7. Conducting the dressing change

Transcript

Nurse: Joy is it alright if I put my dressing pack over here?

Joy: Yes, whatever you need - that is fine.

Nurse: Lovely - thank you very much.

Nurse: So.. That looks like it has leaked through a little bit then, hasn't it?

Joy: Yes, I think i must have caught it on the bed. In the hospital.

Nurse: Oh dear!

Joy: ..and it keeps breaking out and doing that

Nurse: Yes, yeh - have you had wounds on your legs before?

Joy: Er - Not terribly badly - No! I bruise, i do bruise.

Nurse: You do bruise?

Joy: ...yes.

Nurse: So erm, would you say that you heal quite well, normally?

Joy: Normally Yes, yes.

Nurse: Yeh OK, ok. Well we will have a little look at it and we will see what we think.

Nurse: ..and you say you live here with your son?

Joy: Yes, i live with my son and he is very good. He has got me these walking aids here, the zimmer frame and a commode as i can't get up the stairs - that is the difficulty.

Nurse: I see! So that is the difficulty for you at the moment. Getting up the stairs?

Joy: Yes, definetley.

Nurse: You were saying that you can't get up the stairs because of the pain, weren't you?

Joy: Well, yes it is very painful, but I'm not very good on the stairs anyway.

Nurse: Lovely, thankyou - that is lovely. (Nurse positions Joy's leg for examination).

Nurse: OK, now this is quite gentle on your skin, so hopefully it shouldn't pull it.

Joy: Good, good

Nurse: OK, Oh yes. Aww, you do not like looking at it?

Joy: Well i don't mind really.

Nurse: What we'll do - Well it doesn't look like it needs a clean to me? It has just scabbed over, so i have just put a dry dressing on.

Joy: Right...

Nurse: ...and we will probably leave it for a couple of days and then come back and look at it in a couple of days time.

Joy: ...very good

Nurse: I'll just change my gloves so i have sterile gloves on and I'll get a clean dressing as well. Just bare with me a minute. They are in here... Lovely.

Nurse: Yeh, so we will have a look at it in a couple of days. If you should get any increased pain in your leg, redness swelling or anything like that, just let me know?

Nurse: I will give you some contact numbers before i go today.

Joy: That is good - that is reassuring.

Nurse: You know, so if you do have any problems you can give us a ring.

Nurse: The dressing i'm going to put on is shower proof.

Joy: Good.

Nurse: You know i do appreciate that getting in the shower is difficult for you at the moment.

Joy: No it is just a hand basin in the toilet down here.

Nurse: OK, and do you have any carers at all Joy?

Joy: No, no. My son is very good.

Nurse: OK, so are you managing to give yourself a bit of a strip wash and things?

Joy: Yes, yes.

Nurse: Lovely. OK

Joy: Yes, it is difficult I must say. It is not easy.

Nurse: Yes! Early days, you have just come out of hospital. So hopefully, you know, give it a couple of days time and you'll start to get your confidence a bit more.

Joy: Yes, absolutely - thankyou.

Nurse: Shall I just pull that down for you? These are very nice trousers.

Joy: Oh, thankyou, they are a bit tight. Thankyou very much.

Nurse: Lovely. ..and i notice that your ankles are a little bit swollen there?

Joy: Yes, they swell at night.

Nurse: Do they, do they...?

Joy: Yes. but by morning they are usually back to normal.

Nurse: ..and i would imagine, probably sleeping on this is not going to be very helpful, because it is different for you to get your legs up isn't it?

Joy: No, it is not comfortable, no.

Nurse: Yeh, yeh - So I think what we should do, as well as coming back and erm,looking at your wound in a couple of days time. Erm, as far as your pain relief is concerned...

Joy: Yes.

Nurse: ...because you have shown me your tablets and I see what you are taking. Would you be in agreement to me contacting the G.P. to see if we can look at your pain relief and get it maybe increased a bit?

Joy: That would be very helpful. I'm sure. That can only be good.

Nurse: Yes. OK then, so we will do that, cause that will hopefully enable you to get up the stairs and around a bit more.

Joy: Yes, a bit more mobility.

Nurse: Yes. yeh, and erm the other thing I will do, if it is alright with you, is to refer you to the single point of access.

Nurse: Now, they have, erm, people that will come out and see you at home today, psyiotherapists and occupational therapists.

Joy: Today?

Nurse: Yes, yep.

Joy: Oh very good, very good.

Nurse: Yes, cause if you are struggling. It nice for you to know that you have got someway of getting up the stairs, or atleast making things a little bit easier for you to get around down here, erm falls could be a bit of a problem.

Nurse: You could have a few trip hazzards, with everything you have got in the hallway.

Joy: Yes.

Nurse: So, it might be worth your son, thinking if he can put...

Joy: Moving the bike.

Nurse: Elsewhere, yeh! yes, but if you are in agreement, I will get you referred to the single point of access and they can hopefully get a different commode.

Joy: Good!

Nurse: Something that is a bit more sturdy.

Joy: Yes, something more stable!

Nurse: and erm.. The physios might hopefully be able to get you upstairs.

Joy: Good, good - that will be good!

Nurse: So just be very mindful that you know - ..you have just come out of hospital and you are going to be quite frail, quite tired, erm you know and - just...

Nurse: Are you eating and drinking alright?

Joy: Oh yes, I eat very well really!

Nurse: Lovely.

Joy: They are very good, he is very good!

Nurse: Does he do all the cooking?

Joy: oh yes, yeh!

Nurse: ...and all the shopping?

Joy: Absolutely!

Nurse: Yes?

Joy: Everything, yes!

Nurse: Oh, that is brilliant, brilliant!

Nurse: ...and also what I'll do is, I'll order you, if it is alright with you? A cushion for you to sit on..

Joy: Yes!

Nurse: ... which is very good at preventing you getting pressure sores.

Joy: Good - good, I sit alot!

Nurse: Yep, if you sit for long periods of time...

Joy: Yes.

Nurse: and if you are sleeping quite alot at the moment as well, then that means that you are not changing your position very much.

Nurse: So we will do that.

Joy: Good, good!

Nurse: And we could also get you, what is called as a little overlay matress for your bed upstairs. erm...

Joy: Yes?

Nurse: ... Just another thing which will help prevent pressure sores.

Joy: Good, good!

Nurse: ... And they don't make the bed that high!

Joy: I was going to say...as long as I... because I'm not very long in the leg!

(Laughter).

Joy: I don't need it higher!

Nurse: You need to put your feet to the floor don't you!

Joy: I do indeed, i do indeed!

Nurse: Yes, yep. Alright, does that sound alright then Joy?

Joy: Sounds splendid.

Nurse: Lovely!

Joy: Hope it all comes off.

Nurse: Yes and I'm sure it will do..

Nurse: So what I'll do... I'll give you our contact numbers as I say. I have got a bit of computer work to do...

Nurse: So I will just take my apron off and go and wash my hands again and then if it is alright with you. I'll sit and do my computer work while I'm in the house. Alright?

Joy: Yes, that is fine, fine!

Nurse: Lovely! OK, so let me just pop this in the bin.

Joy: Good.

Nurse: Whereabouts, do you want me to put the rubbish?

Joy: In the kitchen. There is a bin in the kitchen.

Nurse: It doesn't need to go in any special bin because it is not what we would class as clinical waste. It is not infected or anything.

Joy: Well, whatever you think. That is fine.

Nurse: All right then, OK. So I will just go and wash my hands again and then I will do my computer work.

Joy: Good.

Nurse: Thankyou!

Joy: OK0!