A Day in the Life of a Wound Care Nurse Practitioner
As a Wound Care Nurse Practitioner, my days typically start with a quiet cup of coffee, preferably outside. I’m a firm believer in self-care and that I need to feel my best if I am going to help others to as well. I’m usually at the clinic about 10 minutes before the first patient is scheduled to arrive. I take this time to print off my schedule, look through any paperwork that has been put aside for me and log into the computer. If there’s a new patient on the schedule for the day, I look for any paperwork that has been put aside for me or search through the EMR to give myself a feel for what they may be coming in to see us for.
And the Day Begins
The first patient arrives and is greeted and checked in by the clinic’s unit secretary. She ensures that the patient has all their documentations and scans their information into the system. While this is going on, the clinic nurse readies the exam room and then assists the patient in and gets them settled. Here, the nurse will check the patient’s vital signs, ask about any issues, and start the initial assessment. The nurse will then remove the old dressing from the wound, clean, measure, and photograph it, and then will come to report the findings to me. Prior to going into the exam room, we will typically discuss if the wound is progressing or if it has stalled or is showing signs of decline. We discuss different treatment options and, as a team, we re-enter the exam room. At this time, I greet the patient and typically will ask about their day. I always chat with the patient and try to engage them in a conversation about any concerns they may have, or even just how things are going overall. I make a conscious effort not to simply walk into the room and zero in on the wound. After all, the patient is a whole patient, and by simply looking at the wound, I would be missing out on the big picture, which is an important part of overall wound care.
Working as a Team
Once we have discussed any concerns, the nurse and I will start to examine the wound. We will typically share the measurements with the patient and show them photos from that day’s visit and compare it to the last visit. If the wound is showing positive signs of healing, we explain this; if it is showing some negative signs, we also discuss this and then we start to come up with a treatment plan. If the wound needs a procedure, such as a surgical or sharp debridement, we will explain this and discuss the merits and possible drawbacks of the procedure.
Once we have completed the exam and the procedure, we discuss our ongoing course of action. The dressings may be doing a great job and if this is the case, we explain why. If we feel the wound would benefit from other types of dressings or treatments, we discuss this with the patient as well. I feel it’s important to involve the patient as much as possible with the treatment. There are many reasons why treatments may fail to work and sometimes it may be a simple matter of the patient not being able to adhere due to outside factors. Perhaps the dressing is too expensive, or the patient simply can’t reach the area that the wound is located. Knowing this ahead of time will be an essential part of care.
The nurse will then dress the wound and print off the instructions for the patient. If they have visiting nurse services, the nurse will typically fax or email the new instructions to them. At that point, the nurse will assist the patient back into the waiting area, where the unit secretary will book them for a follow-up appointment if necessary.
The Patient is a Person
On a typical busy day, I may see between 20 – 25 patients. Each patient is unique, and I make sure that I try to put myself in their shoes. We have all had times where we need to rely on someone else for care or assistance. It’s scary and you have to trust that person to give you the time and attention that you need. It is important to remember that a typical day as a clinician or provider may be a very atypical day for that patient who came to you for help. Once I go into the exam room, that patient has my time and complete attention and focus. I will always try to leave any issues at the door and ensure the patient doesn’t feel rushed, and that they always feel listened to. I also try to document as I go. If I have a few minutes between patients, I write notes, treatment plans, and generally try to stay on track. Our clinic closes for lunch, so if I’m able to, I will go outside for a 20-minute walk to recharge and recenter myself, so I can focus on the rest of my patients that afternoon.
As the clinic day draws to a closure, I make sure that any phone call that needs to be made is done and any documentation that wasn’t completed during the day is completed. Once everything is wrapped up for the evening, I go home to spend time with my family. My clinic days are busy days, but also very rewarding. I feel like I really have a purpose with what I do during the day and I hope that I can help make someone else’s day a little bit better as well.