Wound Dressing

I can't imagine any kind of would would be left open. More details in your question might help.

yes, any wound care must have an order on the chart.

order should include location, what to cleans with, any prep for the peri wound area, if a primary dressing is needed (packing, etc) then what do cover with as a secondary dressing and how to secure it if needed. It should also indicate how often to change the dressing.

Coz in some instances if we in the ward won't do wound care for a surgical patient, our surgeon would get mad but in some cases we have touched the wound,i mean do dressing then he would comment why we did dressing?

Huh? Normally the surgeon does the first dressing then leaves oders for the future dressing changes. There should be a policy and procedure for this of if not who knows how do do what?

Coz in some instances if we in the ward won't do wound care for a surgical patient, our surgeon would get mad but in some cases we have touched the wound,i mean do dressing then he would comment why we did dressing?

Yes, you need an order for wound care. I have a home pt that I do not do wound care for. He's had some skin lesions removed and a graft. There is an order from the doc stating "DO NOT DO WOUND CARE". The pt sees his doc weekly and the doc does his own wound care.

Either way, the order should be written clearly.

Hi,

It would depend alot on what kind of wounds that we are talking about.. I think the fussiest ones would be vascular and plastics - they are pretty anal regarding the dressings and would give strict orders. Otherwise, the drs would even want your recommendations (sometimes if they are not so stuck up)

OK, all/everything (every single thing we do as nurses, to patients) requires an MD order (this can be part of formal, written facility/unit protocals, standards of care and actual MD orders) AND every nurse can do basic first aid without an order, x1 IE dress a new boo-boo but THEN you need an order. Also, anything going on with the patient, MUST be conveyed to the doctor, as he/she has the right and obligation to know who/what he is caring for/treating It is quite unfair, in my opinion, NOT to include the doc and the family forthat matter, in all that is patient.

A lot of facilities or Docs have standing orders for drsgs.

If a surgeon wants a wound dressing left then s/he needs to put this in the plan of care ...

The fact that RNs need ' permission' from a Doctor to do wound care outside of those scenarios is a joke ... even more fun when a dressing requires 'prescription' depending on which unit someone is on as some units are allowed to carry a wider range of dressings as stock ...