Tips for Wound Care Nurses

Are you a nurse interested in the wound care specialty? Or maybe you already work in wound care but want to excel. Below are some tips for wound care nurses that can help fine tune your expertise.

Soak it in

When I was in nursing school (way back before the turn of the millennia), there was no specific focus on wound healing. I discovered my love of healing wounds as a veteran field nurse and began to seek out and absorb everything I could about the skin and healing.

I encourage anyone working in wound care to take the initiative and put in the time to set yourself apart by becoming a lifelong learner.

Do the hard stuff

Do you shy away from tricky wound vacs or wish someone else could see that patient with the oddly shaped abdominal wound right next to the fresh ostomy? Don’t do that! Raise your hand high and say, “I’ll do it!”

Granted, you may need help at first, but if you shy away from the hard stuff, you will never gain the type of experience you’ll need to become an expert wound care nurse.

With time, you will pick up patterns and recognize normal from abnormal well before the inexperienced person and know intuitively when something isn’t right. I am passionate about this: you can have multiple degrees and lots of education, but nothing replaces years of hands-on experience and knowing what you’re seeing and how to handle that tricky dressing because you had a similar one three years ago.

Do the hard stuff and ask for help — until you’re the one being asked to help.

Be a good teacher

Let’s carry that passion into teaching. As a wound care nurse, you’ll teach many people. You’ll teach your patients, their families and caregivers, other clinicians, and new providers.

If you don’t like to teach, wound care is not the specialty for you. Wound care nurses are practitioners and teachers.

Teaching your diabetic foot wound patient the how and why of offloading cannot be underestimated. Without effective offloading, that foot ulcer will not heal and worsen over time. This will increase the chances of infection, osteomyelitis, and could potentially lead to an amputation. But let’s not assume our patients know this. To them, it may be just a draining area that is bothersome. Usually, it doesn’t even cause pain.

A lack of appropriate teaching can be detrimental to the patients. There is no lack of material to teach when dealing with wounds. You will constantly teach offloading, dressing changes, nutrition support, signs of infection, diabetes management, and say…why that vascular procedure is key to healing your patient who just cancelled the vascular appointment you made for them for the second time. The scenarios are endless. You will always be teaching.

Be patient

So you’re seeing a diabetic foot wound patient for several weeks now. You’ve taught them offloading, nutrition, and the importance of managing their blood sugar. You’ve reinforced your education at each visit. You know they understand what you’ve taught them using the teach-back method, and you’ve documented their understanding. But every time you see this patient, they are not wearing their prescribed offloading shoe which is obviously frustrating. And it’s highly unlikely to be your only difficult case for the day.

Wound care nursing requires a lot of patience. If you frustrate easily or need to see immediate results and your instructions consistently followed, wound care nursing is likely not for you. Practice patience and keep your frustrations out of patient care.

Reach out and communicate

It’s important to be an effective verbal and written communicator. Healing wounds often requires the collaboration of primary care, vascular, endocrinology, nutrition, infectious disease, surgery, and radiology. We must make sure we’re communicating clearly, thoroughly, promptly, and professionally for best patient outcomes. Knowing when to reach out to our colleagues for their expertise is often vital to healing difficult wounds.

Learn to listen

You’re busy. You have a list of things to do and questions to ask your patient. But did they just tell you their pain has changed and they are now having difficulty sleeping at night? Did you hear them when they said they were finally able to sleep when they threw their leg off the side of the bed?

This is important information to relay to the provider. It could be a sign of advancing arterial disease requiring a procedure to restore blood flow and finally get that wound to heal — not to mention possibly saving their leg.

Listening is a skill. We can get better at it with practice. Never become too busy to listen.

Document well

It’s no secret that health care has become more litigious. As a wound care nurse, documenting the details of the wound and what you did are crucial. Thorough documentation must be done at each visit. If you are asked in five years if you put a zinc or a calamine unna boot on patient X, will your documentation give the answer, or will you be forced to say you don’t know?

Document everything in detail. Be sure you have the information to answer any question that may be asked about your care.

Wound care is challenging. It takes passion, dedication, and knowledge. It requires multiple pieces of a puzzle coming together. But the reward of getting to know your patients and being able to physically see the difference you are making is priceless.