Crazy for wounds...

Specialties Wound

Published

Okay everyone in my class thinks I'm insane, but I LOVE wounds...I mean I get excited at the thought of changing a dressing...can't wait to see what's under all that gauze...

Anyone know what speciality see's the most wounds? Someone said I should look into post-op (but I'm thinking most of the people there are only there short term, no real dressing changes..maybe I'm wrong), someone also said look into dermatology (but i'm thinking this is mostly pimples??...someone also mentioned ortho (No idea why they suggested this one? Any ideas?

I'm with you about being excited to see what's under the dressing. Fortunately, the hospital where I do my clinical rotation (as well as others in driving distance) has a wound care center. But getting in will be a challenge for a nurse with no experience.

Specializes in Certified Wound Care Nurse.

Rock on! YES! Sometimes I just have to get on YouTube and look at excisions, etc... :-0 TMI, TMI... Depends on the "type" of wounds you "enjoy". If it's pressure ulcers, nursing homes have their share as well as MedSurg units. If it's diabetic ulcers or venous stasis - I did a rotation in an outpatient wound clinic that did a ton of unna boots and the occasional profore. I did get to see a pt with graft versus host disease while there.

I'm more of a pressure ulcer/wound vac kind of girl.

Rivernurse

Specializes in ER.
Okay everyone in my class thinks I'm insane, but I LOVE wounds...I mean I get excited at the thought of changing a dressing...can't wait to see what's under all that gauze...

Gauze as a dressing??

Seriously??

Since when??

Gauze is for wound cleansing only. It is not a dressing. Can we have some sensible evidence based practice going on here please?

Yes I am a wound care nurse among other things, I have a qualification in it, and have worked with all wound care, from major burns to pressure ulcers. Show me one piece of evidence that gauze is therapeutic on a wound please.

Specializes in Pediatric and Adult OR.

@skylark, when I worked on med-surg a couple years ago, pretty much all dressing changes I did were wet-to-dry with gauze packing. I don't have evidence based practice proof, that's just what I saw in my experience (and yes, we had a CWOCN).

@Original poster: echoing what everyone else said about going into wound care. I start my program May 6 (through webWOCnurse.com - Home Page). Until then, work on med-surg. I'm like you...everyone groaned about doing dressing changes, so I would do everyone else's for them :D

Specializes in Emergency Medicine.

Gauze as a dressing??

Seriously??

Since when??

Gauze is for wound cleansing only. It is not a dressing. Can we have some sensible evidence based practice going on here please?

Yes I am a wound care nurse among other things, I have a qualification in it, and have worked with all wound care, from major burns to pressure ulcers. Show me one piece of evidence that gauze is therapeutic on a wound please.

Thank you!!! I have a bit of experience in wound care from caring for my mother who has two stage IVs and when my instructor gave us a wound care lecture yesterday she talked about using 4x4s on the wound bed... I almost got up and yelled NO but I bit my tongue. That's among the other shady wound dressings I've seen within my med surg clinicals -_-

Specializes in ER.
@skylark, when I worked on med-surg a couple years ago, pretty much all dressing changes I did were wet-to-dry with gauze packing. I don't have evidence based practice proof, that's just what I saw in my experience (and yes, we had a CWOCN).

@Original poster: echoing what everyone else said about going into wound care. I start my program May 6 (through webWOCnurse.com - Home Page). Until then, work on med-surg. I'm like you...everyone groaned about doing dressing changes, so I would do everyone else's for them :D

Wet to dry with gauze packing.

And how does that end up?

A soggy damp mess.

Great place to grow infections!

This is the first time I'm hearing that gauze is so taboo for WOCN. Interesting. Nursing school still teaches it this way, though. What should we do WTD dressings with?

Specializes in Wound Care.

oh wow didn't know the thread got moved so I'm just now seeing all these response. You guys are awesome.

Yes clinical was AMAZING for me. My teacher knows i love wounds so that's mostly what she had me do. Every room was like Christmas to me. I went to bed every night just thinking about what I might see the next day. My best experience (but really sad) was a man who lost his eye to cancer and was literally missing the entire side of his face. I got to flush the wound and repack it... yeah I talked about that one for atleast a week.

We wrapped up our last week there a few weeks ago and I'm really sad. I miss it so much. We start our next clinical rotations in 12 weeks. We have an option to find our own preceptor if we don't want to use the schools clinical site so i have been searching like crazy for a wound care clinic that will take me :(

I'm open to working with all types of wounds... I just want to learn. I didn't get a chance to work on any burns so I would love to give that a try. I'm on youtube all the time checking out videos related to wounds. My friends think I'm nuts. I wish more people in my class were into wounds because it would be cool to talk about but everyone in my class wants to either do Peds or L&D...now in my opinion that's crazy lol

Specializes in ER.
This is the first time I'm hearing that gauze is so taboo for WOCN. Interesting. Nursing school still teaches it this way, though. What should we do WTD dressings with?

http://www.deconsolidatenow.org/Documents/9_Ovington_Article.pdf

I didn't write this article, but I kinda wish I had, its all good evidence based practice, unlike what they teach you at school : )

To summarise for those who don't wish to read through -

gauze is not occlusive in any way and is therefore a risk for introducing contamination

it also has no value in retaining skin temp, and if wet actually causes cooling of the wound, which as we all know slows healing.

It has no therapeutic value (many foams etc have anti-microbial content)

it can adhere and therefore remove new granulation at dressing changes

although gauze appears to be a cheap option, ir requires changing far more frequently that a proper absorbent dressing, (such as s foam) and therefore cost significantly more in nurses time.

Is it a cheaper option for denuding unviable tissue?

I just passed my NCLEX practical nursing exam and I am trying to decide whether I want to do trach vent nursing or wound nursing. I discovered there is a wound care class in Jamaica, Queens but it costs $2029. I can pay in installments, though. I used to be so passionate about wounds and ulcers. My mother is a retired RN. She says I should stop being so excited about caring for nasty ulcers because then everybody on my job will give me the worst patients with the nastiest ulcers and I will be known as "the stink nurse". What do you think?

Specializes in Wound Care.
My mother is a retired RN. She says I should stop being so excited about caring for nasty ulcers because then everybody on my job will give me the worst patients with the nastiest ulcers and I will be known as "the stink nurse". What do you think?

I say bring it on....I like the nasty ones... lol Its so awesome to see a wound go from HOLY CRAP HOW DID YOU LET THAT HAPPEN to wow it healed and looks pretty good.

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