. It certainly was not written in the orders to apply X gauze pads, either.

I took the patient's cue, though. She chimed in saying she didn't want all 4 but wanted at least 3. That's what she got!

Don't worry about the lab wound. Practice it like you would practice for a role in a play. That was a piece of cake and just like the CPNE Study Guide. I found it was easier than my fake wound at home through EC.