Bedsores, what bedsores?
BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7365.623 (Published 21 September 2002) Cite this as: BMJ 2002;325:623
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Reading the filler "Bedsores, what bedsores?" I was reminded of my
own observations of the standard of basic nursing care on wards these
days.
I fear that, in their rush to promote nursing as an academic subject, the
Royal College of Nursing has paid inadequate attention to the basics of
nursing.
I am worried that a similar mistake is being made by the Royal College of
General Practitioners.
Competing interests: No competing interests
I suspect prevention of bedsores has been lost in the rush to make
health care jobs more sophisticated. Basics are basics but also are
usually quite boring! Often as we work at the margins of care we assume
wrongly that the basics have been done.
Competing interests: No competing interests
The "filler" entitled Bedsores, what bedsores in September 21st BMJ
completely concurs with the view I find widely held by older medical &
nursing staff. Many nursing practices which were thrown out shortly after
the radical change to the Nursing profession brought about by the Salmon
Report appear to have had beneficial effects on patients. Would the
evidence for their cessation now withstand the rigors of evidence based
medicine? Perhaps the real reason for abandoning the 2 hourly "back round"
was that it allowed reductions in staffing.
The traditional nursing practices tend to survive in military
establishments. Could someone organise a well founded clinical trial
comparing traditional nursing care with the current practice?
Competing interests: No competing interests
Bedsores. What Bedsores
Dear Sir:
Re: Bedsores, what bedsores? BMJ Sept. 21, 2002 Page 623
As a nurse of the old school (SRN 1961) I remember well the routine
for the prevention of bedsores.
Anonymous is quite right. All hell broke loose at the first sign of a
skin breakdown, but bedsores did occur in spite of our best efforts. When
I trained, personal patient care was provided by fulltime student nurses,
supervised by a career Sister. All that has changed. The student now
attends college full time and tends to patients during the required
clinical rotations.
Having seen many hip replacements, I do wonder why Anonymous lost
four pints of blood during the procedure, and why he had to wait two days
for a transfusion. He does not say if he was out of bed or moved at all
during this time, but he was clearly debilitated and anaemic, setting the
stage for an infection.
Current infection control teaching in this country (USA) emphasizes
effective handwashing as the best prophylactic. This is equally important
in the hospital and home.
Mrs. Anonymous is to be applauded for her advocacy for her husband.
More family members should speak up.
I am currently a Registered Nurse with additional certification in
Hospice and Palliative Care, working for a Hospice in the USA. The main
focus, in our practice, for the prevention of skin breakdown, is
scrupulous skin cleanliness, frequent change of position and the use of
moisturizing lotions. These measures help maintain skin integrity and
minimize tiny cracks, which provide a portal of entry for infection.
Sincerely,
Veronica K. Tidd RN ,CHPN (USA) SRN,ONC (UK)
Competing interests: No competing interests