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Mary Regan, RN[/caption] Even after more than 35 years, Mary Regan, RN, PhD, said she has yet to lose her zeal for helping patients close the wounds that hold them back from living their lives to the fullest. Serving now as director of clinical affairs for Libertyville, Ill.-based Hollister Wound Care after more than three decades in a range of settings globally, Regan said she hopes every nurse could share her enthusiasm for wound care. To help nurses in any setting provide better patient wound care, Regan offered a few tips.
Mostly, allow the body to work
Generally, the prescription for every wound is the same, Regan said: Debridement, infection management and moist wound dressing. Ideally, Regan said the wound should close on its own with a minimum of management. But in situations in which wounds become chronic, a patient can slip into a "horrible cycle," in which a wound, whether from injury, surgery or another source, refuses to close. Nurses, whether in clinical or home care settings, must be vigilant, but also patient, and avoid changing dressings too often. "If I'm changing the dressing every four hours, I'm just messing things up every four hours," she said.
Show patients patience, too
Sometimes, patients' wounds -- and the patients themselves -- can be difficult. And there is probably a reason for that. "Nurses should be patient enough to open the onion, to see what's on the inside," said Regan. If a wound has festered too long, the situation may have robbed the patient of dignity. Perhaps a difficult wound forced a formerly active person to miss too much work or other basic life activities. Or perhaps they no longer wish for the wound to heal, for fear of being forced to return to an uncertain life without reassuring visits from a home care nurse. "It could be they feel they've lost control," Regan said. "We need to help them regain that control of their lives and their bodies."
Drive together
Nurses should help the patient navigate the healing process. But the patient should share the driver's seat, Regan said, noting a main part of the nurses' job lies in helping patients learn the keys to success. For instance, for patients living with diabetes, nurses may guide them toward regular physician visits, a plan to attain a healthy weight and monitoring A1C. But also key would be teaching them proper foot care, and warning signs of neuropathy. "Then, they'll know if they develop a wound, to get to a wound center immediately," Regan said, noting this may in many instances avoid both loss of limbs and loss of life. "We keep costs down, we keep them out of the hospital, and we give them control back," she said.
Build on the basics
All nurses should have a working knowledge of the basics of wound care, and work to keep up with new developments in products, research and techniques. But for nurses who desire a more thorough understanding, Regan recommended pursuing wound care certification programs through such organizations as the Wound Ostomy and Continence Nursing Society at www.WOCN.org or the Association for The Advancement of Wound Care at www.aawconline.org.
