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@woundsnwonders-blog
Getting supplies for a complicated dressing
(not my gif)
This actually excites me! I love assembling the supplies for a dressing change- with that possibly being my favorite part about my job on a surgical unit. I’m proud to hold the title of, “Super Wound Care Nurse J” per one of the student nurses on our floor. Super proud.
Reblog and find new blogs! Maybe even leave a nice message to some :) Let’s help each other out! These posts really help me find fantastic study blogs👍
Wound, ostomy, and continence care studyblr! That's me!
Resource Alert!
I stumbled upon this website while browsing through allnurses’ wound ostomy continence specialty forum. It includes a multitude of product information sheets and wound care modules that go over the basics, including wound healing, wound assessment, etc. I’ve saved the link to my phone for personal reading whenever I’m out and about.
One of the modules also helped me figure out what was going on with one of my patients’ wounds from the past week. She had what my coworkers and I referred to as a “scar.” However, it was, in fact, eschar! I saw this when I had her initially, after she was a new admit on the floor. A week later, I had her again and she was being treated with Medihoney. When I lifted the Allevyn and calcium alginate dressing to assess the wound bed, I was surprised to find that underneath, the wound bed had loose, light yellow-colored something instead of the “scar.” I should have connected the dots at that time and realized that it was now slough. However, being a novice at wound care, I wasn’t 100% sure. My thoughts were that the Medihoney would have turned the eschar into slough, which is correct! According to one of the modules, “Eschar turns into slough once the body begins the process of autolytic debridement.”
I’m feeling very satisfied right now. :)
Happy Nurses Week...
To my coworkers, I love you; calling you my peers is an honor. I love our stories, and the hours spent chatting while we work. I love the way we work together. I love the way we can still laugh in the tough times. Thank you for making my job great. Happy Nurses Week.
To the brand new nurse, we’re glad you are here. It’s okay to be scared sometimes. It’s okay to ask questions. To you, sweet brand new nurse, keep your heart in it; it’s okay to care a little too much sometimes. Happy Nurses Week, dear one.
To the brokenhearted, burned out nurse, we’re here for you. We thank you for all you do for your patients and how much you love them. If you need a hand or an ear to listen, we are here. Happy Nurses Week, love.
To the mama nurse, thank you for your willingness to teach and every time you have stood up for the baby nurse. Thank you for the years you spent building this profession up. We are where we are today because of your work and dedication. We will not let you down. Happy Nurses Week.
Thank you all for the good you do this and every other week of the year.
Update: Post-Cohort Class
What a busy few weeks it has been! Finally, I can sit down and update you all on my progress!
I spoke with the manager of the wound care department during the cohort class. We talked briefly, and in this time she was able to recommend two possible programs of study for wound, ostomy, and continence care.
So there are two WOCN-accredited programs that I should consider: Emory University and Cleveland Clinic. I’ve done some research on both programs, and between the two I’ve decided upon Emory University’s distance learning program. Under this program, I will be responsible for completing each module (wound, ostomy, and continence) within 3 months. After this, I will be required to travel to Atlanta, GA for one week (a very enjoyable week, I’ve read) before taking the cumulative final. Then, it will be time for clinical!
She also stated that in order to be hired with the hospital, you need to at least be certified in wound and ostomy care; continence care being only optional. Though, she said it wouldn’t be bad to just go for it, since it was the easier of the three to test for. I decided to do all three, as I know being certified in continence will only aid me in my clinical practice.
Also, during our discussion, she noted how it was nice a younger nurse (as I am) was interested in wound care, especially since there is a growing older population- which also includes a number of the current WOCN in practice today. I’m happy she mentioned that, because it made me realize that my interest in healing is truly valuable and needed in the community.
At the end of our short discussion, we discussed a possible shadow day and she was able to connect me with the WOCN associated with my floor. We’re currently working on scheduling a day for me to follow her. I’m really excited! However, I’d like to be a little more versed in wound care terminology beforehand. In that way, I will have an idea of what I’m looking at and won’t be a deer in the headlights if asked a question!
I also have the contact information of two WOCN who work quite a distance away, however they are the wound care nurses in their area. I’ve been told that one of them enjoys educating nurses about proper wound care, and welcomes shadow days. There is another WOCN I’d like to shadow as well (closer to where I live- even closer than the hospital I work at!), mostly because she specialized in pediatrics. When the time comes, I will be sure to contact these ladies!
When I think about it, this entire process reminds me of when I was starting to seriously consider nursing as a career in the second half of my first year of college. I’m really glad to have an idea of where I might be in 2-3 years. I’m definitely a planner, and without a plan I become somewhat of a blob.
Yep, a pretty accurate representation of me without a plan. ^
So, dear reader, I leave you with one of my favorite quotes:
“A goal without a plan is just a wish.” - Antoine de Saint-Exupery
Very good read!
We think wound care is very cool. If you are a med student we urge you to consider it as your career.
Wound care is very cool~ 😎 Not a med student, but a new RN that has decided upon her career path. (Which is cool 😎too.)
My patient won’t let me do their full skin assessment, insisting that their butt is fine...
You mentioned in a post that wounds shouldn't be stitched after 24 hours; why is that? Are there any exceptions?
You know, I can’t find a good resource on exactly why this can be detrimental?
My preliminary research goes like this: if a wound is going to become infected, that infection usually takes 24-72 hoursto show up. Within that first 24-hour window, it’s safe to close the wound (sutures, liquid stitches, staples, whatever), because the bacteria haven’t taken hold (unless the wound is majorly contaminated). The very last thing we want is to suture a bacterial infection into a wound, underneath a closure, where the bacteria can just eat away at the tissue below. Limbs are lost doing things this way.
There doesn’t seem to have been a lot of research, but the best sources I can find say that most wounds can be safely closed in the first 18 hours (24h+ on the scalp).
If that timeframe has passed, the wound will be left open, dressed, and left for “secondary closure”–letting it heal on its own. For high-risk wounds (such as animal bites) that present, even within the 18 hour window, an approach called tertiary closure is used, where the wound is left open (secondary closure) for a few days to insure there’s no infection before stitching it closed (primary closure).
Wound care is an area that I’m embarrassingly weak in, actually. Believe it or not, the first goal I set up on the blog Patreon account is $200/month for textbooks (we’re 10% of the way there!), with wound care and orthopedics being my first-round-draft textbooks to nab.
HOWEVER, this ask is making me consider a post on different types of wound closures, which is good. It’s always nice to have inspiration now and again :)
Thanks for the question, @penstgrin . Good luck with your stories.
xoxo, Aunt Scripty
disclaimer
The ScriptMedic is supported by generous donations on Patreon. Have you considereddonating?
ELI5: Is letting wounds 'breathe' a thing, if so, what purpose does it serve?
I’m a nurse and have taken a number of courses on wound dressing and healing. Here’s what I can quickly write out for you.
The goal of wound care is moist wound healing. If wounds are draining plenty of blood/pus/serous drainage and it isn’t being removed from the wound by an absorbent dressing, the tissue can become macerated and will appear white. It’s too wet, the tissue is swollen with water. This is bad for wound healing. This is maybe where people got the idea of letting a wound “breathe” to dry up some of the excess moisture.
However, letting it dry out completely is not ideal either.
Natural healing involves developing a scab, a dry cover for the wound. However, if the wound were instead moist (not wet), you would have faster migration of immune cells, new cells, growth factors, etc. as they can move through a moist environment easier. This is what topicals like polysporin (besides the Abx) help to achieve. Petroleum products will moisturize without macerating.
And the other question everyone asks: should I use peroxide to clean it? no. maybe. Here’s the thing. You can clean a wound very well with water or saline (although who has saline at home). Many wounds wash themselves out by bleeding! Peroxide will kill bacteria, but it also hurts exposed skin cells/other tissue, and that can slow healing. The surface of your skin is mostly keratin and peroxide won’t affect intact skin, but when it’s cut, the deeper layers can be affected. Basically, don’t peroxide every wound, but something like a cat bite, go for it.
*edit: I’m aware now of how many people have saline. I pour like half a liter over new wounds, so I’m not sure people have that much contact solution. I have 25/20 vision privilege so am unaware. Yes, you should see a doctor quickly for cat bites. I’ve seen people need strong antibiotics 4x a day to avoid death from cat bites. Go to ER NOW if your wound starts streaking red up your limb. Helpful to outline areas of redness with a pen and the time you marked it to show how it’s progressing.
Explain Like I`m Five: good questions, best answers.
Good to know!
P: Payday & Core Curriculum
Payday! I went ahead and bought WOCN’s Core Curriculum for Wound Management this morning. There are plenty of wound care resources out there, but I decided to use this book as my main source of information for now because it is specific to my profession and is very affordable. I previewed some of the chapters on Amazon, and I feel as though I can benefit from the amount of information and accompanying pictures that go with it. EDIT: It’s arriving in TWO DAYS! Woohoo!
In a week or two, I’ll be able to speak with WOCN members and representatives who will be presenting at our new RN cohort class. Super excited! The road to certification is still extremely fuzzy for me, so I’m hoping they can help me pave the path toward certification.
P: Wounds, Blogging, & Me
Hello, and welcome to my wound care tumblog!
Ever since I was a first-semester nursing student in Fundies, I have always had an interest in wound care nursing. However, given that I was busy with my nose in books and eyes in tissues (am I right?), I never had a change to fully immerse myself in wound care information… until now.
(Ahh, it feels so nice to finally have free time! Even if I sleep 50% of the time…)
The goal of this tumblog is to document my independent wound care learning as I prepare myself for certification (via WOCN).
Thanks again for stopping by and checking out the FIRST POST of my little wound care tumblog! I’m so excited for you and I to learn more about wound care. Here’s to a bright new beginning, and a future full of healing!
- J
