Care for bedsores

Trainee nurse: Good morning. I’m Maureen, the trainee nurse.

Referent nurse: Welcome Maureen. We’ve been expecting you. I’m Susan, the referent nurse. So let’s get to work. We have an elderly patient who suffers from bedsores due to a long-term hospitalization and lack of mobility. But allow me first to check what you know about bedsores. So how many stages of this kind of ulcers can we point out?

Trainee: There are usually four stages, ranging from mild discomfort or reddeing of the skin to severe pain – or sometimes infection – due to spectacular amounts of tissue damage.

Nurse: Ok good. So here we are. Mr Jones, I’d like to introduce you to Maureen, our trainee nurse who will be taking care of you. So what do you think the stage of Mr Jones’ ulcers is?

Trainee: Well, there are red-coloured patches, which don’t seem to turn white when I press my finger upon them. However, we can notice some blisters that are slightly open and that the outer layer of skin has become a little damaged. So I would tend to say that it’s more at stage two here.

Nurse: Excellent diagnosis. At that stage, the skin breaks open or forms an ulcer, which is usually tender and painful. The sore expands into deeper layers of the skin. It can look like a blister or a crater in the skin. Some skin may even be damaged beyond repair or may die. But then how can we deal with the patient’s ulcers?

Trainee: First, let’s try to reposition him in order to relieve pressure on the bedsore area. This way please Mr Jones… perfect ! Maybe we could use the foam cushions that you brought along…

Nurse: Good idea. And then?

Trainee: We’ll try to avoid any further friction maybe by powdering the patient’s bedding so as to avoid rubbing the injured skin.

Nurse: Ok. Let’s do that. And then?

Trainee: Oh, even before that, we need to clean the bedsore. The best way I guess is to use a saline solution, though it might be a bit painful, in order to remove the dead skin tissue. And we’ll cover it with a special type of gauze to help prevent infections.

Nurse: Should we also consider other factors?

Trainee: Yes, we have to make sure that the patient is well-nourished and hydrated. An adequate diet and getting plenty of water is important to keep the skin supple and healthy.

Nurse: All right. You said that the patient has some slightly open wounds. What would you suggest?

Trainee: I’ll ask the doctor for some medication to promote skin recovery and avoid the progression of infection.

Nurse: Would this be all that we can do?

Trainee: In fact we have to proceed to regular repositioning of the patient and inspection of the bedsore to avoid any complication or worsening of the symptoms.

Nurse: Excellent! You’ve got it all.