5 January 2026
When I got to Golden Heights on Sunday, I found out Emilla the RN (who has done Joyce's wound dressing change when the wound care RN was off) had gone home sick.
I found this out when Joyce's dressing fell off in the bathroom and I went to get the wound care nurse to dress the wound immediately.
So who's doing the dressing? The RN. Who's the RN?
Well, it was Sunday and the understaffed facility draws from "the registry" for an RN to fill in.
So we have a guy who had never done the dressing change stuck with reading the miniscule instructions on the screen of the wound care cart to dress Joyce's wound less than a week before Dr. Holland tries to close it?
Yes.
Well, no. I did the dressing change myself.
I told Jeremy the RN that I've done the dressing change over 830 times before I helped him find the various supplies (except for the antibacterial powder Dr. Holland wanted us to use) in two wound carts. There were only small Mediplex bandages, so I took a large one from the bag of them I left in the closet.
Jeremy cleaned the wound with saline solution, which is what we usually do. Then I applied the Santyl (which was leaking from the bottom of the tube) while a small Kerlix (the only one we could find) was soaking up the Vashe I put on it. Then I packed the Kerlix in the wound and we covered the Kerlix with the large Mepilex before wrapping everything in an eight-inch-wide Ace bandage so the Mepilex wouldn't peel off.
It took a while to find the supplies but the change itself was quick and Jeremy appreciated the help.
There would, I knew, be another change by the night shift. And I knew they'd find less supplies than we had. So I drove home, packed a suitcase with supplies and went back to Golden Heights in the late afternoon rain.
I was a little relieved to see Peter the RN was on duty for the night shift. But he had never done the dressing change, it turns out. So we agreed to do it together at 7 p.m.
I thought it would be worth coaching him through it because he's on the staff and may have to do it again. Almost certainly.
I had to make Joyce's bed because the CNA (whoever it was) never did. I put a sheet over the rubber mattress for comfort, a thicker chuck over that where she sits, a blanket and a bedspread over everything.
I got her on the bed and helped her out of the skirt and slip and onto the bed by 7 p.m. Peter drove both wound care carts to the doorway and we assembled the supplies on Joyce's table in the order we had to use them. He was able to find the powder, too.
I supplied the Kerlix and the Mepilex. I did bring Santyl but he had a new tube. He did the work as I guided him through the process, helping spread the powder on the surrounding skin so the Mepilex would adhere.
He felt bad about using my supplies and promised replenish them tomorrow from the facility's locked stock. And he was very appreciative of the help.
It's one thing to know what to do and another to know why you do that instead of this. By explaining why we were doing what we did, I hoped it would be easier to remember what to do.
And what I had to remember to do was drive home under the Wolf Supermoon and make dinner at 8 p.m.
I did feel like howling, I have to confess.