Written by Jennifer Fuentes, PT
As a PT student, I never imagined that wound care would become such a huge part of my future. I had never seen a therapist treat wounds, so it wasn’t something I envisioned in my practice. In my first job, though, it became a necessity. I was working at a skilled nursing facility and over half of the residents had wounds or had experienced some sort of skin breakdown during their stay. I saw the need, had the knowledge through my graduate school training, and figured out the details from there.
I think many therapists think “that’s not my thing,” or “I’m not qualified.” If you have never seen or tried it, you might be surprised at how rewarding wound care can be for both the patient and the therapist. To those who think they aren’t qualified–you don’t have to be certified or specialized to treat wounds (although checking your state practice act for restrictions is always recommended). As therapists, both PT and OT, we receive training in all aspects of anatomy and physiology. We know what unhealthy and healthy tissue looks like, we know where the muscles and bones are, and we should be able to use debridement to help with wound healing. The other variable with wound care is determining what kind of dressing to use on different wounds. There are many different manufacturers that are a great resource for this. Take advantage of the online tools and education they provide, along with appropriate continuing education courses.
In our own hospital, we had a wound nurse who was handling all of the wounds for a time. He was becoming overwhelmed with the caseload, so I started taking his overflow. When he resigned, our department was the natural fit to take over all of the wound care caseload, because we had strategically placed ourselves in that position. When I also got overwhelmed, I was surprised when two of my staff volunteered to help. All I had to do was ask! They were excited to learn a new skill.
If your department is treating lymphedema, you should be treating wounds as well. About one third of my lymphedema patients also have wounds or some sort of skin breakdown problem. Use the whole scope of your skills and treat these wounds yourself rather than letting someone else help your patients or let these wounds go untreated.
The bottom line is if you’re not treating wounds in your community, you need to figure out who is and if it is adequate? I’ve found that oftentimes it can be nursing or even podiatry that are managing wounds. Sometimes patients are traveling out of town to have their wounds treated or trying to handle it at home, which will not usually be as effective. Wound care is also a financially viable program. It reimburses well and is not a financial burden on a facility because the debridement improves and expedites wound healing.
When it comes to treating wounds, therapists can do it and we should.