Has anyone or know anyone who has had wound care?

[ilovedolphins]

My dad poked his leg with a brake wire on his walker in January.  We live in a small town about 2 hours away from a big city.  I have been taking him 2 to 3 times a week to our hospital here in town and three RN's have been tending to his wound.

Since January 24 they have tried 4 different medicine packs to get it to healing and none have worked.  As a matter of fact the wound is worse than when we started because one of the nurses didn't put a bandage over the wound pack, just wrapped it with gauze, so the wound pack moved off the wound and for 3 days was eating away at his healthy skin.  The nurse even dropped the gauze on the floor and picked it up and wrapped it around his wound.

My dad is in dire pain, to the point of tears, with this wound.  Sometimes they just laugh off his pain and tell him it shouldn't hurt that much.

I am fed up with them and want my dad to go someplace else.  He has an appointment with his dermatologist on March 15 and I want him to look at it.  His office said that his doctor should have referred him to a specialist if it hasn't started to heal by now.  But my dad is worried because we live 2 hours away from anywhere that we will have to make several trips a week to wound care.  

The 3 RN's here say it will take more than 6 months to heal this wound.  I can't see me or my dad making it that long.

Does anyone have any thoughts or knowledge on wound care?

[Deleted]

Does your dad have diabetes? 

[busymom]

I don't know the details of her treatment, but I had an older relative who, every winter, had to go to a wound care center.  She had thin skin (like I do), and her leg skin gave her all kinds of trouble in the winter.  Her children told me the wound care center reduced her pain, and definitely made a difference.  If there is a wound care center close to where he is staying, I'd give them a call.  A pox on the staff that is downplaying his pain.  It may be time to find him somewhere else to live.  

[Deleted]

Not a Dr, but has Negative Pressure Wound Therapy been considered?

advancedtissue.com/2014/08/healing-negative-pressure-wound-therapy/

[CCL]

Does he have a home care nurse?

I've had some experience with wound care, but not an expert by any means.

[CCL]

What about IV antibiotics? Has he had surgery? Do they have you doing dressing changes? What does doc say?

It's been a few years since my experiences, but, based on those, I'd be concerned about him, too.

[NomoreDramaQ1015]

I would be reporting those nurses. That's awful and how many other patients are they acting like this with?

It may not result in anything now but the complaint will follow them and if more people complain action will be taken.

I agree with he needs to see a wound specialist first and foremost.

Do you have a VNA nearby? My FIL got a temporary home nurse set up thru the wound care clinic when he got an ostomy bag. I will warn you they had to pay OOP for the nurse but IMO it was worth it to ensure proper care and healing.

If none of those are options can he qualify for temporary nursing home care? My MIL went to one after serious surgery because my 87 year old FIL would not have been able to care for her. This can also be costly though. I think MIL was covered for 30 days? Enough to recover in her case that she could go home with SIL checking in.

It's rough. My grandmother lives 45 minutes away from the nearest hospital, there isn't even a doctor's office in her Podunk town. It was a nightmare when my grandfather had cancer.

My parents are dreading her becoming ill/hurt but she refuses to move.

[ilovedolphins]

Mar 2, 2019 9:45:34 GMT -5 @bamafan1954 said:

Does your dad have diabetes? 

No he doesn't.

[ilovedolphins]

Mar 2, 2019 10:16:38 GMT -5 CCL said:

Does he have a home care nurse?

I've had some experience with wound care, but not an expert by any means.

No he doesn't.  Just the RN's at the hospital are treating him.

[ilovedolphins]

Mar 2, 2019 10:23:09 GMT -5 CCL said:

What about IV antibiotics? Has he had surgery? Do they have you doing dressing changes? What does doc say?

It's been a few years since my experiences, but, based on those, I'd be concerned about him, too.

They have given him 2 rounds of oral antibiotics.  He hasn't had surgery.  I don't change the dressing...I take him to the hospital 2 to 3 times a week so the RN's do it.  The doctor doesn't really seem to have an opinion.  The RN's are picking the medication to use on the wound.

[dannylion]

It sounds like he needs to be referred to a tertiary care center with a wound-care facility (preferably not a stand-alone wound-care center not associated with a hospital).  The treatment he is receiving has not resulted in improvement in his condition, so he needs to understand that regardless of the perceived inconvenience, he needs to seek a different level of care.  It is unlikely that the treatment he is currently receiving will result in a favorable outcome as it has not produced any results so far.  From your description, the competence of the caregivers seems marginal, at best.  What competent nurse picks up gauze from the floor and applies it to a patient's wound?  You are absolutely right to be concerned and looking for a better facility.  


A dedicated wound-care center will have seen and treated wounds similar to his and will have the equipment, materials, and expertise to improve his condition.  It is possible that it could take some time for his wound to heal.  A competent team of caregivers will address his pain; they will not make fun of it.  No caregiver should ridicule a patient's complaints of pain.  Ever.  

[ilovedolphins]

Mar 2, 2019 10:33:38 GMT -5 NomoreDramaQ1015 said:

I would be reporting those nurses. That's awful and how many other patients are they acting like this with?

It may not result in anything now but the complaint will follow them and if more people complain action will be taken.

I agree with he needs to see a wound specialist first and foremost.

Do you have a VNA nearby? My FIL got a temporary home nurse set up thru the wound care clinic when he got an ostomy bag. I will warn you they had to pay OOP for the nurse but IMO it was worth it to ensure proper care and healing.

If none of those are options can he qualify for temporary nursing home care? My MIL went to one after serious surgery because my 87 year old FIL would not have been able to care for her. This can also be costly though. I think MIL was covered for 30 days? Enough to recover in her case that she could go home with SIL checking in.

It's rough. My grandmother lives 45 minutes away from the nearest hospital, there isn't even a doctor's office in her Podunk town. It was a nightmare when my grandfather had cancer.

My parents are dreading her becoming ill/hurt but she refuses to move.

No there isn't a VNA nearby.  And he refuses to go to the nursing home.  He says you go there to die and I don't know if I would want him in the one in our town.  My aunt is in there for broken bones and the people don't treat her very well.

[chapeau]

He sounds like he needs a wound care center. Once they get something set up there a visiting or home care nurse should be able to do the day to day stuff.
They can do a lot of things there to make him more comfortable and speed his healing. And those nurses should definitely be reported.

[NomoreDramaQ1015]

Mar 2, 2019 10:41:15 GMT -5 ilovedolphins said:

Mar 2, 2019 10:33:38 GMT -5 NomoreDramaQ1015 said:

I would be reporting those nurses. That's awful and how many other patients are they acting like this with?

It may not result in anything now but the complaint will follow them and if more people complain action will be taken.

I agree with he needs to see a wound specialist first and foremost.

Do you have a VNA nearby? My FIL got a temporary home nurse set up thru the wound care clinic when he got an ostomy bag. I will warn you they had to pay OOP for the nurse but IMO it was worth it to ensure proper care and healing.

If none of those are options can he qualify for temporary nursing home care? My MIL went to one after serious surgery because my 87 year old FIL would not have been able to care for her. This can also be costly though. I think MIL was covered for 30 days? Enough to recover in her case that she could go home with SIL checking in.

It's rough. My grandmother lives 45 minutes away from the nearest hospital, there isn't even a doctor's office in her Podunk town. It was a nightmare when my grandfather had cancer.

My parents are dreading her becoming ill/hurt but she refuses to move.

No there isn't a VNA nearby.  And he refuses to go to the nursing home.  He says you go there to die and I don't know if I would want him in the one in our town.  My aunt is in there for broken bones and the people don't treat her very well.

Have you called your state's elder services department or maybe try A place for mom? The social services office at the hospital?

They might be able to connect you with services "nearby". My parents had to comb the county before the found a VNA to go to Treynor. Omaha and Council.Bluffs consider it outside their district.



I get it from the VNA perspective. It highlights what a risk it is for an elderly person to live in a one horse town.



He may not have a choice unfortunately regarding having to move. That wound cannot be allowed to fester. A loss of limb would be far worse than temporary nursing home care.

I'm so sorry.

[The Walk of the Penguin Mich]

At this point, he needs to see a specialist, and possibly an infectious disease doctor.  Throwing antibiotics at a wound when there has not been a culture and sensitivity of it done is bad medicine, and causes more problems than it solves.  

[CCL]

I wasn't going to say it because I didn't want to scare you, but loss of limb is a very real complication of wound infections.

If this was my family member, I'd be insisting on an infectious disease doc consultation.

We obviously don't know all the details of his condition, but there is no way I would leave the situation as it is. He's receiving medical care, but is getting worse, not better, and they don't seem to be doing much to remedy that. That would be a big problem for me.

Google something called osteomyelitis, but beware of graphic photos.

[NomoreDramaQ1015]

Mar 2, 2019 10:39:15 GMT -5 ilovedolphins said:

Mar 2, 2019 10:23:09 GMT -5 CCL said:

What about IV antibiotics? Has he had surgery? Do they have you doing dressing changes? What does doc say?

It's been a few years since my experiences, but, based on those, I'd be concerned about him, too.

They have given him 2 rounds of oral antibiotics.  He hasn't had surgery.  I don't change the dressing...I take him to the hospital 2 to 3 times a week so the RN's do it.  The doctor doesn't really seem to have an opinion.  The RN's are picking the medication to use on the wound.

9

Report the doctor too. They'd be hearing me tear the doctor a new one in the next county. It's his fucking job to have "an opinion"!

[ilovedolphins]

I just got back from taking him again.  I am so done with that place.  Whatever registered nurse is on duty does the wound care.  They all do it differently and it's never the same one so they can't say if it's getting better or not.  Today the nurse put a soaked gauze square over the wound and then put the medicine patch on it.  How does the medicine patch work if it's not on the wound.  They haven't done it like that before.  Ugh.

[CCL]

Mar 2, 2019 10:39:15 GMT -5 ilovedolphins said:

Mar 2, 2019 10:23:09 GMT -5 CCL said:

What about IV antibiotics? Has he had surgery? Do they have you doing dressing changes? What does doc say?

It's been a few years since my experiences, but, based on those, I'd be concerned about him, too.

They have given him 2 rounds of oral antibiotics.  He hasn't had surgery.  I don't change the dressing...I take him to the hospital 2 to 3 times a week so the RN's do it.  The doctor doesn't really seem to have an opinion.  The RN's are picking the medication to use on the wound.

I'd be asking for cultures and expecting IV antibiotics.

Can they teach a family member to perform additional wound care? I have done dressing changes and IV antibiotics multiple times daily. Then oral antibiotics for many months after that.

[Lizard Queen]

Sometimes you have to raise a stink in order to get people to step up. A lot of these places break things down so much that they only go through the motions. Raising a stink could knock it into a different level of care.

[ilovedolphins]

Mar 2, 2019 12:10:29 GMT -5 NomoreDramaQ1015 said:

Mar 2, 2019 10:39:15 GMT -5 ilovedolphins said:

They have given him 2 rounds of oral antibiotics.  He hasn't had surgery.  I don't change the dressing...I take him to the hospital 2 to 3 times a week so the RN's do it.  The doctor doesn't really seem to have an opinion.  The RN's are picking the medication to use on the wound.

9

Report the doctor too. They'd be hearing me tear the doctor a new one in the next county. It's his fucking job to have "an opinion"!

I keep telling my dad he needs to go to a different doctor.  This is the same doctor that wouldn't give him pain pills for his back pain and told him to take an obscene amount of ibruprofen.  My dad ended on a flight for life helicopter with a bleeding stomach ulcer and almost died.  Then he went to him for some preskin cancer stuff and he prescribed a cream that wasn't even for that.  The dermatologist couldn't figure out why he would prescribe that for preskin cancer.  

When my mom fell and broke her shoulder and I took her to the emergency room the nurse who came to the car with a wheelchair wouldn't help her out and blocked my way to help her out.  She said she could get out on her own.  My mom couldn't get out of the car on her own without a broken shoulder.  We did report her and she got a suspension.

I don't go to this place for medical care.  I will drive 30 miles to my doctor.  I actually drove 30 miles to my doctor at midnight a couple years ago with severe kidney stone pain.  There was no way I was going to the doctors in my town.

[CCL]

Mar 2, 2019 12:10:29 GMT -5 NomoreDramaQ1015 said:

Mar 2, 2019 10:39:15 GMT -5 ilovedolphins said:

They have given him 2 rounds of oral antibiotics.  He hasn't had surgery.  I don't change the dressing...I take him to the hospital 2 to 3 times a week so the RN's do it.  The doctor doesn't really seem to have an opinion.  The RN's are picking the medication to use on the wound.

9

Report the doctor too. They'd be hearing me tear the doctor a new one in the next county. It's his fucking job to have "an opinion"!

Agree! I'd give the doc a chance to explain the situation, but then he better do something about it!

[CCL]

Mar 2, 2019 12:12:14 GMT -5 ilovedolphins said:

I just got back from taking him again.  I am so done with that place.  Whatever registered nurse is on duty does the wound care.  They all do it differently and it's never the same one so they can't say if it's getting better or not.  Today the nurse put a soaked gauze square over the wound and then put the medicine patch on it.  How does the medicine patch work if it's not on the wound.  They haven't done it like that before.  Ugh.

Those nurses ought to be able to document his condition and treatment well enough so that any other healthcare worker can understand what's going on. That's ridiculous!

ETA: Nurses don't just "pick a medication." A doctor, or equivalent like nurse practitioner, has to prescribe it.

[CCL]

From what you have shared here, if this were my family member, I'd take him to the ER in a bigger city and get another opinion. I wouldn't wait for another doc appointment. This is based on my experience, but we (YM) really don't know how bad the wound is, so you have to use your own judgement.

[ilovedolphins]

They said they could numb the area so it didn't hurt so much but the manufacturer of their 5% lidocaine is having a problem with production.  Are you telling me there isn't any thing else that will help with the pain or another company to get it from.  I can get on Amazon and buy some which I will probably do just to see if it will help on the area around the wound that hurts.

[ilovedolphins]

Mar 2, 2019 12:21:33 GMT -5 CCL said:

Mar 2, 2019 12:12:14 GMT -5 ilovedolphins said:

I just got back from taking him again.  I am so done with that place.  Whatever registered nurse is on duty does the wound care.  They all do it differently and it's never the same one so they can't say if it's getting better or not.  Today the nurse put a soaked gauze square over the wound and then put the medicine patch on it.  How does the medicine patch work if it's not on the wound.  They haven't done it like that before.  Ugh.

Those nurses ought to be able to document his condition and treatment well enough so that any other healthcare worker can understand what's going on. That's ridiculous!

ETA: Nurses don't just "pick a medication." A doctor, or equivalent like nurse practitioner, has to prescribe it.

It appears the nurses are choosing what to use.  The first few times they tried medihoney.  It didn't work so right then they said well let's try this other kind.  They have just decided in the appointment that they are trying something else.  They don't ask a doctor because they don't even leave the room.  They go get it and put it on.

[skeeter]

It sounds like you trust YOUR doctor a lot. Even though it is 30 miles away, could you take your dad there for a second opinion even though he is not his patient? Your doc might be willing to see him, especially if you mention wound is getting worse.

[Deleted]

BUY THIS! 


www.amazon.com/Amerigel-Wound-Dressing-Tube-Ounce/dp/B0001ZA3YW/ref=sr_1_3?hvadid=177769654227&hvdev=c&hvlocphy=9032672&hvnetw=g&hvpos=1t1&hvqmt=e&hvrand=11182027581452212700&hvtargid=kwd-3636796696&keywords=amerigel+wound+dressing&qid=1551548851&s=gateway&sr=8-3&tag=googhydr-20

My late husband had diabetic ulcers on his feet. The doctors and wound clinic told him they wouldn't ever heal. 

His mother read an article about the Amerigel and bought him some. The doctors said it couldn't hurt but wouldn't help.

In TWO WEEKS his ulcers were GONE. We had more ulcer issues later in his life and every time this stuff worked.

It worked so well the doctor got Kaiser to do a study on it and was trying to get them to use it in their wound clinics. 

It's the BEST $20 you will ever spend. I promise. 

[The Walk of the Penguin Mich]

At this point, I’d be going to an ER with a good ID department.  It might be one associated with a university.

If a wound is infected, your dad can get septic quickly (I have personal experience with this), then it isn’t a matter of simply pain and and increasing wound, but his life.

[NomoreDramaQ1015]

Mar 2, 2019 12:35:53 GMT -5 ilovedolphins said:

Mar 2, 2019 12:21:33 GMT -5 CCL said:

Those nurses ought to be able to document his condition and treatment well enough so that any other healthcare worker can understand what's going on. That's ridiculous!

ETA: Nurses don't just "pick a medication." A doctor, or equivalent like nurse practitioner, has to prescribe it.

It appears the nurses are choosing what to use.  The first few times they tried medihoney.  It didn't work so right then they said well let's try this other kind.  They have just decided in the appointment that they are trying something else.  They don't ask a doctor because they don't even leave the room.  They go get it and put it on.

If this is exactly how you describe you need to report this ASAP. It should also go to the state medical and nursing boards. If they are not nurse practitioners they are not licensed to be changing medicines or treatments.

You need to have your dad sign permission for you to access his records if he has not already done so. You need ALL the information to find the truth of what's going on.



I know it's hard but given your description you don't have another option besides driving 2 hours out. These nurses could end up killing your dad.

If he can't advocate you have to.