Guest guest Posted December 5, 2008 Report Share Posted December 5, 2008 indeed .  rule one-IT,never heard of it. one good power surge,criminal alteration or failed storage device and you are snookered(behind the eight ball for our American Friends)  no need for a quill,a decent fountain shall suffice. copperplate not required-just legible with any alteration crossed through once and initialled. back in the mists of time when a young student nurse,a wise old tutor told me the first two rules. she also suggested that I adopt ish police tactics and get corroboration when a matter was serious. in Scots law you need a witness. cops go about in twos. hence get it signed by a witness or better still one of higher rank.  hence rule 5-always communicate-all over the place preferably(within ethical boundaries of course). kick it up to topside. get advice(as done here),and sign everything-time and date stamp as well.   rule 2-,I think if its legible its OK. spell check first on those computer thingies -then write down. or carry a small dictionary and thesaurus.   rule 3-yes ,the blame game. great fun for all,except the person left holding the recordable injury. see rule one-tell everyone,and then its diluted. still too many police HSE,not enough Coach/mentor ones. but with shyster lawers still plying their loathsome trade,one can see why HSE are reluctant to stop covering arse by finding a root cause that is AKA blame.  rule 4-see three above. but keep a good journal. perchance one of those digital voice recorders. get it corroberated by others-get other documents to list your facts. remember dragnet-just the facts mam! and then like shakespear in juliues caeser,you can say  there is no terror in your threats for I am armed so strong in honesty that they pass by me as the idle wind which i respect not.  Finaly in this world of extended roles,ie doing things that we might get jailed for,but we do cos we have been trained and are cheaper than docs(did I say that out loud again?)  rule six. before initiating a course of action-stop and think. think about you in a dock. before either a group of peers in a professional hearing or a selection of the general public(perhaps in a country without your home ones legal system and safeguards), and before you is a lawer in a suit that would cost several months of your salary. you tell them all what you did and why. does it make sense? is it plausable? if not-do not do it. Fraser       > Dear , > > Thank you for your reply which is helpful to see what you would want > in treatment continuation notes. > > A/ 'Wound Toilet' is the cleaning of the wound area prior to > applying the dry dressing, main purpose for a Venous Ulcer is to > keep it moist and clean. > > B/ Venous Ulcers are most frequently located on the lateral aspect > of the ankle, as a result of the mechanism causing them. > > C/ The cause is age - venous wear & tear - varicose veins - gravity, > as a gradual process. > > D/ Size of ulcer will take time to change once treatment starts with > healing it generally gets bigger first - in ideal circumstances a > specialised dressing is done once a week - in remote location with > circumstances of work bd is OK - can take a month to change - so > daily there is no need for measurements. > > E/ Venous ulcers would rarely be bilateral - the oedema is venous > fluid under pressure from gravity so stays in lower region of ankle > around the laterall malleous - part of the treatment is periods of > foot elevation during the day and at night - while the principle > healing comes from compression of the venous system - tubi-grip - > reinforcing natural venous return, which will encourage a reduction > in the oedema. > > F/ As this is a long term treatment then bed rest and restricted > duties for a cook are excluded and as this is not a debilitating > problem, when treated, so full duty is OK. > > It is an interesting condition and as mentioned the treatment is > long term and quite specific unless infection gets in then anti- > biotics are included, sometimes NSAIDs for pain from exposed nerve > endings. > > The points you raised are appreciated but being now familar with the > situation would you require that degree of information, twice daily, > to have an appreciation of the progress, or could you be comfortable > with - ' Varicose Ulcer - clean - moist', treatment, 'Wound toilet - > dressing - tubigrip', considering that usually you would have a > verbal hand over to your relief as well. > > There has been a discussion re this and we are interested in other > points of veiw. > > Brgds > > P. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 6, 2008 Report Share Posted December 6, 2008 " If in doubt, don't " thanks Carl > Dear , > > Thank you for your reply which is helpful to see what you would want > in treatment continuation notes. > > A/ 'Wound Toilet' is the cleaning of the wound area prior to > applying the dry dressing, main purpose for a Venous Ulcer is to > keep it moist and clean. > > B/ Venous Ulcers are most frequently located on the lateral aspect > of the ankle, as a result of the mechanism causing them. > > C/ The cause is age - venous wear & tear - varicose veins - gravity, > as a gradual process. > > D/ Size of ulcer will take time to change once treatment starts with > healing it generally gets bigger first - in ideal circumstances a > specialised dressing is done once a week - in remote location with > circumstances of work bd is OK - can take a month to change - so > daily there is no need for measurements. > > E/ Venous ulcers would rarely be bilateral - the oedema is venous > fluid under pressure from gravity so stays in lower region of ankle > around the laterall malleous - part of the treatment is periods of > foot elevation during the day and at night - while the principle > healing comes from compression of the venous system - tubi-grip - > reinforcing natural venous return, which will encourage a reduction > in the oedema. > > F/ As this is a long term treatment then bed rest and restricted > duties for a cook are excluded and as this is not a debilitating > problem, when treated, so full duty is OK. > > It is an interesting condition and as mentioned the treatment is > long term and quite specific unless infection gets in then anti- > biotics are included, sometimes NSAIDs for pain from exposed nerve > endings. > > The points you raised are appreciated but being now familar with the > situation would you require that degree of information, twice daily, > to have an appreciation of the progress, or could you be comfortable > with - ' Varicose Ulcer - clean - moist', treatment, 'Wound toilet - > dressing - tubigrip', considering that usually you would have a > verbal hand over to your relief as well. > > There has been a discussion re this and we are interested in other > points of veiw. > > Brgds > > P. Quote Link to comment Share on other sites More sharing options...
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