Margaret Heale's blog

By Margaret Heale, RN, MSc, CWOCN

Medical device–related pressure injuries (MDRPIs) are recognized as a significant problem, evidenced by the inclusion in the National Pressure Injury Advisory Panel pressure injury definitions and described by Pitman and Gillespie in 2020.¹ Prevention of medical device-related pressure injuries is a goal that may be achieved through meticulous patient care.

By Margaret Heale, RN, MSc, CWOCN

It is important for nurses to strive toward excellence. Our patients deserve the best we are able to give, and sometimes we need to look critically at how we care and how we might improve outcomes. In theory, we update practice because we read research that indicates a change needs to be incorporated into what we do. More often, maybe we follow a colleague and like what we see, or the patient indicates a preference and we change an approach. It may be that a company representative visits and what they say makes sense, has the support of management, and we gladly (or not) incorporate a product into our practice. Looking at a standard of practice and reflecting on how we measure up require honesty and an openness that some might shy away from. Such reflective practice, combined with clinical supervision, leads to high-quality care and is an excellent method of reviewing, updating, and improving practice for patients with problems of the lower leg.

By Margaret Heale, RN, MSc, CWOCN

I had shopped before lockdown and had not needed to go to a supermarket for a while. Before my first big shopping event, I came across this online video: preventing your kitchen getting contaminated from your shopping. I smiled at the thought of people trying to use an aseptic technique in their kitchen while trying hard not to contaminate the kitchen, its contents, or themselves with imagined glitter (or coronavirus).

By Margaret Heale, RN, MSc, CWOCN

Nurses week, which took place in May, may have fallen a little flat this year, as employers were not able to gather staff and celebrate as they might otherwise have done, but the caring continues. As a group, we have been recognized as essential. In managing wounds, nurses play a vital role in supporting patients' progress toward healing, as well as prevention. It is likely our recognition will last a while, as generally nurses come out on top in polls that ask which profession is the most trusted and caring. Unfortunately, our assistant colleagues, who care just as much, don't do so well when it comes to their pay packet.

By Margaret Heale, RN, MSc, CWOCN

As patient-driven groupings model hits home care, patients or their caregivers will be expected to do more of the care. Subsequently, nursing staff are expected to provide more education, making "how to" information more crucial than ever.

By Margaret Heale, RN, MSc, CWOCN

Oral health is more than just important. As a child in a family supported by the state, we could afford hot water for a bath only once a week, but I cleaned my teeth twice a day and had regular dental visits. At school, we were taught to brush our teeth, and the twice a day routine was reinforced. I remember as a 16 year old showing my junior charges the scuzzy stuff at the gum margin and telling them it was called plaque. At nursing school, I once again was taught how to brush teeth, and we practiced on each other. Oral hygiene may seem irrelevant to wound care, but there is no doubt that the mouth can release bacteria into the bloodstream and be the root cause of deep bone infections after orthopedic surgery, pneumonia in intensive care unit (ICU), and subacute bacterial endocarditis.

By Margaret Heale, RN, MSc, CWOCN

Not very long ago, when working in an in-patient rehab center, I was shocked to discover patients calling the adult incontinence garments "hospital underwear." We were making good inroads into reducing the use of these products with the hope that if we used less it would be possible to acquire higher-quality products that would function optimally for patients who really needed them. It was of concern that some facilities had become diaper-free because many of our patients benefited from briefs, particularly as a "just in case security blanket" and we felt it was unrealistic for our patient population to be brief-free.

By Margaret Heale, RN, MSc, CWOCN

In the United Kingdom, we are well into spring. As I look at the garden, there are patterns of growth literally cut into rock. Old stones with beautiful mosses, and next to a stone step, one type of rock plant has thrown up five stems and atop each is a bright red flower. The path has some wild strawberries growing up through it, and there are two bunches of well-established chives. It is a small plot on the outskirts of Newcastle, and as you walk down the road there are other gardens with similar flowers and weeds.

By Margaret Heale, RN, MSc, CWOCN

"Must Love Dogs (Cats, Lizards, Snakes, Birds, AND Arachnids)." This is a line that needs to be next to all job advertisements for home health care staff. You see, I am a dog lover, not because I love dogs but because I have a way of being able to adapt in order to survive. I work in home care as a clinical nurse specialist and have slowly learned to love dogs ever since I was reported to my manager for mentioning I didn't like them much. Shortly after this I was told not to visit a patient whose cat I had shooed away from my wound dressing field. While discussing this with a colleague, she told me of the bird that had landed on her head that morning just as she was probing the patient's foot wound with a Q-tip. Maybe everybody has had experiences like mine, but maybe not, so I would like to put mine to paper to entertain you in this season of good cheer.

By Margaret Heale, RN, MSc, CWOCN

In our point, click, fill-in-the -blanks world of ever increasing wound care algorithms and MOs, I have an ax to grind (straight into my so-called smart phone if I had the courage).