Visualize a body riddled with blisters and open wounds over 80% of its surface and within orifices. Imagine the accompanying discomfort and frustration faced by the patient as his caregivers take on the daily task of removing old dressings, cleansing wounds, applying ointment, and reapplying clean dressings and wraps. That was the scenario faced by the 6 East Medical Surgical Oncology Unit staff for 75 consecutive days.
A male patient, diagnosed with a severe autoimmune condition, was admitted to 6 East for over 75 days. His condition affected him from head to toe, with skin blisters and open lesions over 80% of his body, to include his oral cavity, requiring extensive daily dressing changes. A multidisciplinary approach was paramount to his care and successful recovery.
Daily care was coordinated with the primary care and charge nurses, Wound Care Nurses, Infectious Diseases, Dermatology, Internal Medicine, Environmental Services, Nursing Assistants, and Materials Management, and required collaboration with ancillary staff such as Ward Clerks and others who supported the nursing staff in their challenging work. In the beginning, it took two hours and a minimum of three staff members to perform his dressing change. Upon discharge, the time had been cut by half. The patient was assessed every day for physiological pain and psychosocial needs and was provided pain medication and appropriate room temperature maintained to the patient's comfort prior to dressing changes. Empathy and compassion were necessary elements of his care.
Despite challenges, the dedicated and skillful nursing staff completed the daily tedious, time-consuming, critical dressing changes, which included cleansing the whole body with normal saline, applying steroid appointment, Mepilex transfer, and plastic wrap. The nursing team performed care in a manner that ensured minimal discomfort and prevention of life-threatening hospital-acquired conditions such as infection and superimposed pressure injuries - to which he was at increased risk.
As partners in care, the patient and family exhibited patience and appreciation for the extraordinary care provided by his caregivers. The 6 East nursing and Materials Management supervisors communicated weekly to ensure adequate supplies would be available daily. At the time of discharge wound care supplies were provided to the patient for one week until seen by the Home Health RN.
The 6 East staff developed and executed an effective and efficient multidisciplinary approach to specialized individualized care for our patient. On discharge, the staff sent our patient off with well wishes, and a sign they created, which read, "Congratulations, You Will Be Missed." This brought tears to his eyes.
This outcome could not be achieved without a dedicated, empathetic, and compassionate multidisciplinary team, and reflects our commitment to fulfilling our KP Mission and living our Nursing Visions and Values.