I’ve now entered my third week of district nursing and let me tell you, it’s been an adventure. I realized on my first morning that wounds are the majority of the case load-which is perfect! I’ve wanted some hands on wound care experience for ages, and I’m a bit of a gore fan. All the nurses have also been very helpful in letting me get stuck in with the goriest of wounds, and the patients seem to be pretty happy with letting me do that too! After all, its not everyday that you see someone’s foot tendon exposed..
Thanks to this exposure to wound care, I’ve started to appreciate how nursing is an art and a science. The science comes from knowing your stuff. You need to be able to look at a wound explain how well its healing, and what it looks like. It might be granulated, which means the wound is all red but dry. So the next stage is for the wound to epithelialize, where new skin grows back from the edges inwards. And then there’s sloughy (pronounced sluth-e) wounds. This makes the wound look all white/yellow, caused by dead epithelial cells and white blood cells. Slough often makes a wound look quite bad. When I first saw one, I was a bit shocked that the nurse wasn’t overly worried!
The art comes from the practical side; dressing the wound. A lot of patients I’ve seen require their wounds to be packed, as it’s a cavity. This is to aid the healing process, and draw out the nasty stuff. I’ve packed a few wounds now, and its slightly scary but really interesting. The skill comes in ensuring you don’t pack it in too much, as you’ll be pulling it out next time!! (like unwrapping a surprise you weren’t sure you asked for).
And then there’s bandaging. From blue-line to bi-layer, it must make district nurses insanely good at wrapping presents! They can look at a wound and bandage it perfectly. I tried, believe me. I’m not very crafty, but with practice its doable!
If you’ve had some interesting wounds on your placements or have any questions about district nursing, comment on our Facebook page or email us at firstname.lastname@example.org.