What patient sticks in your mind this week?

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Hi

just wondered if you had any patient stick in your mind this week?

Was on Home visits today and went to see a lady following a request from the Community Nursing Team.

She had a dressing on the left 1st toe (allevyn border).
Nursing notes said "drying up well only small amounts of discharge".

Medical: recent vascular surgery for PVD (stents both legs) ? what artery/s

Past lower leg ulcers and left knee ulcer.
Stents working well for pain.

Dressing removed and soft green nail plate noted.

Nail plate was easy to remove and not painful.
(nail bed full of yellow pus)

Following cleaning nail bed showed no ulceration.

used antimicrobial to reduce bacterial burden in area no evident infection noted.

just found it funny the nursing team seemed to think it was drying up!!

Thanks
Ed

 

Ed,
It never ceases to amaze me what the DN nursing team do.

Once I referred a patient to the DN because she had an ulcer between 2 of her toes that revealed bone. I wrote a letter (keeping a copy) and personally delivered it to the DN office with the reccomendation that a Tissue Viability Nurse was engaged.
The next time I saw this patient 6 weeks later the ulcer was twice as big, the toe was a mess and there was only a bit of manky-looking melolin between the toes that fell out of the i/d space when I parted the toes. The pt said the DN had been a "couple of times" and just put melolin between the toes.

I have come to the conclusion that DNs cannot be faulted when it comes to actual nursing, but their knowledge of wound-care leaves a lot to be desired.