Nursing as a profession in health care focuses on the care of people and communities. It is the most diverse and has a wide range of settings. Study reveals that the nurses play a dominant role in taking care of the patients. They are present all the time with the compassion and kindness required to help patients overcome the fear and anxiety which occurs majorly due to absence of the family members or closed ones.
The chronic wounds are those which do not respond to medications, can reoccur or fails to cure completely. It can be any sort of infection or amputation that continues to grow.According to the American Diabetes Association (ADA), about 9–12 million Americans suffer from chronic ulcers. The mortality rate for leg ulcers after the first amputation has dramatically doubled from 20% to 50% in the first 3 years to 70% after 5 years. There is an immense psychological impact on the patients suffering from chronic wounds, such as loneliness, isolating themselves from active social life, and depression. These psychosocial stressors further worsen healing outcomes.(Sen K Chandan, 2019,Human wounds and its burden. Indiana)
The physical care of the chronic wounds is of utmost importance. Starting from the tissue damage, maintaining appropriate moisture, removing dead skin and controlling the odor and the pain. The physical traits are to be controlled so that the healing progresses.The wound can become a constant reminder which can lead to self loathing and low self esteem. In recent years, stem cells have been shown to play an important role in wound healing. These cells can be recruited into the circulation in response to injury. Subsequently, they are found to engraft into the remodeling (Frykbergs; Banks, 2015. Challenges in treatment of chronic wounds. Arizona)
The chronic wounds may need quite a few years to heal or may remain the same for decades. Studies have shown that the wounds not only accompany physical trauma to the patient but also to the family. Therefore it becomes important to have cost effective practices. There has to be methodology that must be implemented to lower cost burden.
Wound healing tests the endurance of the patient. Grieving for a lost limb or deformities have to be coped up. During that time,patients can feel emotional distress and social isolation. Emotional responses to the wounds are far ranging. It may include depression, poor sleep, poor nutrition and frustration. Overall the patient can feel in jeopardy. The coping mechanisms include therapeutic techniques such as breathing exercises, relaxation through yoga and reiki therapy. Listening, encouraging to talk,constant communication with the nursing staff acts as a counselling.
To provide cultural needs to the patients, one has to understand the cultural background as well. Customs and values are in relation with the holistic cure of the person. Communication again is the key point here. The family has to be involved in knowing the past history, likes, dislikes, comfort and adjustments. There has to be endeavour to understand peoples' beliefs, religious sensitivities and cultural backgrounds and involve patients in decisions rather than imposing it on them. This may include avoiding appointments during festivals, seeking patients' permission to incorporate certain specific treatments and helping people to overcome the belief that certain treatments are ineffective. It is to be accepted that people have a right to refuse treatments or want to use alternative therapies.
In the end, it can be concluded that nurses, in addition to being educated and trained to provide acute and rehabilitative holistic care, represent an important component of the wound care department.Chronic wounds often present severe physical challenges to wound patients. The issues faced may it be physical , cognitive or other in spheres must be addressed by properly trained allied medical professionals.
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