Patient Issues

Margaret Heale, RN, MSc, CWOCN "Personalized medicine" is apparently a new concept that has evolved from taking good family histories, then adding a genetic testing component. The idea is to help assess the risk of specific traits that may be evident, and confirm with genetic testing so people can make lifestyle changes that reduce risk. It has attracted a huge amount of attention over the past few years.

Benjamin Franklin famously stated, “An ounce of prevention is worth a pound of cure.” This statement was made in reference to the importance of fire prevention in 18th century Philadelphia, but it aptly applies to modern diabetic limb salvage. The multidisciplinary model for amputation prevention has been in place now for almost two decades, but how far have we really come? Recent literature suggests that there has not been a significant decline in reamputation rates for diabetic patients despite the team approach to care. Diabetes is a complex and aggressive disease that affects multiple organ systems and robs patients of sight, sensation, limb, and quality of life. Treating such an aggressive disease is challenging, to say the least, and often the desired outcome is not achieved.

When working with a person who has been living with a chronic wound, it can be frustrating to try to figure out why the wound isn’t closing as the wound healing model would predict. Not all patients follow the “traditional” timeline. The wound may not progress neatly through the four phases of wound healing as expected. There may be an underlying issue that is preventing the wound from healing. How, as clinicians, can we address this? Can we actually expect closure of this wound based on the specific patient’s condition, or should we consider a palliative approach?

By Karen Zulkowski DNS, RN, CWS I have talked about treating wounds, assessing wounds and care planning, but have not discussed the patient as a person. I always talk to the patient and family about options for care, how aggressive they want to be in their treatment plan and explain to them what I am doing and why I am doing it. The importance of this communication process is one of the reasons why I got involved in the Wound App project. I realized rural facilities don’t have wound expertise available and additional testing may mean many miles of travel. The consultation plan calls for patient/family involvement. But the communication with the patient and family is important regardless of how or where you are doing wound care.

Patient education should be a priority to empower patients to care for themselves and improve patient outcomes. Involving patients in their own care can help them to understand about their wound and be more adherent to the overall treatment plan. Remember to involve the caregiver or family if applicable. Ask your patient questions about who will be changing the dressing so the appropriate parties can be involved.

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA It is hard to read a newspaper (my preferred news source) or an online news site without discovering false information. I recently read an NPR article about how to vet news yourself and how to recognize this.1 The vulnerability I felt made me think about protecting my decisions from this reporting and even more, how I can help my patients weed out fake reports.

About 89 percent of people who come to doctors’ offices have already Googled their symptoms, notes D. Scott Covington, MD, FACS, CWSP. He says most patients wanted to see how serious their health condition was before going to an actual doctor. “They’re armed with misinformation. They’re really on the wrong path,” Dr. Covington told the audience at his presentation at the Symposium on Advanced Wound Care (SAWC) Fall.

By Terri Kolenich, RN, CWCA, AAPWCA We all have hobbies outside of what we do for a living. At least, we all should have hobbies or interests outside of our careers. Our hobbies are our outlet for stress. I love to draw. I also enjoy painting. What I love most of all is acting and theater. I love being on stage, performing, and getting an emotional response from my audience. Everyone that knows me well knows how much I love acting on stage. Bringing a script to life exhilarates me. Just the thought of performing live, delivering memorized lines, and anticipating the reaction of my fellow actors stirs and motivates me. Most of all I crave the opportunity to use my improvising skills when a scene goes an unexpected direction.