Once more the nurses have no supplies…

New rules sort of apply here – The View from Bed Three. No photos.

Surgery is looking more attractive by the day. Nurses arrived an hour late this morning, no explanation, no apology and – even worse – no supplies. AGAIN!

So I had to raid my hidden, only to be used in the direst emergency stash, meagre though it is. Or was – it’s now gone. And I had to construct a usable dressing by combining 3 separate items. It works, but it shouldn’t have to happen!

And, I’m sorry to say, there was a lot of anger – mine. When they say, at 11.00 “We’ll be there in half an hour” and still haven’t shown up by 12.30 a phone call at some point isn’t an unreasonable expectation, not least because when leg ulcers are exposed to the air they become even more painful than normal. And trust me, normal is something you do not want to experience. As it was I was sat here wetting it down with Prontosan wound wash to keep it moist.

I know lack of supplies isn’t the nurses’ fault, and I made that clear, but I do hope that they report back just how bloody furious I was at this apparently endless fuckuppery.

Someone is doing a piss-poor job. I don’t know if the problem is one of funding – hey, I’m just one of the many patients who are suffering, and we’re clearly not important enough to be kept informed – or plain, old-fashioned, incompetence but, as I said previously, part of my job in a previous life was ordering supplies for a shipyard medical centre, and running out wasn’t just a capital crime (well, almost), it simply wasn’t allowed to happen. The Community Nurse service should be no different.

It puts patients at risk (I, for example, have no more dressings, yet mine will still need changing over the weekend**), and it puts nurses at risk from violent patients who are terminally pissed off (and they’re not always tattooed thugs – little old ladies with walking sticks can be dangerous too).

**OK, I’m nothing if not resourceful (not to mention modest Winking smile ), and as long as I have my Aquacel Ag bactericidal dressings I can build on that and cobble up what I need from scratch – I need a sterile absorbent pad – I have lots – a sterile impermeable membrane so that it doesn’t either leak through or, worse, dry out and weld itself to the wound which, as well as pain, causes damage when it’s removed, which I’ll have to make, and find a way of securing the whole assembly to my leg in such a way as to not cause more damage. The proper dressing, even the improvised one described below, is adhesive, the DIY version won’t be.

I’ve done all this when the ulcer was the size of 2 5p coins. I dare say I can still do it now it’s the size of my hand, though it does increase the risk of infection.

But – I keep coming back to this – I shouldn’t bloody well have to!

And what about the patients who are too ill, don’t have a stash, or the initiative, to fend for themselves. What of them? Are they expected to keep dressings in place until the decay? Or infection sets in? Today the nurse brought me a handful of Aquacel Ag – that’s the bactericidal pad that’s applied directly to the wound. These are normally topped with an impermeable hydrocolloid pad, or an absorbent foam pad with an adhesive border. The nurse had nothing.

I had three of the latter, small ones from when the ulcer was small, two of which I combined into one larger pad which was just barely big enough (stretching “big enough” to breaking point), the nurse sitting watching, “so I can see what you do,”. I actually devised this combination of products months ago, and got it approved by the nurses, and it was clear that the idea was novel which, to be honest, I find worrying. I find it hard to believe I’d come up with something the pros hadn’t, but that did seem to be the case.

 

On a different note, something is going on with my GP. He’s being helpful. Today I got my second 6-month supply of hydrocortisone. And last week I got my Oramorph early, without so much as a token gripe.

He seems to have given up arguing with me.

Then, on Wednesday, there was the possibility of surgery offer out of the blue. Last time I mentioned it he just wouldn’t talk about it – flatly refused. So what’s changed?

Can it be that, as with my COPD, I’m much worse than I think I am? Which really wouldn’t surprise me given the severity of my pain, which also now extends from toes to hip. Today’s nurse was all in favour of the surgery too, and the nurses are against amputation on principle, normally.

I do know I’m profoundly weak again. If the surgery is to go ahead, I’ll have to be able to get around on one leg and crutches for a while. I’ve just tried – I can’t – I simply don’t have the strength. Not even to move the couple of feet to transfer from bed to wheelchair.

Something has changed that I don’t know about, that’s for sure, and I have a horrible feeling that this weakness is just the tip of a rather large iceberg. The research I’ve done and the information I’ve downloaded since my “promotion” to COPD Stage 3 suggests I’m seriously screwed from almost every perspective, and that such severe weakness isn’t unexpected as a result of poor oxygenation.

And as far as I’m concerned, heart failure is still in play.

On that note I’m off to bed.

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5 thoughts on “Once more the nurses have no supplies…

  1. on the rare occasions i have needed the help of the district nurse team, i too have found myself using what I’ve got here on more than one occasion. when i get a skin tear , i need to put a dressing on straight away.I bleed like a stuck pig at times. if its in a place where i cant see what I’m doing, usually back of my upper arm,(even through a mirror its difficult to see properly exactly how bad it is. and therefore what it needs putting on.) that’s when i need help for the first 2-3 days. i just slap a mepore on (these days with a small square of inidine on it to stop it sticking)until they can come up here to check it out.i no longer am expected to go to their building for it doing. i am aghast though at them cleaning wounds with tap water.(i insist on having some ready in a very clean bowl rinsed in boiling water…and then boiled water put in it and covered by a piece of gauze or saucer or something.better than tap water anyway n cooled enough by time they arrive.) many times have they told me they have difficulty in obtaining certain types of dressings. either because of cost or because they’ve been pulled off the market.what they do manage to get has to be eked out between the patients on their books. anyway. for what its worth Ron. that’s what nurses over here in my part of Yorkshire have told me.
    hope things improve for you very soon.

    • They’ve just withdrawn Prontosan wound wash here. Can’t say I’m too surprised as as far as I can tell it’s no better than Normal Saline. The bactericide I use to clean my ulcer,Octenisan, is still available though. I could be in trouble is they lose that.

      I’ve just bought a new nebuliser, so buying more dressings is out. I compared a pro model £80-ish to a very plain but much cheaper model, both from Omron – and both have the same output and the same retention percentage (so quite possibly the have the same compressor). They certainly have the same nebuliser unit. So I got the cheap one from Amazon and saved 50 quid. The main attraction was the quietness of the cheap one – nebs are noisy damn things at the best of times!

      I bought two packs of dressings earlier this year – for emergencies like this. Then I noticed some of them would turn up without any of their own, and use mine instead, and at £27 a pack it’s not exactly pocket money. And, of course, when we got an emergency, they’d been used up already! The current ones would be £10 a day, so no way I can buy those.

      The problem with tap water is that I have to soak my leg in a bucket of water almost knee-deep – I just don’t have the means of boiling that much water and, to be honest, if tap water (from the hot tap), is heated to 60C it’s considered safe. I do monitor that as below 60 it can be a breeding ground for nasties like Legionnaires Disease.

      But here’s some nurse logic. I have to line the bucket with a bin bag, “because they’re sterile inside”. Probably true, with the heat of the manufacturing process. The same is also true for food bags – exactly the same process, but if I use a piece of food bag as an impermeable membrane, as I will later today, they practically have a stroke!

      Anyway, on a lighter note I’ve just portioned 4 litres of this
      https://ronsrants.wordpress.com/2014/01/31/organic-lamb-casserole-a-recipe-with-a-middle-eastern-vibe/

      I couldn’t get dates so I had to use dried apricots. They’re a bit sweeter but it tastes just as good, maybe even slightly better. I got 7 full portions and one that’s about equal parts meat, veg, and gravy. Not sure what I’m doing with that – might just pour it over a plate of chips! Not exactly Haute Cuisine, but by god it’ll taste good.

  2. or a nice big Yorkshire pudding. a wee bit healthier than chips (but then i rarely eat chips and on the odd occasion i do ill eat about half a dozen and that’s mi lot.lol.)
    Nebuliser….don’t they issue those on prescription nowadays then?

    • Nebules are on prescription, don’t think the nebulisers are. They might be though – most people call the whole machine the nebuliser, but the actual neb is just the little plastic aerosoliser on the end of the tube. The machine is the compressor – the expensive bit.

      If the whole thing is on prescription, then you can be sure it’ll be the horrible, noisy, heavy, hospital machine. Mine’s nice and light, and quiet – both important.

  3. Hi Ron, I can really empathise with your plight about dressings. My late father had problems from time to time with his supply if dressings for his venous/arterial ulcer. The Gp came once and made a decision as to what was required. He phoned the DN office to ensure a supply; he was assured there was. No effort was made to deliver the dressings. If we. ( his family) hadn’t taken the initiative to go to the office to collect the dressings, he would have had to wait until Monday as it was 5pm on a Friday pm! The nurse was totally dismissive when this was pointed out to her. This was reported to the Gp who said it was “typical” of this nurse! But he couldn’t intervene in the situation as the DN’s didn’t come under his jurisdiction!! :/ Fortunately despite this Dads ulcer healed 11 months later.
    Keep fighting!

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