What is wound care like? what skills needed?

TheCommuter, BSN, RN · Jul 7, 2011

To function as a good wound care nurse, you will need several attributes and skills:

1. Excellent assessment skills (Is it a stage IV? Is it approximated? Is it tunneling? How does the drainage look? How does the wound smell? Is it a stasis ulcer? How does the wound bed look? Is granulation tissue forming?)

2. Excellent documentation skills (You will have to complete meticulous paperwork on the progress of these wounds to avoid liability. You might have to take daily or weekly pictures of the wounds. You will have to chart clearly and succinctly).

3. Excellent communication skills (You will have to communicate with doctors regarding wound care orders. You will have to educate patients and families on possible care of the wounds at home. You will have to communicate with the floor nurses).

4. Excellent interpersonal skills (You will be collaborating with case management, the lab, infectious disease docs, suppliers of wound care products, pharmacy, physical therapy, dietary, physicians, home health agencies, and other entities).

caryrey02 · Jul 7, 2011

well it is doable and you can learn quickly. Hopefully they place you might start working at has a wound care team and you can learn from them. I really like wound care, you can see some tough cases but it is rewarding to see the patients get better when done well and around the clock ;-)

Good luck

Xauphkamia · Jul 7, 2011

Wound care encompasses pressure ulcers, peripheral vascular ulcers, diabetic foot ulcers, chemical burns and regular burns, lacerations, surgical sites, wound vacs, etc. My experience is strictly as a wound care nurse for a SNF - however, I imagine it is similar to hospital work.

Generally, you are responsible for wound care for all wounds, documentation, implementing interventions, care plans, MD and family notification. Also you are responsible for weekly measurements with appropriate documentation. In some facilities you may have secondary functions such as weights variance or IDT along with the RD.

I was relatively inexperienced when I accepted a wound care position at the SNF where I work. However it has changed my desired path and I truly enjoy doing it. You have to have a strong stomache at times, and you have to not mind poking around in someone's gaping wound with a cotton swab as well.

Hope this helps fill in the basics. I can reccomend looking in the wound care forum here at All Nurses, there are links to good sites for learning more. Also you did not mention if your LVN or RN - but there are two different certs for wound care nurses depending.

I think important skills for wound care are attention to detail, a sense of humor, excellent documentation skills, and the desire to continue learning everyday.

Double-Helix, BSN, RN · Jul 7, 2011

To add to the excellent post by The Commuter above:

Knowledge of wound dressings and product, their indications and usage. Especially in home care positions, the wound nurse is the one seeing the wound every day, not the doctor. The nurse might often need to recommend certain products to the PCP. (If the wound looks infected, a silver dressing might help. If the wound is draining a lot, requiring frequent dressing changes, an absorbant foam might help.) There are endless combinations of primary and secondary dressings that can be used to treat wounds. There are lots of wound care products that are not dressings, such as barrier cream, stoma paste, wound cleansers, growth factor and antibacterial pastes.
Experience with dressing changes. You'll gain this as you do along, but certain dressings, such as wound vacs, are complicated and can take some time to master. You'll also be teaching patients how to change their dressings.
A good handle on the physiology surrounding the wound. You'll need to teach the patient about their wound, ways to help it heal and ways to prevent new wounds from forming. It's important to understand what the patient's underlying condition is (immobility, diabetes, PVD, arterial insufficiency, obesity, etc) and what other interventions can be employed to help heal the wound.

Next to Pediatrics, wound care is one of my loves. Every wound is like a puzzle: it has unique characteristics and co-morbidities. It's up to the doctor and nurse to match the best wound care products and interventions to each wound to help heal it. There's a lot of critical thinking and education involved. It can be a lot of fun.

christinacub · Jul 7, 2011

Wow...these are all great answers and i do appreciate my fellow nurses taking the time to write about this so quickly. I am more and more excited about the prospect. I worked in dermatology and enjoyed working with skin. I truly hope this works out. From what was said here, I believe I fit the bill. Perhaps this may be a good niche for me. Gross wounds will not bother me- I will see it too as a challenge a puzzle. I hope they call me for an interview :) it looks like something Id very much would like to pursue.

roser13, ASN, RN · Jul 7, 2011

I have always thought that Wound Care Team would be a great nursing role. Plenty of patient contact and care, without the floor/unit politics.

Plus you can measure the success of your treatments daily!

Nccity2002, MSN, RN · Jul 7, 2011

I just talked to a nurse recruiter who is Fwding my resume to a would care position. I have not been in a hospital in a very long time. School nurse here...no IV's, bloodwork, nothing...Is this too much to start with?? Trying to get back into more acute care. Last time was a Peds floor for about 8 months back in 93! Im almost like a new grad.

The wound, ostomy nursing society have many resources and education opportunities for anyone interested in becoming a wound care specialist. They also provide certification in wound care. Check out their web site below... hope you get that job.

http://www.wocn.org/Education/

Sugarcoma, RN · Jul 7, 2011

Hi christina,

You have gotten some excellent replies here (Thecommuter summed it all up very nicely!). I too see wounds as a challenge and a puzzle and wound care appeals to my anal-retentive side. We have EXCELLENT wound care nurses at the facility I work at and they have taught me soo much. It is a position where you truly get to advocate for your patient because you would be surprised how little docs know about wound care and how many of them think nothing of a patient having their wound vac changed without additional pain meds ordered. It is also a position which requires a ton of teaching so if you enjoy that you will like the job.

I love figuring out what type of mattress will aid in healing, the best ointments for specific wounds, nutritional support, etc. There is something very rewarding about seeing the patient with a nasty stage IV healing well. I will keep my fingers crossed for you!

christinacub · Jul 8, 2011

Thankyou sugarcoma(love that name), Nccity,rosa, ashley, Xauphcamia,cary, commuter...great responses and actually has me Wanting this wound care job. It has encouraged my interest and is a great goal. The nurse recruiter from the corrections position called me back and seems interested now. I talked to the nurse recruiter at the hosptial I worked at ( with the wound care position) and she says she is forwarding my application to the head nurse there-that was yesterday. No calls yet. I would like to do anything I can to get that position. Should I call the supervisor and let her know I would very much like the job? (I feel she probably knows that already since I applied- lol). Should I call nurse recruiter back? Let her know, I am really interested? Is contact bad? Should I just sit on my haunches and wait? I really do not know proper technique here....

Thanks for the info again!!

Christina